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南亚和东南亚国家评估营养不良双重负担的局部人体测量参数：综述与回顾性分析

Local anthropometric parameters for assessing double burden of malnutrition in South Asian and Southeast Asian countries: a review and retrospective analysis.

作者信息

Khadilkar Anuradha V, Oza Chirantap, Kajale Neha, Pulungan Aman B, Wacharasindhu Suttipong, Moelyo Annang Giri, Amalia Gassani, Wejaphikul Karn, Julia Madarina, Dejkhamron Prapai, Khadilkar Vaman

机构信息

Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI), Lower Ground Floor, Block V, Jehangir Hospital, 32 Sassoon Road, Pune, 411001, Maharashtra, India.

Department of Health Sciences, Savitribai Phule Pune University, Pune, 411007, Maharashtra, India.

出版信息

Lancet Reg Health Southeast Asia. 2024 Aug 27;28:100473. doi: 10.1016/j.lansea.2024.100473. eCollection 2024 Sep.

DOI:10.1016/j.lansea.2024.100473

PMID:39280018

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11399708/

Abstract

UNLABELLED

The double burden of malnutrition (DBM) is a significant public health issue in South and Southeast Asia (SA and SEA). This study aimed to assess the impact of using local and regional ethnicity-specific anthropometric references versus international references on the prevalence of DBM in these regions.A narrative review of DBM prevalence using local versus international standards was conducted. Additionally, deidentified datasets from India and Indonesia were analyzed to evaluate the effectiveness of different growth standards in identifying DBM. Anthropometric Z-scores were compared, and sensitivity, specificity, and positive predictive value (PPV) were calculated.WHO standards had the lowest specificity for identifying short stature in India and Indonesia. BMI-for-age charts using WHO Growth Reference (2007) had lower sensitivity and higher specificity for metabolic risk. Local references showed lower stunting and higher overweight or obesity prevalence. International standards overestimated stunting and underestimated obesity, leading to misclassification and missed cases of metabolic risk.

FUNDING

None.

摘要

未标注

营养不良双重负担（DBM）是南亚和东南亚（SA和SEA）的一个重大公共卫生问题。本研究旨在评估使用当地和区域特定种族人体测量参考标准与国际参考标准对这些地区DBM患病率的影响。对使用当地与国际标准的DBM患病率进行了叙述性综述。此外，分析了来自印度和印度尼西亚的去识别化数据集，以评估不同生长标准在识别DBM方面的有效性。比较了人体测量Z评分，并计算了敏感性、特异性和阳性预测值（PPV）。世卫组织标准在印度和印度尼西亚识别身材矮小的特异性最低。使用世卫组织生长参考标准（2007年）的年龄别体重指数图表对代谢风险的敏感性较低且特异性较高。当地参考标准显示发育迟缓率较低，超重或肥胖患病率较高。国际标准高估了发育迟缓率，低估了肥胖率，导致分类错误和代谢风险病例的漏诊。