Ma Xiaowei, Mao Yong, Wang Jian, Wang Xiaomei
College of Health and Exercise Science, Tianjin University of Sport, Tianjin, China.
Education (Sports) Bureau of Jomda County, Chamdo, China.
Front Nutr. 2022 Oct 14;9:1036470. doi: 10.3389/fnut.2022.1036470. eCollection 2022.
It is known that high altitude influences the growth metrics of high-altitude residents. Using a WHO-recommended standard, the research aimed to establish growth and development reference values for children of Tibetan ethnicity between the ages of 6 and 17 years old.
The measurements took place in Jomda County, Tibet with an average altitude of 3,650 m above sea level. A total of 3,955 observations (1,932 boys and 2,023 girls) were utilized to model the centile estimations. Included in the measurements are height, weight, body mass index, heart rate, blood pressure, forced lung capacity, sit and reach, and standing long jump. The measurements were modeled using the generalized additive models for location, scale, and shape (GAMLSS). Models were fitted with suitable distributions and locally smoothed using the P-spline for each GAMLSS hyper-parameter. Using the smallest Schwarz Bayesian criterion, the optimal model for each measurement was selected. After model adjustment, centile estimations were calculated for each model.
Compared to the height reference values at the 50th percentile for multi-ethnic Chinese children residing at low altitudes, Tibetan ethnic children exhibit apparent stunted growth. In terms of forced vital capacity, it is remarkable that Tibetan ethnic children lag behind multi-ethnic Chinese children residing at low altitudes. Heart rate and blood pressure regulation are generally normal. Centile estimations are provided in this article and tabulated centiles (1p, 3p, 5p, 15p, 25p, 50p, 75p, 85p, 95p, 97p, 99p) in Chinese, Tibetic, and English are openly available in FigShare (doi: 10.6084/m9.figshare.20898196.v1).
This study established the first GAMLSS based growth and development reference values for Tibetan ethnic children aged 6-17. These reference values have numerous clinical and scientific applications. We offer Chinese policymakers with practical initiatives to further enhance the health of Tibetan ethnic children.
众所周知，高海拔会影响高海拔地区居民的生长指标。本研究采用世界卫生组织推荐的标准，旨在建立6至17岁藏族儿童的生长发育参考值。
测量在西藏类乌齐县进行，平均海拔3650米。共3955例观察对象（1932名男孩和2023名女孩）用于百分位数估计建模。测量项目包括身高、体重、体重指数、心率、血压、用力肺活量、坐位体前屈和立定跳远。测量数据采用位置、尺度和形状的广义相加模型（GAMLSS）进行建模。模型采用合适的分布进行拟合，并使用P样条对每个GAMLSS超参数进行局部平滑。根据最小施瓦茨贝叶斯准则，为每个测量项目选择最优模型。模型调整后，计算每个模型的百分位数估计值。
与居住在低海拔地区的多民族中国儿童第50百分位数的身高参考值相比，藏族儿童明显生长迟缓。在用力肺活量方面，值得注意的是，藏族儿童落后于居住在低海拔地区的多民族中国儿童。心率和血压调节总体正常。本文提供了百分位数估计值，图共享平台（doi:10.6084/m9.figshare.20898196.v1）公开提供了中文、藏文和英文的百分位数表格（第1百分位数、第3百分位数、第5百分位数、第15百分位数、第25百分位数、第50百分位数、第75百分位数、第85百分位数、第95百分位数、第97百分位数、第99百分位数）。
本研究首次建立了基于GAMLSS的6至17岁藏族儿童生长发育参考值。这些参考值有许多临床和科学应用。我们为中国政策制定者提供了进一步促进藏族儿童健康的实际举措。
