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Developing neck circumference growth reference charts for Pakistani children and adolescents using the

Muhammad Asif1, Muhammad Aslam2, Saadia Khan3

  • 1Department of Statistics, Government Degree College, Qadir Pur Raan, Multan, Pakistan.

Public Health Nutrition
|August 25, 2021
PubMed

Insights

This study developed neck circumference (NC) growth charts for Pakistani children aged 2-18. Results show Pakistani children have lower NC percentiles than other populations, highlighting the need for localized obesity markers.

Area of Science:

  • Pediatric Endocrinology
  • Anthropometry
  • Public Health Nutrition

Background:

  • Neck circumference (NC) is an emerging marker for obesity and related health risks.
  • Standardized, sex- and age-specific NC cut-offs are lacking for Pakistani children, limiting clinical and epidemiological use.
  • Existing international NC references may not accurately represent the Pakistani pediatric population.

Purpose of the Study:

  • To establish sex- and age-specific growth reference charts for neck circumference (NC) in Pakistani children and adolescents aged 2-18 years.
  • To provide essential data for accurate obesity assessment and risk stratification in this population.

Main Methods:

  • Utilized data from a cross-sectional multi-ethnic anthropometric survey (MEAS) of 10,668 healthy Pakistani children and adolescents (2-18 years).
  • Applied lambda-mu-sigma (LMS) and quantile regression (QR) methods to construct smoothed percentile (5th-95th) growth reference charts for NC.
  • Analyzed age, sex, and NC data.

Main Results:

  • Developed comprehensive NC growth reference charts for Pakistani children and adolescents.
  • Observed an increase in NC with age in both sexes; girls exhibited larger NC than boys between 8 and 14 years.
  • Pakistani children and adolescents demonstrated significantly lower median NC percentiles compared to Iranian and Turkish populations.

Conclusions:

  • International NC references are inadequate for Pakistani children, necessitating localized growth charts.
  • Quantile regression (QR) is a recommended alternative method for constructing growth charts due to minimal variability with empirical centiles.
  • These new charts will aid in the accurate identification of obesity and associated risks in Pakistani youth.
Abstract

Keywords:
Growth chartsLMS methodNeck circumferenceQuantile regression

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