Johnston Francis E, Macvean Robert B
University of Pennsylvania, Philadelphia, Pennsylvania 19104-6398.
Universidad del Valle de Guatemala City, Guatemala City, Guatemela.
Am J Hum Biol. 1995;7(6):731-740. doi: 10.1002/ajhb.1310070608.
The extent and persistence of stunting and growth status across a 10-year period, and their relationship to changes in the home environment, have been analyzed using data from a 10-year longitudinal study of three birth cohorts, seen initially at 3, 5, and 7 years and examined annually thereafter. The children came from an economically disadvantaged community located on the periphery of Guatemala City. The sample used in the analysis consisted of 271 subjects with complete growth and SES data over a 10-year period. Stunting was high initially, with 43.5% of the sample displaying USNCHS height z-scores < -2.0 at the first examination. Growth status at the first visit was a significant predictor of status after 10 years. The odds ratio for stunting in adolescence if stunted in early childhood was 18.39. Characteristics of the household at the first visit were a significant determinant of height, weight, estimated arm muscle, the triceps skinfold, and the BMI at the last visit, after adjusting for confounding variables. Changes in household status between the first and last visits were associated with greater growth increments in height and weight but not in the BMI, triceps skinfold, or estimated arm muscle circumference. These analyses have demonstrated that improved growth status during adolescence relative to status 10 years earlier (a form of catch-up growth) was attributable to two factors: first, for the sample as a whole there was a general improvement in growth status with a mean change in height-and weight-for-age z-scores of 0.218 and 0.420, respectively; second, the change in household score from first to last visit was a significant determinant of growth increment over that period, but only in the case of height and weight. Thus, while the early environment is a powerful determinant of later growth status, some catch-up growth can be identified both as a general systemic response as well as a response to changing environmental conditions. © 1995 Wiley-Liss, Inc.
利用对三个出生队列进行的为期10年的纵向研究数据，分析了10年间发育迟缓的程度和持续性、生长状况，以及它们与家庭环境变化的关系。这些队列最初在3岁、5岁和7岁时接受观察，此后每年进行检查。这些儿童来自危地马拉城周边一个经济条件不利的社区。分析中使用的样本包括271名在10年期间拥有完整生长和社会经济地位（SES）数据的受试者。最初发育迟缓情况严重，在首次检查时，43.5%的样本的美国国家卫生统计中心（USNCHS）身高z评分＜-2.0。首次就诊时的生长状况是10年后状况的一个重要预测指标。幼儿期发育迟缓的儿童在青春期发育迟缓的比值比为18.39。在调整混杂变量后，首次就诊时家庭的特征是末次就诊时身高、体重、估计的手臂肌肉、三头肌皮褶厚度和体重指数（BMI）的一个重要决定因素。首次和末次就诊之间家庭状况的变化与身高和体重的更大增长相关，但与BMI、三头肌皮褶厚度或估计的手臂肌肉周长无关。这些分析表明，相对于10年前的状况，青春期生长状况的改善（一种追赶生长形式）可归因于两个因素：第一，对于整个样本而言，生长状况普遍有所改善，年龄别身高和体重z评分的平均变化分别为0.218和0.420；第二，从首次就诊到末次就诊家庭评分的变化是该时期生长增量的一个重要决定因素，但仅在身高和体重方面如此。因此，虽然早期环境是后期生长状况的一个有力决定因素，但一些追赶生长既可以被视为一种一般的系统性反应，也可以被视为对不断变化的环境条件的反应。© 1995威利 - 利斯公司。
