PEACH Unit, University of Glasgow, Glasgow G3 8SJ, UK.
Proc Nutr Soc. 2012 Nov;71(4):545-55. doi: 10.1017/S0029665112000687. Epub 2012 Sep 7.
In this paper we set out to explore the prevalence of child undernutrition found in community studies in affluent societies, but a preliminary literature review revealed that, in the absence of a gold standard method of diagnosis, the prevalence largely depends on the measure, threshold and the growth reference used, as well as age. We thus go on to explore describe the common clinical 'syndromes' of child undernutrition: wasting, stunting and failure to thrive (weight faltering) and how we have used data from two population-based cohort studies, this paper to explore how much these different 'syndromes' overlap and the extent to which they reflect true undernutrition. This analysis revealed that when more than one definition is applied to the same children, a majority are below the lower threshold for only one measure. However, those with both weight faltering and low BMI in infancy, go on in later childhood to show growth and body composition patterns suggestive of previous undernutrition. In older children there is even less overlap and most children with either wasting or low fat seem to be simply growing at one extreme of the normal range. We conclude that in affluent societies the diagnosis of undernutrition is only robust when it relies on a combination of both, that is decline in weight or BMI centile and wasting.
在本文中，我们着手探讨在富裕社会的社区研究中发现的儿童营养不足的流行情况，但初步文献回顾表明，由于缺乏金标准诊断方法，流行情况在很大程度上取决于所使用的测量、阈值和生长参考标准，以及年龄。因此，我们继续探讨描述儿童营养不足的常见临床“综合征”：消瘦、发育迟缓、生长不良（体重缓慢），以及我们如何利用两项基于人群的队列研究的数据，来探讨这些不同的“综合征”有多大程度的重叠，以及它们在多大程度上反映了真正的营养不足。这项分析表明，当对同一儿童应用多个定义时，大多数儿童的多项指标都低于一个阈值。然而，那些在婴儿期同时出现体重缓慢和低 BMI 的儿童，在以后的童年时期会表现出与之前营养不足相关的生长和身体成分模式。在年龄较大的儿童中，重叠的情况更少，大多数患有消瘦或低脂肪的儿童似乎只是在正常范围的一个极端生长。我们的结论是，在富裕社会中，营养不足的诊断只有在依赖体重或 BMI 百分位数下降和消瘦的组合时才可靠。
