Assessment of the Internal Consistency of Two Polish References in Detecting Short Stature and Obesity in Children and Adolescents

Zbigniew Kułaga; Aneta Kotowska

doi:10.18778/1898-6773.88.4.04

Authors

Zbigniew Kułaga Public Health Department, The Children’s Memorial Health Institute, Warsaw, Poland https://orcid.org/0000-0003-0509-1004
Aneta Kotowska Public Health Department, The Children’s Memorial Health Institute, Warsaw, Poland https://orcid.org/0000-0003-3289-2878

DOI:

https://doi.org/10.18778/1898-6773.88.4.04

Keywords:

growth references, children, z-score, percentile

Abstract

In paediatric practice, growth references are used by doctors and nurses to evaluate a child’s growth status. We present an assessment of the internal consistency of two Polish references in detecting short stature and obesity in children and adolescents. Key diagnostic thresholds, the 3^rd percentile for height and the 95^th for Body Mass Index (BMI), were selected for comparison. Percentiles were calculated for hypothetical heights 0.2 cm lower than the third percentile of specific references and 0.1 units lower than the 95^th percentile of specific references, in the case of height and BMI references, respectively. The z-scores were calculated and converted to percentiles. MS Excel was used. Around the 3^rd percentile of height and the 95^th percentile of BMI, there is a discrepancy in the Warsaw growth reference for measured height and BMI, respectively, and the calculated percentile. In the case of the Polish 2010 and 2012 growth references, a hypothetical height 0.2 cm below the third percentile of height-for-age reference yielded percentiles below 3 for all ages in both sexes. The Polish 2010 and 2012 growth references for measurements 0.1 units below the obesity threshold yielded percentiles of 94.69–94.86 in boys and girls. The Polish 2010 and 2012 growth references provide consistent and coherent calculation results for the 3^rd percentile of height and the 95^th percentile of BMI for children and adolescents aged 3–18 years.

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References

Cole TJ. 1990. The LMS method for constructing normalized growth standards. Eur J Clin Nutr 44: 45–60.
View in Google Scholar

de Onis M, Garza C, Onyango AW, Martorell R. 2006. WHO Child Growth Standards. Acta Paediatr 95, Suppl 450: 1–101.
View in Google Scholar

Gelander L. 2006. Children’s growth: a health indicator and a diagnostic tool. Acta Paediatr 95(5): 517–18. https://doi.org/10.1111/j.1651-2227.2006.tb02276.x.
View in Google Scholar

González-Álvarez MA, Lázaro-Alquézar A, Simón-Fernández MB. 2020. Global trends in child obesity: are figures converging? Int J Environ Res Public Health 17(24): 9252. https://doi.org/10.3390/ijerph17249252.
View in Google Scholar

Jodkowska M, Woynarowska B, Oblacińska A. 2007. Test przesiewowy do wykrywania zaburzeń w rozwoju fizycznym u dzieci i młodzieży w wieku szkolnym. Warszawa: Instytut Matki i Dziecka.
View in Google Scholar

Kułaga Z, Grajda A, Gurzkowska B, Góźdź M, Wojtyło M, Świąder A et al. 2013. Polish 2012 growth references for preschool children. Eur J Pediatr 172: 753–61. https://doi.org/10.1007/s00431-013-1954-2.
View in Google Scholar

Kułaga Z, Litwin M, Tkaczyk M, Palczewska I, Zajączkowska M, Zwolińska D et al. 2011. Polish 2010 growth references for school-aged children and adolescents. Eur J Pediatr 170: 599–609. https://doi.org/10.1007/s00431-010-1329-x.
View in Google Scholar

Mazur A, Wójcik M, Zachurzok A. 2024. Otyłość u dzieci i młodzieży. W: Socha P, Lebensztejn D, Kamińska D. Gastroenterologia dziecięca. Warszawa: Media-Press. 719–731.
View in Google Scholar

Minister of Health, 2023. Ministry of Health decree from 24th of September 2013 on guaranteed benefits in the field of primary health care. J Laws Rep Poland; 1427. Warsaw: Minister of Health. https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20230001427.
View in Google Scholar

Minister of Health, 2024. Announcement of the Minister of Health of 18 December 2024 on the list of reimbursed medicines, foodstuffs for particular nutritional uses and medical devices. Official J Min Health 137, Appendix B.19. Warsaw: Minister of Health. https://dziennikmz.mz.gov.pl/legalact/2024/137/.
View in Google Scholar

Palczewska I, Niedźwiedzka Z. 2001. Somatic development indices in children and youth of Warsaw. Dev Period Med 5 (2 Suppl 1): 18–118.
View in Google Scholar

Reilly JJ, Wilson ML, Summerbell CD, Wilson DC. 2002. Obesity: diagnosis, prevention, and treatment; evidence-based answers to common questions. Arch Dis Child 86: 392–94. https://doi.org/10.1136/adc.86.6.392.
View in Google Scholar

WHO. 1995. Report of a WHO Expert Committee: Physical status: the use and interpretation of anthropometry. Geneva: World Health Organization.
View in Google Scholar

Woynarowska B, Palczewska I, Oblacińska A. 2012. WHO child growth standards for children 0–5 years. Percentile charts of length/height, weight, body mass index and head circumference. Dev Period Med 16(3): 232–39.
View in Google Scholar

Wright EM, Royston P. 1997. A comparison of statistical methods for age-related reference intervals. J R Statist Soc A 160(1): 47–69. https://doi.org/10.1111/1467-985X.00045
View in Google Scholar