| Background:Growth reference curves are widely used to monitor the individual child’s growth, and to assess the nutritional status of populations. Originally, children’s growth curves have been established to detect dysplasia. Then, as childhood obesity and overweight in many countries or regions emerged, those curves have also been used to define overweight and obesity children.Purpose:This study aims to draw the growth curve of children aged 3-6 in Nanjing by LMS method to understand those children’s growth condition in domestic and international levels and to asisst to identify growth deviations in Nanjing preschool children aged 3-6 years old in their early life. Meanwhile, possibilities could be made to monitor children’s growth and "obesity rebound" phenomenon. What’s more, through early detection and intervention, researchers could solve overweight and obesity issue by promoting children’s growth and health services.Methods:This study is divided into two parts. The first one is to establish and assess the growth and development of reference standard in Nanjing urban children with the LMS method. By using stratified random sampling method,3-6 years old children in13 districts of Nanjing was added in this research. Data acquisition time from September 2014 to June 2015. Samples was constituted by three-stage stratified random sampling method. Firstly, sampling schools were determined, then grades were layered. Finally, the classes as a unit were randomly been selected. 56 kindergartens were included in this study, in which 17 were private schools,39 were public schools. Extraction of 30% of the total sample (N= 10818; M= 5898, M= 4920). But the sample filtered twice. Physiological causes diseases and special health failed with the completion of the sample population anthropometric was ruled out (excluded 81 people, the ratio becomes 0.75%). The second one was eradication of extreme value in the reference population curve to establish a proper LMS model. Each data group which was out of the range of M ± 5S was been removed (excluded 127 people, the removal ratio was 1.17%). The child’s age, gender, height and weight data were collected by Epi data3.0 software with double entry error detection. SPSS 17.0. LMS Chartmaker LMSgrowth software were used to make statistical processing. The second one is that comparative analysis was made through the Nanjing region and the international standard reference established by IOTF, WHO and CDC. Therefore, the mutual relationship could be explored and the regional growth condition could be understood.Results:Using the LMS method, we analysis the height, weight and body mass index (BM1) curve in 3-6 years old Nanjing children. After several adjustments and verification, finally we found the boy effective degree of freedom were 3,5,3; 2,5,4 and 2,5.3 seperately. And the girls fit freedom edf were 3,6,3; 3,5,3 and 2,6,2 seperately. Because in these parameters, the fitting effect was fine and the L, M. S percentile of the reference values in different age and gender groups were then obtained. In a comparative analysis of international standards, we found that obesity is defined by the cut-off P97 or P95, P90 or P85 to distinguish overweight and obese, growth and development of children 3-6 years old Nanjing assessment of a certain significance.Conclusion:The 3-6 years old children’s height, weight and body mass index in Nanjing city area compared to the national level haven’t had significant difference (P> 0.05), but when it comes to gender, the difference is significant (P< 0.05). In comparison, the threshold of overweight and obesity of 3-6 years children in international standard WHO, IOTF and CDC United States if used in Nanjing in children might reduce the actual detection rate of overweight or obese. Thus regional standard might be meaningful and be critical to statistical epidemiological study. |
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