Costello A M
Department of Paediatrics, University College and Middlesex School of Medicine, London.
Arch Dis Child. 1989 Oct;64(10):1478-82. doi: 10.1136/adc.64.10.1478.
In a community based study, height and weight increments of 441 Nepali children aged 0-6 years were measured before harvest and six months later and compared with centile standards derived from American children. Low mean growth velocities for height were found only in children under 2 years of age, and for weight during the first 18 months. The mean height for age standard deviation score for the 12-23 months age group was already -2.8 at first measurement. The effect of the initial thinness of the child on subsequent height and weight velocity was reciprocal: thin children seemed to catch up weight at the expense of height. These results suggest that stunting is caused largely by a reduced growth velocity during the nutrition dependent infantile phase of growth, with some additional impairment and delay in onset of the early childhood phase of growth hormone dependent growth, especially in thin children. Nutritional interventions after the second year of life are unlikely to alter the prevalence of linear growth retardation in poor communities. Growth velocity may be more useful than static anthropometry to assess the impact of such interventions.
在一项基于社区的研究中，对441名0至6岁尼泊尔儿童在收获前及六个月后测量了身高和体重增长情况，并与源自美国儿童的百分位标准进行了比较。仅在2岁以下儿童中发现身高平均生长速度较低，在最初18个月中体重平均生长速度较低。在首次测量时，12至23个月年龄组的年龄别身高标准差得分均值已为-2.8。儿童最初消瘦对随后身高和体重增长速度的影响是相互的：消瘦儿童似乎以牺牲身高为代价追赶体重。这些结果表明，发育迟缓主要是由营养依赖的婴儿期生长阶段生长速度降低所致，在生长激素依赖的幼儿期生长阶段还存在一些额外的损害及起始延迟，尤其是在消瘦儿童中。生命第二年之后的营养干预不太可能改变贫困社区线性生长迟缓的患病率。生长速度可能比静态人体测量学更有助于评估此类干预措施的影响。
