7岁以下儿童中国生长标准与世界卫生组织新标准比较

Comparison of the China child growth standards and the WHO child growth standards from 0 to 7 years old

【目的】比较中国儿童生长标准与WHO新标准之间的差异，为正确选择和合理使用生长标准提供科学依据。【方法】中国标准、WHO新标准来源于公开发表的数据。比较两种标准各指标在一2倍标准差（-2s）、中位数（Os）、＋2s上的差值。以“1995年九市7岁以下儿童体格发育调查”为验证人群，比较两种标准在“生长迟缓”、“低体重”、“消瘦”和“肥胖”评估中的差异。【结果】1）两种标准在-2s、Os、＋2s上的差值：身长／身高均略高于WHO新标准；男、女童体重在-2s和Os上均略高于WHO新标准，但在＋2s上男、女童表现不一致，女童2岁后略低，男童5岁后略高。头围与WHO新标准差异不大，在-2s上轻微偏高；男童身长／身高别体重（wFL／H）在60em以后较WHO新标准略高，在-2s上较为明显，女童80cm以后在0s、＋2s上较WHO新标准低，100em以后更明显。2岁前体质指数（bodymassindex，BMI）略高于WHO新标准，2岁后男、女童趋势不同，女童在＋2s上低于、在-2s上却略高于WHO新标准，男童与WHO新标准差异不大。2）两种标准在营养评估中的差异：以中国标准计算的“生长迟缓率”、“低体重率”、“消瘦率”均略高于WHO新标准，男童“肥胖率”低于WHO新标准，2岁以下较为明显，但2～5岁差异不大，女童“肥胖率”在2岁以下略低于、2～5岁高于WHO新标准。从WFL／H、BMI两种指标看，无论采取哪种标准，计算的“消瘦率”或“肥胖率”差异并不明显，2～5岁更小。【结论】中国标准总体上略高于WHO新标准。WFL／H和BMI两指标在“消瘦”、“肥胖”筛查效率上差异不大。

[Objective] To compare the difference on growth curves and estimates of malnutrition and obesity be- tween the China Child Growth Standards and WHO Child Growth Standards. [Methods] Reference data published for the two standards was used to calculate the difference values of each index on - 2 standard deviations （s） from the median, median （0s） and -1-2s from the median. Estimates of stunting, underweight, wasting and obesity were compared based on ＂the National Study on Physical Growth and Development of Children under 7 years old in 1995 （NSPGDC）＂ between the China and WHO standards. [Results] 1） Difference values in growth curves： length/height for age was slightly higher than the WHO standards. Weight for age was also higher than the WHO＇s on - 2s and 0s from the median, but lower for girls after 2 years old and higher for boys after 5 years old on ＋2s. No obvious difference was found for head circumference for age. Weight for length/height （WFL/H） for boys after 60 cm was a little bit higher than the WHO＇s （obvious on -2s）, but slightly lower on 0s and ＋2s for girls after 80 cm （obvious after 100 cm）. Body mass index （BMI） was higher ihan the WHO＇s before 2 years old, and no obvious difference for boys after 2 years old, but lower on q-2s and higher on -2s for girls at this age stage. 2） Population estimates of nutritional status： the prevalence of stunting, underweight, and wasting based on the China standards were higher than the WHO＇s. Obesity rates was lower than based On the WHO＇s before 2 years old, but no obvious difference for boys and higher for girls during 2 to 5 years old. The difference of estimates of wasting or obesity rates was less evident between WFL/H and BMI according to the China or WHO standards, even smaller for 2 to 5 years old. [Conclusions] The China standards is slightly higher than the WHO standards, and presented sig- nificant ethnic characteristics. The difference of prevalence of wasting or obesity is less evident between WFL/H and BMI.