中国标准和WHO标准检出婴儿生长迟缓、消瘦、低体质量和超重率的差异分析

The comparison of wasting, stunting, low weight, and overweight rate in infants by using the World Health Organization Child Growth Standards and China Growth Standards

目的：对比分析中国2005和WHO 2006儿童生长标准在0-12月龄婴儿生长迟缓、消瘦和低体质量、超重检出率的差异。方法利用“婴儿营养与喂养”课题收集横断面和纵向调查数据，分别采用中国2005和WHO 2006儿童生长标准计算身长的体质量Z评分（WLZ）、年龄的身长Z评分（LAZ）和年龄的体质量Z评分（WAZ），确定0-3、4-6、7-9和10-12月龄生长迟缓、消瘦、低体质量、超重的检出率，比较两种生长标准检出率之间的差异。结果978名婴儿提供3909人次有效测量数据。其中，男婴数据占53.88%（2106/3909），女婴数据占46.12%（1803/3909）。生长迟缓率和消瘦率各月龄组中国标准和WHO标准的检出率差异无统计学意义（P〉0.05）。低体质量率在4-6、7-9月龄WHO标准检出率低于中国标准，差异有统计学意义（P均〈0.05）。超重率除10-12月龄外，其余月龄WHO标准检出率与中国标准差异均有统计学意义（P〈0.05）。结论中国标准和WHO标准在评价0-12月龄婴儿体格生长情况的结果方面存在差异，WHO标准检出低体质量率低于中国标准，而检出超重率高于中国标准。

Objectives To compare the 2006 World Health Organization （WHO） growth standards and the 2005 China national growth standards for identification of the wasting, stunting, low weight and overweight in infants. Methods Data were drawn from“Infants’feeding and growth”project. Weight-for-length, weight-for-age and length-for-age were derived in z-scores using the two growth references. Stunting was defined as having a length-for-age Z-score less than-2. Low weight was defined as having a weight-for-age Z-score less than-2. Wasting was defined as having a weight-for-length Z-score less than-2. Overweight was defined as having a weight-for-length Z-score more than＋2. Results Data of a total of 3909 records from 959 health children aged from 2 to 12 months from June 2008 to May 2009 were analyzed. Of them, 53.88%（2106/3909）were from male and 46.12%（1803/3909）were from female. There was no difference in wasting rate and stunting rate between using two growth references. Fewer infants were identified as low weight by using WHO growth standard than using China growth stan-dard. The results were 0.57%at 0-3 months （0.85%vs.1.42）, P〉0.05, 0.72%at 4-6 months （0.39%vs. 1.11%） and 0.97%at 7-9 months （0.79% vs.1.76%）, P〈0.05. They were equivalent at 10-12 months （1.3% vs.1.3%）, P=1.00. Oppositely, more infants were identified as overweight by using WHO growth standard than using China growth standard in our study. The results were 2.9 times at 0-3 months （6.54%vs. 3.13%）, 2.12 times at 4-6 months （9.02%vs.4.25%） and 1.62 times at 7-9 months （7.11%vs. 4.39%） , P〈0.05. It was 1.37 times at 10-12 months（4.84%vs. 3.54%）without statistically significant difference （P〉0.05）. Con-clusion Some differences were found in low weight and overweight rate by using two growth standards. Infant low weight rate was lower and overweight rate was higher by using WHO growth standard than that using China growth standard.