Division of Endocrinology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States.
Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States.
Front Endocrinol (Lausanne). 2023 Aug 11;14:1227886. doi: 10.3389/fendo.2023.1227886. eCollection 2023.
The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) created separate growth charts for girls and boys because growth patterns and rates differ between sexes. However, scenarios exist in which this dichotomizing "girls versus boys" approach may not be ideal, including the care of non-binary youth or transgender youth undergoing transitions consistent with their gender identity. There is therefore a need for growth charts that age smooth differences in pubertal timing between sexes to determine how youth are growing as "children" versus "girls or boys" (e.g., age- and sex-neutral, compared to age- and sex-specific, growth charts).
Employing similar statistical techniques and datasets used to create the CDC 2000 growth charts, we developed age-adjusted, sex non-specific growth charts for height, weight, and body mass index (BMI), and z-score calculators for these parameters. Specifically, these were created using anthropometric data from five US cross-sectional studies including National Health Examination Surveys II-III and National Health and Nutrition Examination Surveys I-III. To illustrate contemporary clinical practice, we overlaid our charts on CDC 2000 girls and boys growth charts.
39,119 youth 2-20 years old (49.5% female; 66.7% non-Hispanic White; 21.7% non-Hispanic Black) were included in the development of our growth charts, reference ranges, and z-score calculators. Respective curves were largely superimposable through around 10 years of age after which, coinciding with pubertal onset timing, differences became more apparent.
We conclude that age-adjusted, sex non-specific growth charts may be used in clinical situations such as transgender youth in which standard "girls versus boys" growth charts are not ideal. Until longitudinal auxological data are available in these populations, our growth charts may help to assess a transgender youth's growth trajectory and weight classification, and expectations surrounding these.
疾病控制与预防中心（CDC）和世界卫生组织（WHO）为女孩和男孩分别创建了生长图表，因为性别之间的生长模式和速度不同。然而，在某些情况下，这种将“女孩与男孩”二分的方法可能并不理想，包括对非二元性别青年或跨性别青年的护理，他们正在经历与其性别认同一致的过渡。因此，需要有生长图表来平滑性别之间青春期时间的差异，以确定年轻人作为“儿童”与“女孩或男孩”（例如，年龄和性别中性，与年龄和性别特定的生长图表相比）的生长情况。
我们采用与创建 CDC 2000 生长图表相同的统计技术和数据集，为身高、体重和体重指数（BMI）开发了年龄调整、性别非特定的生长图表，以及这些参数的 z 分数计算器。具体来说，这些图表是使用来自五项美国横断面研究的数据创建的，包括国家健康检查调查 II-III 和国家健康与营养检查调查 I-III。为了说明当代临床实践，我们将我们的图表叠加在 CDC 2000 女孩和男孩的生长图表上。
我们的生长图表、参考范围和 z 分数计算器的开发中纳入了 39119 名 2-20 岁的年轻人（49.5%为女性；66.7%为非西班牙裔白人；21.7%为非西班牙裔黑人）。在大约 10 岁之前，各自的曲线基本可以重叠，之后，随着青春期开始时间的临近，差异变得更加明显。
我们的结论是，在某些情况下，如跨性别青年，使用年龄调整、性别非特定的生长图表可能更为理想，而不是标准的“女孩与男孩”生长图表。在这些人群中获得纵向生长数据之前，我们的生长图表可能有助于评估跨性别青年的生长轨迹和体重分类，以及围绕这些的预期。
