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首页> 外文期刊>BMC Pediatrics >Using height-for-age differences (HAD) instead of height-for-age z-scores (HAZ) for the meaningful measurement of population-level catch-up in linear growth in children less than 5?years of age
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Using height-for-age differences (HAD) instead of height-for-age z-scores (HAZ) for the meaningful measurement of population-level catch-up in linear growth in children less than 5?years of age

机译：使用年龄高度差异（HAD）代替年龄高度z分数（HAZ）来有意义地衡量5岁以下儿童的线性增长中的人口水平追赶

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Background Evidence from studies conducted in nutritionally deprived children in low- and middle-income countries (LIMC) in past decades showed little or no population-level catch-up in linear growth (mostly defined as reductions in the absolute height deficit) after 2?years of age. Recent studies, however, have reported population-level catch-up growth in children, defined as positive changes in mean height-for-age z-scores (HAZ). The aim of this paper was to assess whether population-level catch-up in linear growth is found when height-for-age difference (HAD: child’s height compared to standard, expressed in centimeters) is used instead of HAZ. Our premise is that HAZ is inappropriate to measure changes in linear growth over time because they are constructed using standard deviations from cross-sectional data. Methods We compare changes in growth in populations of children between 2 and 5?years using HAD vs. HAZ using cross-sectional data from 6 Demographic and Health Surveys (DHS) and longitudinal data from the Young Lives and the Consortium on Health-Orientated Research in Transitional Societies (COHORTS) studies. Results Using HAD, we find not only an absence of population-level catch-up in linear growth, but a continued deterioration reflected in a decrease in mean HAD between 2 and 5?years; by contrast, HAZ shows either no change (DHS surveys) or an improvement in mean HAZ (some of the longitudinal data). Population-level growth velocity was also lower than expected (based on standards) in all four Young Lives data sets, confirming the absence of catch-up growth in height. Discussion We show no evidence of population-level catch-up in linear growth in children between 2 to 5 years of age when using HAD (a measure more appropriate than HAZ to document changes as populations of children age), but a continued deterioration reflected in a decrease in mean HAD. Conclusions The continued widening of the absolute height deficit after 2 years of age does not challenge the critical importance of investing in improving nutrition during the first 1000 days (i.e., from conception to 2 years of age), but raises a number of research questions including how to prevent continued deterioration and what is the potential of children to benefit from nutrition interventions after 2 years of age. Preventing, rather than reversing linear growth retardation remains the priority for reducing the global burden of malnutritionworldwide.
机译：背景过去几十年来，对低收入和中等收入国家（LIMC）的营养匮乏儿童进行的研究表明，在2岁后线性增长（主要定义为绝对身高赤字的减少）很少或根本没有赶上人口水平。岁。但是，最近的研究报告了儿童的人口水平追赶性增长，定义为平均年龄z分数（HAZ）的正向变化。本文的目的是评估当使用年龄间的身高差异（HAD：儿童的身高与标准身高，以厘米为单位）代替HAZ时，是否发现线性增长中的人口水平追赶。我们的前提是，热影响区不适用于测量线性增长随时间的变化，因为它们是使用横截面数据的标准偏差构造的。方法我们使用来自6个人口与健康调查（DHS）的横断面数据以及来自Young Lives和以健康为导向的研究联盟的纵向数据，比较使用HAD与HAZ进行的2至5岁儿童的人口增长变化在过渡社会（COHORTS）研究中。结果使用HAD，我们发现不仅线性增长没有人口水平的追赶，而且持续恶化反映出平均HAD在2至5年间下降;相比之下，热影响区显示无变化（DHS调查）或平均热影响区（某些纵向数据）有所改善。在所有四个“青年生命”数据集中，人口水平的增长速度也低于预期（基于标准），这证实了身高没有出现追赶性增长。讨论我们没有证据表明使用HAD（2岁至5岁儿童线性增长的人口水平赶超水平）（一种比HAZ更为恰当的方法来记录随着儿童年龄增长而发生的变化），但是持续恶化反映在平均HAD降低。结论2岁后绝对身高赤字的持续扩大并没有挑战在开始的1000天内（即从受孕到2岁）投资改善营养的关键重要性，但提出了许多研究问题，包括如何预防持续恶化以及2岁以下儿童从营养干预中受益的潜力是什么？减轻而不是扭转线性增长迟缓仍然是减轻全球营养不良全球负担的优先事项。

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