印度尼西亚青少年儿童早期身高对后期认知功能的影响：使用国家生长参考标准与世界卫生组织生长标准的比较
The effect of early childhood stature on later cognitive functions in Indonesian adolescents: comparation using the National growth reference and the WHO growth standard.
作者信息
Moelyo Annang Giri, Pulungan Aman B, Sitaresmi Mei Neni, Julia Madarina
机构信息
Department of Child Health, Faculty of Medicine/Dr. Moewardi Hospital, Universitas Sebelas Maret, Surakarta, Indonesia.
Department of Child Health, Faculty of Medicine/Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
出版信息
BMC Pediatr. 2025 Jun 7;25(1):466. doi: 10.1186/s12887-025-05829-9.
BACKGROUND
The prevalence of short stature in children under 5 using the National Growth Reference vs. the WHO Growth Standard is known to vary in many countries. Previous research has suggested possible associations between short stature early in childhood, frequently regarded as stunting, and later cognitive function.
OBJECTIVE
This study aimed to identify the effect of early childhood stature, using the National Indonesian Growth Chart (NIGC) vs. the WHO Growth Standard (WHO), on cognitive function in adolescence.
METHODS
The study used two cohort data from the Indonesia Family Life Surveys (IFLS) that had both anthropometric data at the age of 2-5 years and at adolescence, as well as information on cognitive function at adolescence. At the age of 2-5 years, the height-for-age Z-score (HAZ) of the subjects were classified using both NIGC and WHO as follows: Normal NIGC & Normal WHO; Normal NIGC & Short WHO; and Short NIGC & Short WHO. In adolescence, cognitive function were assessed. An analysis was performed to assess the associations between variables.
RESULTS
Cohort-1 included 866 subjects with complete information, while Cohort-2 included 1,436 subjects. After adjustment, subjects aged 2 to 5 years classified as Short NIGC & Short WHO had a consistent significantly negative effect on their later adolescent cognitive function: coefficient regression (95%CI): -2.82 {(-5.58)-(-0.06), p = 0.046}for Cohort-1 and - 4.13 {(-7.22)-(-1.04), p = 0.009} for Cohort-2. On the other hand, those classified as Short for WHO but Normal for NIGC were not associated with later negative cognitive function: coefficient regression (95%CI): -1.88 {(-4.00)- 0.24, p = 0.082} for Cohort-1 and - 1.32 {(-3.50)-0.87, p = 0.237} for Cohort-2. Cognitive function of both cohorts was also significantly influenced by the subjects' education, parental education and resicence in urban and Java-Bali (p < 0.05).
CONCLUSIONS
Childhood stature was associated with later negative cognitive function only when the children were classified as short using NIGC. Classified as short stature using WHO, but not short using NIGC, was not associated with later negative cognitive function.
CLINICAL TRIAL NUMBER
Not applicable.
背景
在许多国家，5岁以下儿童使用国家生长参考标准与世界卫生组织生长标准时，身材矮小的患病率有所不同。先前的研究表明，儿童早期的身材矮小（常被视为发育迟缓）与后期的认知功能之间可能存在关联。
目的
本研究旨在确定使用印度尼西亚国家生长图表（NIGC）与世界卫生组织生长标准（WHO）评估的儿童早期身材对青少年认知功能的影响。
方法
该研究使用了印度尼西亚家庭生活调查（IFLS）的两个队列数据，这些数据包含2至5岁以及青少年时期的人体测量数据，还有青少年时期的认知功能信息。在2至5岁时，使用NIGC和WHO对受试者的年龄别身高Z评分（HAZ）进行如下分类：NIGC正常且WHO正常；NIGC正常且WHO矮小；NIGC矮小且WHO矮小。在青少年时期，对认知功能进行评估。进行分析以评估变量之间的关联。
结果
队列1包括866名信息完整的受试者，队列2包括1436名受试者。调整后，2至5岁时被分类为NIGC矮小且WHO矮小的受试者对其后期青少年认知功能有持续显著的负面影响：队列1的系数回归（95%CI）：-2.82{（-5.58）-（-0.06），p = 0.046}，队列2的系数回归：-4.13{（-7.22）-（-1.04），p = 0.009}。另一方面，那些被分类为WHO矮小但NIGC正常的受试者与后期负面认知功能无关：队列1的系数回归（95%CI）：-1.88{（-4.00）-0.24，p = 0.082}，队列2的系数回归：-1.32{（-3.50）-0.87，p = 0.237}。两个队列的认知功能还受到受试者的教育程度、父母教育程度以及是否居住在城市和爪哇-巴厘岛的显著影响（p < 0.05）。
结论
仅当儿童使用NIGC被分类为矮小时，儿童期身材才与后期负面认知功能相关。使用WHO被分类为身材矮小，但使用NIGC不矮小，与后期负面认知功能无关。
临床试验编号
不适用。
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