Клиническая медицина Медицина и экология, 2021, 3



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Journal3-21

MATERIALS AND METHODS 
519 adolescents aged 14-17 years were 
examined, of which 349 were included in the 
main group (186 boys and 163 girls) and 170 in 
the control (89 boys and 81 girls) groups. 
The children of the main group lived in 
the village of Kenkiyak, Temir district of the Ak-
tobe region of Kazakhstan, where an oil field has 
been developed since 1959. As a control group, 
children living in the village of Kobda, an environ-
mentally friendly area, where there are no oil and 
gas enterprises, were examined. 
Inclusion criteria:
adolescent children 
living in the survey area for at least 10 years or 
more; with informed consent to conduct research 
and process personal data, in accordance with 
the requirements of the Ethical committee of 
West Kazakhstan Medical University named after 
Marat Ospanov. 
The exclusion criteria:
the presence of 
acute and chronic inflammatory diseases from the 
examination program; autoimmune, hereditary 
and mental diseases. 
To determine physical development, body 
length was measured in centimeters using a 
stadiometer, weight –
in kilograms using a floor 
scale. 
The indicators of the harmony of physical 
development in terms of body length and weight 
were determined using centile scales of 
nomograms proposed and tested by N.A. 
Matveeva and Yu. G. Kuzmichev. This method 
was developed on the basis of the centile method 
recommended by the WHO in the form of an 
international standard as a screening test to 
identify 
children 
5-17 
years 
old 
with 
developmental disabilities. 
The indiactors of physical development 
according to centile scales are presented in a 
system of two coordinates, where the vertical 
indicates the body length (cm), and the 
horizontal indicates the body weight (kg). 
One-dimensional age centile scales are 
plotted in parallel to each coordinate axis,: on the 
right scales for body length, above - for body 
weight. In the center there is a nomogram for 
assessing the correspondence of body weight to 
its length. Numbers 1-8 on scales and nomo-
grams indicate centile intervals. The average val-
ues of length and body weight, limited at the 4th 
and 5th centile intervals, are shaded; the medi-
ans (50
th
centiles) are marked with a dotted line. 
Body length was assessed using one-
dimensional centile scales. For this, the value of 
the child's body length was found on the ordinate 
axis. From this point, the perpendicular was re-
stored to its intersection with the age scale of 
body length located in the right margin of the 
figures. 
The indicators that fell into the 4-5
th
in-
tervals were characterized as average, in the 3
rd 

low, in the 2
nd 

low, in the 1
st 

very low, 6
th 

increased, in the 7
th

high, in 8
th

very high. 
Body weight was assessed using age cen-
tile scales located in the upper field of the figures 
and nomograms in which centile body weight 
intervals are presented per unit of body length 
(weight index/body length). 
The assessment of body weight by age 
centile scales was carried out similarly to the as-
sessment of body length. 
According to the nomograms proposed 
for use, the physical development of children was 
regarded as harmonious if the body weight corre-
sponded to the 4-5 interval; disharmonious –
when assessed by the 2-3
rd
or 6-7
th
intervals; 
sharply disharmonious –
when assessed by the 1
st
or 8
th
centile interval of the nomogram. 
In this regard, 3 groups of physical devel-
opment were distinguished: normal physical de-
velopment, risk, with deviations in physical devel-
opment. 
The concept of «normal physical develop-
ment» corresponds to an average, decreased or 


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