Department of Pediatric Surgery - Faculty of Medicine, Tishreen University, Latakia, Syria.
Department of Endocrinology and Metabolism, Al-Baath University, Homs, Syria.
BMC Pediatr. 2022 May 14;22(1):282. doi: 10.1186/s12887-022-03331-0.
During the past three decades, growth charts have become one of the principal tools for monitoring anthropometric development in individuals and populations as well. Growth references by the CDC and other countries have been widely used in our hospitals and healthcare units for clinical assessment of children's development. The apparent overestimation and underestimation of many children's anthropometrics indicated the need to construct our own references. The objective of this study is to establish the national growth references for the Syrian population 2-20-year-old.
A multicenter cross-sectional sample of 13,548 subjects, aged 2-20 years, were recruited from various kindergartens, schools, and universities across the Syrian Arab Republic between February and May-2019. Response variables (stature, weight, and BMI) were fitted against age using P-splines and three empirical distributions: Box-Cox T, Box-Cox Power Exponential, and Box-Cox Cole and Green. Residuals diagnostic Q-tests and worm plots were used to check the validity of fitted models.
Box-Cox T provided the best fit for stature-for-age, whereas Box-Cox Power Exponential provided the best fit for weight-for-age and BMI-for-age. Residuals diagnostics revealed adequate models fitting. BMI cutoffs revealed an increased prevalence of obesity (4.5% and 3.66%) and overweight (20.1% and 19.54%), for boys and girls respectively, in our population.
Growth charts are available for use now in our hospitals and healthcare units. For 0-2-year-old children, we recommend using the World Health Organization's standards.
在过去的三十年中，生长图表已成为监测个体和人群人体测量发育的主要工具之一。美国疾病控制与预防中心和其他国家的生长参考标准已在我们的医院和医疗单位广泛用于儿童发育的临床评估。许多儿童人体测量数据的明显高估和低估表明需要构建我们自己的参考标准。本研究的目的是为 2-20 岁的叙利亚人群建立国家生长参考标准。
2019 年 2 月至 5 月期间，从叙利亚阿拉伯共和国各地的幼儿园、学校和大学招募了一个多中心、横断面的 13548 名年龄在 2-20 岁的受试者。使用 P 样条和三种经验分布（Box-Cox T、Box-Cox Power Exponential 和 Box-Cox Cole and Green）拟合反应变量（身高、体重和 BMI）与年龄的关系。残差诊断 Q 检验和蠕虫图用于检查拟合模型的有效性。
Box-Cox T 为身高-年龄提供了最佳拟合，而 Box-Cox Power Exponential 为体重-年龄和 BMI-年龄提供了最佳拟合。残差诊断表明模型拟合良好。BMI 切点显示肥胖（4.5%和 3.66%）和超重（20.1%和 19.54%）在我们的人群中男孩和女孩的患病率增加。
生长图表现在可在我们的医院和医疗单位使用。对于 0-2 岁的儿童，我们建议使用世界卫生组织的标准。
