卫生研究

目的探讨2006年WHO新标准与NCHS参考标准评价中国儿童营养状况的差别。方法利用2005年中国儿童营养监测调查资料,比较不同生长标准的儿童Z评分和营养不良率的差别。结果2种标准评价农村儿童的Z评分有显著差别,不同月龄儿童表现不一致。农村儿童WHO标准计算的低体重率是6.1%,低于NCHS参考标准得到的8.6%(P<0.0001),除了<6月龄的婴儿,其余年龄组WHO标准儿童低体重率都要低于NCHS参考标准。农村儿童WHO标准生长迟缓率是16.3%,高于NCHS参考标准的13.0%(P<0.0001),<6月龄以下儿童WHO标准生长迟缓率是NCHS参考标准的2.1倍;儿童消瘦率没有显著性差别(P>0.05),但是<6月龄儿童WHO标准消瘦率是NCHS参考标准的1.9倍。利用WHO标准计算的城市儿童超重率是6.7%,要高于NCHS参考标准得到的5.4%(P<0.0001)。结论与NCHS参考标准相比,WHO标准评价儿童的营养情况随月龄、评价指标的不同而改变,WHO标准可以更好地监测婴儿早期的生长变化,有必要应用该标准进一步分析现有数据。

Objective To compare children's growth patterns and estimates of malnutrition using the WHO standards versus the NCHS reference in China. Methods Data originated from China children nutrition surveillance in 2005, Z-scores and prevalence of malnutrition were compared between standards.Results There was substantial difference in Z-scores between standards in rural (P<0.0001). According to the WHO standards, prevalence of underweight in rural was lower than that of underweight based on the NCHS reference (6.1%. vs. 8.6%, P<0.0001). Except for children under 6 months, all age groups underweight rates were lower according to the WHO standards. Prevalence of stunting in rural was higher based on the WHO standards (16.3%. vs. 13.0%, P<0.0001), prevalences of stunting under 6 months were 2.1 times of that based on NCHS reference. As for wasting, there were no differences between standards, but wasting was substantially higher during the first half of infancy. Overweight rates based on the WHO standards were higher than those based on NCHS reference in urban (6.7%. vs. 5.4%, P<0.0001).Conclusion In comparison with NCHS reference, population estimates of malnutrition would vary by age, growth indicator based on WHO standards. The WHO standards could provide a better tool to monitor the rapid and changing rate of growth in early infancy, further analysis on existing data was needed.