Muhammad Asif1, Muhammad Aslam2, Justyna Wyszyńska3, Saima Altaf2. 1. Department of Statistics, Govt. Degree College, Multan, Pakistan - asifmalik722@gmail.com. 2. Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan. 3. Medical College of Rzeszów University, Rzeszów, Poland.
Abstract
BACKGROUND: Assessment of growth and nutritional status is an essential part of clinical evaluation and care in pediatrics. We therefore, aimed to establish age and gender specific smoothed BMI growth reference charts of Pakistani children and adolescents aged 2-18 years and to compare our LMS median percentile values with WHO 2007 international references and with references from other foreign studies. METHODS: A representative cross-sectional sample of 10,668 healthy Pakistani subjects aged 2 to 18 years was studied. For calculation of BMI (kg/m2), height (cm) and weight (kg) were measured using standard procedures. Age and gender specific smoothed BMI growth reference values and associated charts were obtained using lambda-mu-sigma (LMS) as well as quantile regression (QR) statistical methods. RESULTS: In the sample studied, the mean (± SD) BMI of all subjects was 16.50 (± 2.83 kg/m2). Smoothed BMI percentile curves (5th, 10th, 25th, 50th, 75th, 90th and 95th) obtained by using LMS and QR methods, showed that BMI increased with age in both sexes. During pubertal age, girls had larger percentiles than boys. Centile values estimated by the LMS and QR procedure had small variability from the empirical centiles. Comparison of LMS BMI 50th percentile with references from WHO 2007 and data from other countries demonstrated that Pakistani children had substantially lower BMI percentiles than their counterparts in the reference population. CONCLUSIONS: This comprehensive study suggests that WHO 2007 references are not suitable for Pakistani children. The QR method should be considered as an alternative method to develop growth charts.
BACKGROUND: Assessment of growth and nutritional status is an essential part of clinical evaluation and care in pediatrics. We therefore, aimed to establish age and gender specific smoothed BMI growth reference charts of Pakistani children and adolescents aged 2-18 years and to compare our LMS median percentile values with WHO 2007 international references and with references from other foreign studies. METHODS: A representative cross-sectional sample of 10,668 healthy Pakistani subjects aged 2 to 18 years was studied. For calculation of BMI (kg/m2), height (cm) and weight (kg) were measured using standard procedures. Age and gender specific smoothed BMI growth reference values and associated charts were obtained using lambda-mu-sigma (LMS) as well as quantile regression (QR) statistical methods. RESULTS: In the sample studied, the mean (± SD) BMI of all subjects was 16.50 (± 2.83 kg/m2). Smoothed BMI percentile curves (5th, 10th, 25th, 50th, 75th, 90th and 95th) obtained by using LMS and QR methods, showed that BMI increased with age in both sexes. During pubertal age, girls had larger percentiles than boys. Centile values estimated by the LMS and QR procedure had small variability from the empirical centiles. Comparison of LMS BMI 50th percentile with references from WHO 2007 and data from other countries demonstrated that Pakistani children had substantially lower BMI percentiles than their counterparts in the reference population. CONCLUSIONS: This comprehensive study suggests that WHO 2007 references are not suitable for Pakistani children. The QR method should be considered as an alternative method to develop growth charts.
Authors: Muhammad Asif; Muhammad Aslam; Iqra Mazhar; Hamza Ali; Tariq Ismail; Piotr Matłosz; Justyna Wyszyńska Journal: Int J Environ Res Public Health Date: 2022-10-03 Impact factor: 4.614
Authors: Muhammad Asif; Muhammad Aslam; Kalim Ullah; Muhammad Qasim; Khurram Afzal; Asad Abbas; Manzar Ali; Muhammad Younis; Sami Ullah; Muhammad Hassham Hassan Bin Asad; Justyna Wyszyńska Journal: Biomed Res Int Date: 2021-09-15 Impact factor: 3.411