A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.
A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.
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DOI：
10.1136/bmj.j3423
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发表时间：
2017-08-03
期刊：
影响因子：
--
通讯作者：
Berkley JA
中科院分区：
文献类型：
--
作者：
Mramba L;Ngari M;Mwangome M;Muchai L;Bauni E;Walker AS;Gibb DM;Fegan G;Berkley JA
目的建立雅阁世界卫生组织生长标准的5-19岁奥尔兹中上臂围（MUAC）-年龄z评分生长曲线，并评价其对随后死亡率的判别性能。 设计生长曲线构建和纵向队列研究。 设置美国和国际增长数据，以及肯尼亚，乌干达和津巴布韦的队列。 参与者健康检查调查（HES）/国家健康和营养检查调查（NHANES）美国人口数据集（年龄5-25岁），用于构建2007年WHO体重指数生长参考，与匹配WHO 2006年生长标准分布的插补数据集（年龄2-6岁）合并。验证数据来自乌干达和津巴布韦参加Watoto抗逆转录病毒研究（ARROW）试验的685名5-17岁艾滋病毒感染儿童;以及肯尼亚农村医院出院的1741名5-13岁儿童（3.8%艾滋病毒感染）。两个队列均接受了一年的生存随访。 主要结果测量与WHO 2006年生长标准的一致性，根据年龄MUAC和年龄体重指数z评分，在60个月时和一年内的生存率。 结果新生长曲线在5岁时平稳过渡，符合WHO生长标准。年龄组MUAC z评分为-2至-3和小于-3，与-2或更高相比，一年内死亡的风险比为3.63（95%置信区间0.90 - 14.7; P=0.07）和11.1在ARROW试验参与者中，分别为3.40至36.0; P<0.001）;在肯尼亚儿童出院后，分别为2.22（1.01至4.9; P=0.04）和5.15（2.49至10.7; P<0.001）。用于区分随后死亡率的年龄MUAC和年龄体重指数z评分的AUC为0.81（95%置信区间0.70 - 0.92）和0.75（0.63至0.86）在ARROW试验中（绝对差0.06，95%置信区间-0.032至0.16; P=0.2）和0.73（0.65 - 0.80）和0.58（0.49 - 0.67）（AUC绝对差异为0.15，0.07 - 0.23; P=0.0002）。 结论：在评估非洲学龄儿童和青少年与营养不良相关的死亡风险方面，MUAC年龄z评分至少与体重指数年龄z评分一样有效。MUAC可以在营养和艾滋病毒方案以及研究中提供简化的筛查和诊断。
Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality. Design Growth curve construction and longitudinal cohort study. Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe. Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year. Main outcome measures Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores. Results The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of −2 to −3 and less than−3, compared with −2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval −0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002). Conclusions The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research.
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影响因子：
2
作者：
COLE, TJ;GREEN, PJ
通讯作者：
GREEN, PJ
影响因子：
5.2
作者：
Craig, E.;Bland, R.;Reilly, J. J.
通讯作者：
Reilly, J. J.
DOI：
10.1097/qai.0000000000000176
发表时间：
2014-07-01
影响因子：
3.6
作者：
Idele, Priscilla;Gillespie, Amaya;Luo, Chewe
通讯作者：
Luo, Chewe
影响因子：
2
作者：
Borghi, E;de Onis, M;Martines, JC
通讯作者：
Martines, JC
影响因子：
7.1
作者：
Addo, O. Yaw;Himes, John H.;Zemel, Babette S.
通讯作者：
Zemel, Babette S.