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

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.