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

Korean Journal of Pediatrics 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 Lee1, Youn Nam Kim2, Yeon Ji Kang1, Myoung-Jin Jang3, Jinheum Kim4, Jin Soo Moon5, Chong Guk Lee5, Kyungwon Oh3, Young Taek Kim3, Chung Mo 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
2007 한국 소아청소년 성장곡선 및 정상혈압 분포 개발 방법론
이순영1, 김윤남2, 강연지1, 장명진3, 김진흠4, 문진수5, 이종국5, 오경원3, 김영택3, 남정모6
1아주대학교 의과대학 예방의학교실
2연세대학교 보건대학원
3질병관리본부 만성병 조사팀
4수원대학교 통계정보학과
5인제대학교 의과대학 소아과학교실
6연세대학교 의과대학 예방의학교실
Correspondence: 
Chung Mo 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.
Key Words: Growth chart, Blood pressure nomogram, LMS method


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