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A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
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Z-score reference values for height in Turkish children aged 6 to 18 years.

Hülya Günöz1, Rüveyde Bundak, A Furman

  • 1İstanbul University Faculty of Medicine, Department of Pediatrics, İstanbul Turkey. E-ma-il: hugunoz@hotmail.com.

Journal of Clinical Research in Pediatric Endocrinology
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Z-score charts offer a better assessment of child growth than percentile charts. This study presents Z-score growth data for Istanbul children, revealing an upward trend in height and secular changes.

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Area of Science:

  • Pediatric endocrinology
  • Human growth and development
  • Biostatistics in health sciences

Background:

  • Standard deviation (Z-score) charts are increasingly preferred over percentile charts for assessing pediatric growth, especially for measurements outside normal ranges.
  • Previous growth data for Istanbul children were published as percentiles.
  • Z-score charts provide a more sensitive tool for monitoring growth deviations in children.

Purpose of the Study:

  • To establish Z-score reference tables for height and weight in Istanbul children aged 6-18 years.
  • To present data on the secular trend of height in Turkish children.
  • To provide updated growth references for clinical and research use.

Main Methods:

  • Analysis of height and weight measurements from 1100 boys and 1020 girls (aged 6-18 years) from well-to-do families in Istanbul.
  • Data collected through biannual school visits, with measurements taken by trained technicians.
  • LMS method employed for analysis, with results expressed as Z-score values for age.

Main Results:

  • Height measurements for both boys and girls across all age groups closely align with updated USA growth references.
  • An upward trend in height was observed compared to previous data on Turkish children.
  • Weight data also indicated growth patterns consistent with established references.

Conclusions:

  • Height growth in affluent Turkish school-aged children aligns with updated USA growth data, indicating a secular trend.
  • The findings underscore the necessity of periodically updating local growth data to reflect current population trends.
  • Z-score reference data are crucial for accurate assessment of child growth in the Turkish population.