Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The methodology for developing the 2007 Korean growth charts and blood pressure nomogram in Korean children and adolescents

2007 한국 소아청소년 성장곡선 및 정상혈압 분포 개발 방법론

  • Lee, Soon Young (Department of Preventive Medicine & Public Health, Ajou University School of Medicine) ;
  • Kim, Youn Nam (Graduate School of Public Health, Yonsei University) ;
  • Kang, Yeon Ji (Department of Preventive Medicine & Public Health, Ajou University School of Medicine) ;
  • Jang, Myoung-Jin (Division of Chronic Disease, Surveillance, Korea Centers for Disease Control and Prevention) ;
  • Kim, Jinheum (Department of Applied Statistics, Suwon University) ;
  • Moon, Jin Soo (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Lee, Chong Guk (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Oh, Kyungwon (Division of Chronic Disease, Surveillance, Korea Centers for Disease Control and Prevention) ;
  • Kim, Young Taek (Division of Chronic Disease, Surveillance, Korea Centers for Disease Control and Prevention) ;
  • Nam, Chung Mo (Department of Preventive Medicine, Yonsei University College of Medicine)
  • 이순영 (아주대학교 의과대학 예방의학교실) ;
  • 김윤남 (연세대학교 보건대학원) ;
  • 강연지 (아주대학교 의과대학 예방의학교실) ;
  • 장명진 (질병관리본부 만성병 조사팀) ;
  • 김진흠 (수원대학교 통계정보학과) ;
  • 문진수 (인제대학교 의과대학 소아과학교실) ;
  • 이종국 (인제대학교 의과대학 소아과학교실) ;
  • 오경원 (질병관리본부 만성병 조사팀) ;
  • 김영택 (질병관리본부 만성병 조사팀) ;
  • 남정모 (연세대학교 의과대학 예방의학교실)
  • Received : 2007.12.14
  • Accepted : 2008.01.09
  • Published : 2008.01.15
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Abstract

Purpose : This study was to provide the methods of developing the growth charts and the blood pressure nomogram among Korean children and adolescents. Methods : The growth charts were developed based on the data from the national growth surveys for children and adolescents in 1998 and 2005. The percentile charts were developed through two stages. At the first stage, the selected empirical charts were smoothed through several fitting procedures including parametric and non-parametric methods. At the second stage, a modified LMS (lambda, mu, sigma) statistical procedure was applied to the smoothed percentile charts. The LMS procedure allowed to estimate any percentile and to calculate standard deviation units and z-scores. The charts for weight-for-age, height-for-age, BMI-for-age, weight-for-height and head circumference-for-age were developed by sex. Age and normalized height controlled sex-specific nomograms of systolic and diastolic blood pressure were developed by a fixed effect model of general regression using the data from 2005 national growth survey. Results : The significant systemic differences between the percentiles of growth charts and the empirical data were not found. The final output of the study is available from Korean Center for Disease Control and Prevention homepage, http://www.cdc.go.kr/webcdc/. Blood Pressure nomogram was tabulated by height percentiles and age using the regression coefficients analyzed with regression model. Conclusion : 2007 growth charts and blood pressure nomogram were the first products based on the statistical modeling using the national survey data. The further study on the methodology including data collection, data cleaning and statistical modeling for representative growth charts would be needed.

목 적 : 1998년과 2005년 신체발육표준 제정사업 자료를 이용하여 2007년 소아청소년 성장곡선의 개발과정에서에 이용된 성장곡선 및 혈압분포 개발 방법론을 제시하고자 하였다. 방 법 : 성장곡선은 1998년과 2005년 자료를 이용해서 각 백분위수의 성장곡선 모형을 추정하고 LMS를 방법을 이용하여 최종 성장곡선을 생산하였다. 연령과 신장별 혈압 성장곡선은 2005년 자료를 이용하여 남녀별로 고정효과 회귀모형을 적용하여 산출하였다. 결 과 : 2007 소아청소년 성장곡선 및 혈압분포 표를 제시할 수 있었다. 결 론 : 2007년 성장곡선과 혈압분포 표는 현재 가용한 자료와 최신의 통계적 방법을 최대한 활용한 국내 최초의 결과로서 향후 지속적인 발전을 위한 논의와 연구가 필요하다.

Keywords

Acknowledgement

Supported by : 보건복지부

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