儿童性早熟与生活方式及家族因素相关性分析
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摘要
目的探讨儿童性早熟与生活方式及家族因素的相关性,为防控儿童性早熟提供依据。方法采用病例对照研究方法,选择2015年6月—2016年8月在金华市各医院儿科或内分泌科确诊为性早熟的126名儿童纳入病例组,对照组为按性别、年龄匹配的126名正常儿童,对出生状况、生活方式、饮食习惯、家庭环境、遗传因素等进行问卷调查。结果病例组平均身高、体重、体质量指数(BMI)、肥胖率[(136.34±11.54)cm,(33.65±11.14)kg,(117.76±3.82)kg/m~2,26.2%]均高于对照组[(132.39±14.61)cm,(29.73±9.74)kg,(16.61±3.26)kg/m~2,14.3%](P值均<0.05)。二元Logistic回归分析结果显示,不午睡(OR=3.135,P=0.000)、食量(OR=1.944,P=0.002)与性早熟呈正相关,母亲学历(OR=0.576,P=0.004)、母亲初潮年龄(OR=0.645,P=0.000)、父亲陪伴(OR=0.763,P=0.038)与性早熟呈负相关。结论应培养儿童健康的生活习惯,注意营造良好的家庭环境,减少儿童性早熟的发生。
Objective To explore possible lifestyle and family factors associated with precocious puberty, and to provide scientific basis for precocious puberty prevention and treatment. Methods A case-control study was conducted among 126 children with precocious puberty diagnosed by pediatric endocrinologists in Jinhua and 126 controlled children matched with age, sex, during June 2015 to August 2016. Perinatal characteristics, lifestyle, dietary habits, family environment and genetic factors were assessed through questionnaire. Results Average height, weight, BMI, obesity prevalence in precocious puberty group were higher than those in the control group( P<0.05). Binary Logistic regression analysis showed that no nap time( OR = 3.135, P< 0.01), large amount of food intake( OR = 1.944, P = 0.002) was risk factor for precocious puberty; high education of mother( OR = 0.576, P =0.004), age of menarche of mother( OR = 0.645, P<0.01), father engagement( OR = 0.763, P = 0.038) were protective factors for precocious puberty. Conclusion Further investigation needs to explore the role of healthy lifestyles and family environment in precocious puberty prevention.
Objective To explore possible lifestyle and family factors associated with precocious puberty, and to provide scientific basis for precocious puberty prevention and treatment. Methods A case-control study was conducted among 126 children with precocious puberty diagnosed by pediatric endocrinologists in Jinhua and 126 controlled children matched with age, sex, during June 2015 to August 2016. Perinatal characteristics, lifestyle, dietary habits, family environment and genetic factors were assessed through questionnaire. Results Average height, weight, BMI, obesity prevalence in precocious puberty group were higher than those in the control group( P<0.05). Binary Logistic regression analysis showed that no nap time( OR = 3.135, P< 0.01), large amount of food intake( OR = 1.944, P = 0.002) was risk factor for precocious puberty; high education of mother( OR = 0.576, P =0.004), age of menarche of mother( OR = 0.645, P<0.01), father engagement( OR = 0.763, P = 0.038) were protective factors for precocious puberty. Conclusion Further investigation needs to explore the role of healthy lifestyles and family environment in precocious puberty prevention.
引文
[1]中华人民共和国卫生部.性早熟诊疗指南(试行)[J].中国儿童保健杂志,2011,19(4):390-392.
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[3]朱铭强,傅君芬,梁黎,等.中国儿童青少年性发育现状研究[J].浙江大学学报(医学版),2013,42(4):396-402.
[4]中华医学会儿科学分会内分泌遗传代谢学组.中枢性性早熟诊断与治疗共识(2015)[J].中华儿科杂志,2015,53(6):412-418.
[5]ROSENFIELD R L,LIPTON R B,DRUM M L.The larche,pubarche,and menarche attainment in children with normal and elevated body mass index[J].Pediatrics,2009,123(1):84-88.
[6]尤箫萌,单川,沈秀华.儿童肥胖与性早熟的研究进展[J].上海交通大学学报(医学版),2012,32(7):949-951.
[7]史晓燕,陈梦莹,王斐,等.单餐大份量进食是儿童单纯性肥胖的饮食危险因素[J].营养学报,2011,33(2):138-142.
[8]杨章萍,郑晓萍,张旭慧,等.女童性早熟的影响因素分析[J].中国学校卫生,2014,35(1):133-135.
[9]DURAND A,BASHAMBOO A,MCELREAVEY K,et al.Familial early puberty:presentation and inheritance pattern in 139 families[J].BMC Endocr Disord,2016,16(1):50.
[10]ELLIS B J,ESSEX M J.Family environments,adrenarche,and sexual maturation:a longitudinal test of a life history model[J].Child Dev,2007,78(6):1799-1817.
[11]BOGAERT A F.Age at puberty and father absence in a national probability sample[J].J Adoles,2005,28(4):541-546.
[2]黄捷婷.国内儿童性早熟研究16年主题文献分析[J].临床儿科杂志,2007,24(12):1016-1017.
[3]朱铭强,傅君芬,梁黎,等.中国儿童青少年性发育现状研究[J].浙江大学学报(医学版),2013,42(4):396-402.
[4]中华医学会儿科学分会内分泌遗传代谢学组.中枢性性早熟诊断与治疗共识(2015)[J].中华儿科杂志,2015,53(6):412-418.
[5]ROSENFIELD R L,LIPTON R B,DRUM M L.The larche,pubarche,and menarche attainment in children with normal and elevated body mass index[J].Pediatrics,2009,123(1):84-88.
[6]尤箫萌,单川,沈秀华.儿童肥胖与性早熟的研究进展[J].上海交通大学学报(医学版),2012,32(7):949-951.
[7]史晓燕,陈梦莹,王斐,等.单餐大份量进食是儿童单纯性肥胖的饮食危险因素[J].营养学报,2011,33(2):138-142.
[8]杨章萍,郑晓萍,张旭慧,等.女童性早熟的影响因素分析[J].中国学校卫生,2014,35(1):133-135.
[9]DURAND A,BASHAMBOO A,MCELREAVEY K,et al.Familial early puberty:presentation and inheritance pattern in 139 families[J].BMC Endocr Disord,2016,16(1):50.
[10]ELLIS B J,ESSEX M J.Family environments,adrenarche,and sexual maturation:a longitudinal test of a life history model[J].Child Dev,2007,78(6):1799-1817.
[11]BOGAERT A F.Age at puberty and father absence in a national probability sample[J].J Adoles,2005,28(4):541-546.