All issues > Volume 51(1); 2008

Review Article

Korean J Pediatr. 2008;51(1):26-32. Published online January 15, 2008.

The methodology for developing the 2007 Korean growth charts and blood pressure nomogram in Korean children and adolescents

Soon Young SY Lee¹, Youn Nam YN Kim², Yeon Ji YJ Kang¹, Myoung-Jin MJ Jang³, Jinheum JH Kim⁴, Jin Soo JS Moon⁵, Chong Guk CG Lee⁵, Kyungwon KW Oh³, Young Taek YT Kim³, Chung Mo CM Nam⁶

¹Department of Preventive Medicine & Public Health, Ajou University School of Medicine
²Graduate School of Public Health, Yonsei University
³Division of Chronic Disease, Surveillance, Korea Centers for Disease Control and Prevention
⁴Department of Applied Statistics, Suwon University
⁵Department of Pediatrics, Inje University Ilsan Paik Hospital
⁶Department of Preventive Medicine, Yonsei University College of Medicine

Correspondence Chung Mo CM Nam ,Email: cmnam@yuhs.ac

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.

Keywords :Growth chart, Blood pressure nomogram, LMS method