Anuradha V. Khadilkar , Chirantap Oza , Neha Kajale , Aman B. Pulungan , Suttipong Wacharasindhu , Annang Giri Moelyo , Gassani Amalia , Karn Wejaphikul , Madarina Julia , Prapai Dejkhamron , Vaman Khadilkar
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引用次数: 0
摘要
营养不良的双重负担（DBM）是南亚和东南亚（SA 和 SEA）的一个重要公共卫生问题。本研究旨在评估使用当地和地区特定种族的人体测量参考标准与国际参考标准对这些地区双重营养不良患病率的影响。此外，还分析了印度和印度尼西亚的去身份化数据集，以评估不同生长标准在识别DBM方面的有效性。对人体测量学 Z 值进行了比较，并计算了灵敏度、特异性和阳性预测值 (PPV)。在印度和印度尼西亚，世卫组织标准在识别身材矮小方面的特异性最低。采用世卫组织生长参照标准（2007 年）的年龄 BMI 图表在代谢风险方面的灵敏度较低，特异性较高。当地参考值显示发育迟缓率较低，超重或肥胖率较高。国际标准高估了发育迟缓率，低估了肥胖率，导致分类错误和遗漏代谢风险病例。
Local anthropometric parameters for assessing double burden of malnutrition in South Asian and Southeast Asian countries: a review and retrospective analysis
The double burden of malnutrition (DBM) is a significant public health issue in South and Southeast Asia (SA and SEA). This study aimed to assess the impact of using local and regional ethnicity-specific anthropometric references versus international references on the prevalence of DBM in these regions.
A narrative review of DBM prevalence using local versus international standards was conducted. Additionally, deidentified datasets from India and Indonesia were analyzed to evaluate the effectiveness of different growth standards in identifying DBM. Anthropometric Z-scores were compared, and sensitivity, specificity, and positive predictive value (PPV) were calculated.
WHO standards had the lowest specificity for identifying short stature in India and Indonesia. BMI-for-age charts using WHO Growth Reference (2007) had lower sensitivity and higher specificity for metabolic risk. Local references showed lower stunting and higher overweight or obesity prevalence. International standards overestimated stunting and underestimated obesity, leading to misclassification and missed cases of metabolic risk.
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