Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 30059, Taiwan.
Department of Family Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan.
Int J Environ Res Public Health. 2020 May 22;17(10):3652. doi: 10.3390/ijerph17103652.
High prevalence of child underweight and stunting in high-altitude areas has often been reported. However, most previous studies on this topic were cross-sectional. Another critical concern is that using the World Health Organization (WHO) Child Growth Standards to evaluate child growth in high-altitude areas may lead to overestimations of underweight and stunting. Our study aimed to evaluate the long-term growth pattern of children (3 to 18 years) above the altitude of 3500 m in Ladakh, India. The participants' body weight (BW), body height (BH), and body mass index (BMI) were measured annually according to the WHO Child Growth Standards for children under 5 years old and the WHO reference data for children aged 5 to 19 years. The generalized estimating equation (GEE) was used to estimate the means and z-scores of BW, BH, and BMI at different ages. A total of 401 children were enrolled from 2012 to 2018. Their mean z-scores of BW, BH, and BMI were -1.47, -1.44, and -0.85 in 2012 and increased to -0.74, -0.92, and -0.63 in 2018. This population's specific growth curve was also depicted, which generally fell below the 85th percentile of the WHO standards. This is the first cohort study about long-term child growth patterns in a high-altitude area. The detailed underlying mechanisms of our findings need future research on more representative data of high-altitude populations.
高海拔地区儿童消瘦和发育迟缓的患病率较高，这一现象经常被报道。然而，大多数关于这一主题的先前研究都是横断面研究。另一个关键问题是，使用世界卫生组织（WHO）儿童生长标准来评估高海拔地区儿童的生长情况可能会导致消瘦和发育迟缓的高估。我们的研究旨在评估印度拉达克海拔 3500 米以上地区儿童（3 至 18 岁）的长期生长模式。根据 WHO 5 岁以下儿童生长标准和 WHO 5 至 19 岁儿童参考数据，每年测量参与者的体重（BW）、身高（BH）和体重指数（BMI）。使用广义估计方程（GEE）估计不同年龄时 BW、BH 和 BMI 的均值和 z 分数。2012 年至 2018 年期间共纳入 401 名儿童。他们在 2012 年的 BW、BH 和 BMI 的平均 z 分数分别为-1.47、-1.44 和-0.85，并在 2018 年增加到-0.74、-0.92 和-0.63。还描绘了该人群的特定生长曲线，该曲线通常低于 WHO 标准的第 85 百分位数。这是第一项关于高海拔地区儿童长期生长模式的队列研究。我们研究结果的详细潜在机制需要对更多高海拔人群的代表性数据进行未来研究。
