Department of Statistics, Govt. Degree College, Qadir Pur Raan Multan, Pakistan -
Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan.
Minerva Pediatr (Torino). 2023 Dec;75(6):866-875. doi: 10.23736/S2724-5276.20.05745-X. Epub 2020 Jun 5.
Assessment of growth and nutritional status is an essential part of clinical evaluation and care in pediatrics. Therefore, we aimed to establish age and gender specific smoothed BMI growth reference charts of Pakistani children and adolescents aged 2-18 years and to compare our LMS median percentile values with WHO 2007 international references and with references from other foreign studies.
A representative cross-sectional sample of 10,668 healthy Pakistani subjects aged 2 to 18 years was studied. For calculation of BMI (kg/m), height (cm) and weight (kg) were measured using standard procedures. Age and gender specific smoothed BMI growth reference values and associated charts were obtained using lambda-mu-sigma (LMS) as well as quantile regression (QR) statistical methods.
In the sample studied, the mean (±SD) BMI of all subjects was 16.50 (±2.83 kg/m). Smoothed BMI percentile curves (5, 10, 25, 50, 75, 90 and 95) obtained by using LMS and QR methods, showed that BMI increased with age in both sexes. During pubertal age, girls had larger percentiles than boys. Centile values estimated by the LMS and QR procedure had small variability from the empirical centiles. Comparison of LMS BMI 50 percentile with references from WHO 2007 and data from other countries demonstrated that Pakistani children had substantially lower BMI percentiles than their counterparts in the reference population.
This comprehensive study suggests that WHO 2007 references are not suitable for Pakistani children. The QR method should be considered as an alternative method to develop growth charts.
评估生长和营养状况是儿科临床评估和护理的重要组成部分。因此，我们旨在为 2-18 岁的巴基斯坦儿童和青少年建立年龄和性别特异性平滑 BMI 生长参考图表，并将我们的 LMS 中位数百分位值与 WHO 2007 年国际参考值和其他国外研究的参考值进行比较。
对 10668 名年龄在 2 至 18 岁的健康巴基斯坦受试者进行了代表性的横断面研究。使用标准程序测量 BMI（kg/m）、身高（cm）和体重（kg）。使用 lambda-mu-sigma（LMS）和分位数回归（QR）统计方法获得年龄和性别特异性平滑 BMI 生长参考值和相关图表。
在所研究的样本中，所有受试者的平均（±SD）BMI 为 16.50（±2.83 kg/m）。使用 LMS 和 QR 方法获得的平滑 BMI 百分位曲线（5、10、25、50、75、90 和 95）显示，BMI 在两性中均随年龄增长而增加。在青春期，女孩的百分位值大于男孩。LMS 和 QR 程序估计的百分位值与经验百分位值的变异性较小。LMS BMI 50 百分位值与 WHO 2007 年参考值和其他国家的数据比较表明，巴基斯坦儿童的 BMI 百分位值明显低于参考人群中的对应值。
这项全面的研究表明，WHO 2007 年的参考值不适合巴基斯坦儿童。QR 方法应被视为制定生长图表的替代方法。
