上海市城郊两区整群抽样6～18岁儿童青少年身高分布特点及矮小症患病率调查

A cluster systematic sampling survey of the body height distribution profile and the prevalence of short stature of urban and surburban children aged from 6 to 18 years in Shanghai

目的研究上海市6～18岁儿童青少年身高及矮小症患病率分布特点。方法采用整群抽样抽取上海市1个城区和1个郊区,普查2个区内所有6～18岁共70431名中小学生的身高。分析身高的年龄别分布特点,并与1975、1995年全国和上海市学生体质测试标准进行比较;并以1995年上海市身高评价标准进行评价,分析矮小症患病率分布特点。结果①研究人群中身高特点为男性显著高于女性(P<0.0001)。②男性身高增长以6～15岁较为明显,11岁后身高增长加快,15岁后增幅减小;女性身高增长在6～14岁较为明显,10岁以后增长加快,14岁后增幅减小。③与全国身高标准相比,上海城区和郊区儿童青少年的各年龄组身高均高于全国标准。与1975年上海儿童青少年身高参考标准相比,身高增长分别为城区男性(6.4±2.1)cm,郊区男性(10.5±2.5)cm,城区女性(4.8±0.9)cm,郊区女性(8.6±1.9)cm,其中以郊区儿童青少年特别是11岁以上儿童青少年身高增长更为显著;而城区儿童青少年身高在1995至2003年的增幅较小,在1975至1995年增幅较大。④上海市儿童青少年各年龄组总体矮小症的患病率为0.5%～6.03%,平均患病率为3.77%;城区矮小症的粗患病率为2.78%,标准化患病率为2.57%;郊区矮小症的粗患病率为4.52%,标准化患病率为3.75%。矮小症患病率在13岁以前较高;城区矮小症患病率低于郊区,男、女矮小症患病率在城区相近,在郊区则男性高于女性。结论上海市儿童青少年身高生长曲线存在性别的三相性差异,6～9岁和12～18岁均呈现男高女低,10～11岁呈现女高男低的特点。1975至2003年上海儿童青少年身高均呈现显著增长现象,但城区儿童身高在1995年后增幅明显减小。上海儿童青少年平均矮小症患病率为3.77%,患病率在13岁以前较高;郊区儿童青少年矮小症患病率高于城区。

Objective The aim of the current study was to investigate the body height distribution profile and prevalence of short stature of children and adolescents aged from 6 to 18 years in Shanghai. Methods One urban district and one suburban district in Shanghai were selected. 70 431 children and adolescents aged from 6 to 18 years were recruited. Body heights were measured and were evaluated using a local growth standard. Short stature was defined as the body height was two standard deviation below the mean body height in each sex matched age group. The prevalence of short stature was calculated and standarized using the local population data. Results （1）The mean body heights in boys were （ 153.33 ± 17.93） cm and those in girls were （ 149.75 ± 14.50） cm. Body heights were significantly higher in boys than that in girls （P 〈0. 000 1 ）. （2）There existed triple phases character about the growth profile in Shanghai children and adolescents. The boy＇s heights were higher than those of girls between age 6 to 9 years, girl＇s growth spurt appeared after 10 years old and the body heights were higher than those of boys between age 10 to 11 years, and finally boy＇s heights were higher than those of girl＇s between age 12 and 18 ）,ears. The body heights of boys nearly stoped increasing after 16 years old while the heights in girls stoped increasing after 15 years old. （3）The body heights of children in Shanghai were higher than the average values of the national growth charts. The heights in each group of urban boys increased by （6.4 ± 2.1 ） cm and suburban boy＇s heights increased by （ 10.5 ± 2.5 ） cm between 2003 and 1975, while the heights in each group of urban girls increased by （4.8 ±0.9 ） cm and suburban girl＇ s heights increased by （ 8.6±1.9 ） cm in the same time. However, the heights in each group of urban boys only increased by （0.8 ±1.2） cm（ -0.1±3.1 cm） and suburban boy＇s heights increased （3.5 -± 0.9） cm （2.2 -5.6 cm） between 2003 and 1995, the heights in each group of urban girls increased by （0.7 ± 1.0） cm（ -0.3 -2.8 cm） and suburban girl＇s heights increased （3.3 ± 0.9） cm（2.1 -5.4 cm） in the same period. （4）The overall short stature crude morbidity rate （CMR） was 3.77%, and the standardized morbidity rate （SMR） was 3.26% ,the rate was significantly higher in boys than that in girls. The short stature CMR in urban area was 2.78% , and the SMR was 2.57% ,the rate was significantly lower in urban area than that in suburban area （CMR 4.51% , SMR 3.75% ）. The short stature prevalence was higher before 14 years old. Conclusions The growth profile in Shanghai children and adolescents showed triple phases character. Boys＇heigbts were higher than those of girls＇ among age from 6 to 9 years and from 12 to 18 years, while the girls＇s heights were higher than those of boys＇ between age 10 to 11 years. The body heights in Shanghai children and adolescents were higher than those of the national survey results, there existed a significant height increase between 1975 and 2003 in all age groups. The heights continued to increase between 1995 and 2003 in Shanghai suburban children and adolescents, however the body heights increased little in urban children and adolescents. The overall short stature standardized morbidity rate was 3.26% , the rate was significantly lower in urban area than that in suburban area. The overall SMR was significantly lower than that of other developing countries. Future targeted etiology study may disclose the pathogenesis of short stature in Shanghai, and may be beneficial for establishing proper intervention measures for short stature children and adolescents.