Mei Z, Yip R, Grummer-Strawn L M, Trowbridge F L
Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
Arch Pediatr Adolesc Med. 1998 May;152(5):471-9. doi: 10.1001/archpedi.152.5.471.
To better characterize childhood growth and further assess potential limitations of the current National Center for Health Statistics and World Health Organization international growth reference.
The LMS method was used for curve fitting to summarize the changes in height and weight distributions by 3 curves representing the skewness (L), median (M), and coefficient of variation (S). A series of polynomial regression procedures was applied to smooth the L, M, and S curves.
Subset data from 18 states contributing clinic data to the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System were used for this research reference.
We chose only those clinics in which the height and weight distributions of children closely matched with those of the first and second National Health and Nutrition Examination Surveys.
Unlike the current international growth reference, the new reference has no disjunction at 24 months of age because it is based on a single data source for children aged 0 to 59 months. The reference also better characterizes the growth for infants than the current international reference, a fact we demonstrated with data from the National Health and Nutrition Examination Surveys, Pediatric Nutrition Surveillance System 1995, and the Davis Area Research on Lactation, Infant Nutrition, and Growth studies.
The current National Center for Health Statistics and World Health Organization international growth reference needs to be updated. The methods used in this study will be useful to evaluate other data sets and to evaluate future modifications of growth references.
更好地描述儿童生长情况，并进一步评估美国国家卫生统计中心和世界卫生组织当前国际生长参考标准的潜在局限性。
采用LMS方法进行曲线拟合，通过代表偏度（L）、中位数（M）和变异系数（S）的3条曲线总结身高和体重分布的变化。应用一系列多项式回归程序对L、M和S曲线进行平滑处理。
本研究参考采用了向疾病控制与预防中心儿科营养监测系统提供临床数据的18个州的子集数据。
我们仅选择那些儿童身高和体重分布与第一次和第二次国家健康与营养检查调查密切匹配的诊所。
与当前国际生长参考标准不同，新的参考标准在24月龄时没有间断，因为它基于0至59月龄儿童的单一数据源。该参考标准也比当前国际参考标准能更好地描述婴儿的生长情况，我们通过国家健康与营养检查调查、1995年儿科营养监测系统以及戴维斯地区泌乳、婴儿营养和生长研究的数据证明了这一事实。
美国国家卫生统计中心和世界卫生组织当前的国际生长参考标准需要更新。本研究中使用的方法将有助于评估其他数据集以及评估生长参考标准未来的修订情况。
