Spencer Phoebe R, Sanders Katherine A, Judge Debra S
School of Human Sciences, The University of Western Australia, Crawley 6009, Western Australia.
Am J Phys Anthropol. 2018 Feb;165(2):286-298. doi: 10.1002/ajpa.23350. Epub 2017 Oct 27.
Population-specific growth references are important in understanding local growth variation, especially in developing countries where child growth is poor and the need for effective health interventions is high. In this article, we use mixed longitudinal data to calculate the first growth curves for rural East Timorese children to identify where, during development, deviation from the international standards occurs.
Over an eight-year period, 1,245 children from two ecologically distinct rural areas of Timor-Leste were measured a total of 4,904 times. We compared growth to the World Health Organization (WHO) standards using z-scores, and modeled height and weight velocity using the SuperImposition by Translation And Rotation (SITAR) method. Using the Generalized Additive Model for Location, Scale and Shape (GAMLSS) method, we created the first growth curves for rural Timorese children for height, weight and body mass index (BMI).
Relative to the WHO standards, children show early-life growth faltering, and stunting throughout childhood and adolescence. The median height and weight for this population tracks below the WHO fifth centile. Males have poorer growth than females in both z-BMI (p = .001) and z-height-for-age (p = .018) and, unlike females, continue to grow into adulthood.
This is the most comprehensive investigation to date of rural Timorese children's growth, and the growth curves created may potentially be used to identify future secular trends in growth as the country develops. We show significant deviation from the international standard that becomes most pronounced at adolescence, similar to the growth of other Asian populations. Males and females show different growth responses to challenging conditions in this population.
特定人群的生长参考标准对于理解当地生长差异至关重要，尤其是在儿童生长状况较差且对有效健康干预需求较高的发展中国家。在本文中，我们使用混合纵向数据来计算东帝汶农村儿童的首条生长曲线，以确定在发育过程中偏离国际标准的情况发生在何处。
在八年时间里，对来自东帝汶两个生态环境不同的农村地区的1245名儿童进行了总共4904次测量。我们使用z分数将生长情况与世界卫生组织（WHO）标准进行比较，并使用平移和旋转叠加法（SITAR）对身高和体重增长速度进行建模。使用位置、尺度和形状的广义相加模型（GAMLSS）方法，我们创建了东帝汶农村儿童身高、体重和体重指数（BMI）的首条生长曲线。
相对于WHO标准，儿童在生命早期生长迟缓，在整个童年和青少年时期都存在发育迟缓。该人群的身高和体重中位数低于WHO第五百分位数。在z-BMI（p = 0.001）和年龄别身高z分数（p = 0.018）方面，男性的生长情况比女性差，并且与女性不同的是，男性持续生长至成年期。
这是迄今为止对东帝汶农村儿童生长情况最全面的调查，所创建的生长曲线可能会用于识别该国发展过程中未来生长的长期趋势。我们发现与国际标准存在显著偏差，这种偏差在青春期最为明显，这与其他亚洲人群的生长情况类似。在该人群中，男性和女性对挑战性条件表现出不同的生长反应。
