Khadilkar Vaman V, Khadilkar Anuradha V
Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India.
Indian J Endocrinol Metab. 2015 Jul-Aug;19(4):470-6. doi: 10.4103/2230-8210.159028.
Growth chart committee of Indian Academy of Pediatrics (IAP) has revised growth charts for 5-18-year-old Indian children in Jan 2015. The last IAP growth charts (2007) were based on data collected in 1989-92 which is now >2 decades old. India is in an economic and nutrition transition and hence growth pattern of Indian children has changed over last few years. Thus, it was necessary to produce contemporary, updated growth references for Indian children. The new IAP charts were prepared by collating data from nine groups who had published studies in indexed journals on growth from India in the last decade. Growth charts were constructed from a total of 87022 middle and upper socioeconomic class children (m 54086, f 32936) from all five zones of India. Data from middle and upper socioeconomic class children are likely to have higher prevalence of overweight and obesity and hence growth charts produced on such populations are likely to "normalize" obesity. To remove such unhealthy weights form the data, method suggested by World Health Organization was used to produce weight charts. Thus, the new IAP weight charts are much lower than the recently published studies on affluent Indian children. Since Indian's are at a higher risk of obesity-related cardiometabolic complications at lower body mass index (BMI), BMI charts adjusted for 23, and 27 adult equivalent cut-offs as per International obesity task force guidelines were constructed. IAP now recommends use of these new charts to replace the 2007 IAP charts.
印度儿科学会(IAP)生长图表委员会于2015年1月修订了5至18岁印度儿童的生长图表。IAP上一版生长图表(2007年)是基于1989年至1992年收集的数据,而这些数据现在已经有二十多年的历史了。印度正处于经济和营养转型期,因此印度儿童的生长模式在过去几年中发生了变化。因此,有必要为印度儿童制定当代的、更新的生长参考标准。新的IAP图表是通过整理来自九个研究小组的数据编制而成的,这些小组在过去十年中在索引期刊上发表了关于印度儿童生长的研究。生长图表是根据来自印度所有五个地区的总共87022名中高社会经济阶层儿童(男性54086名,女性32936名)的数据构建的。中高社会经济阶层儿童的数据中超重和肥胖的患病率可能更高,因此基于这类人群编制的生长图表可能会使肥胖“正常化”。为了从数据中去除这些不健康的体重,采用了世界卫生组织建议的方法来编制体重图表。因此,新的IAP体重图表比最近发表的关于富裕印度儿童的研究结果要低得多。由于印度人在较低的体重指数(BMI)下患肥胖相关心脏代谢并发症的风险更高,因此根据国际肥胖特别工作组的指南,构建了针对23和27的成人等效临界值进行调整的BMI图表。IAP现在建议使用这些新图表来取代2007年的IAP图表。