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浙江大学学报(医学版)  2013, Vol. 42 Issue (4): 396-    DOI: 10.3785/j.issn.1008-9292.2013.04.005
专题报道     
中国儿童青少年性发育现状研究
朱铭强1,傅君芬1,梁黎1,7,巩纯秀2,熊丰3,刘戈力4,罗飞宏5,陈少科6
1.浙江大学医学院附属儿童医院,浙江 杭州 310003;
2.首都医科大学附属北京儿童医院,北京 100045;
3.重庆医科大学附属儿童医院,重庆 400014;4.天津医科大学总医院儿科,天津 300052;
5.上海复旦大学附属儿科医院内分泌与遗传代谢科,上海 200032;
6.广西壮族自治区妇幼保健院,广西 南宁 530003;
7.浙江大学医学院附属第一医院儿科,浙江 杭州310003
Epidemiologic study on current pubertal development in Chinese school-aged children
 
ZHU Mingqiang1,FU Junfen1,LIANG Li1,7,GONG Cunxiu2,XIONG Feng3,LIU Geli4,LUO Feihong5,CHEN Shaoke6
1.Children′s Hospital,Zhejiang University School of Medicine,Hangzhou 310003; 2.Beijing Children′s Hospital of Capital Medical University,Beijing 100045; 3.Children′s Hospital of Chongqing Medical University,Chongqing 400014; 4.General Hospital of Tianjin Medical University,Tianjin 300052; 5.Children′s Hospital of Shanghai Fudan University,Shanghai 200032; 6.Maternal and Child Health Care Institute of Guangxi Zhuang Autonomous Region,Guangxi 530003;7.Department of Pediatrics,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003
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摘要:

[摘要]目的:了解中国儿童青少年性发育现状,比较不同地区性早熟情况。方法:于2009年10月至2010年10月,选择有地域代表的北京、天津、杭州、上海、重庆和南宁六地区6~18岁中小学生共18 707名(男9 812名和女8 895名),按标准化方法测定各年龄组儿童身高、体重、臀围和腰围等数据。采用女性乳房和男性睾丸容积Tanner分期指标衡量青春期发育。采用概率分析法测算男女第二性征出现的年龄中位数及95%可信区间。用精确概率法分析不同地区性早熟发生率,用t检验比较组间不同BMI、腰围计量资料。结果:女孩8岁组以前出现乳房发育的比例为2.91%,男孩9岁以前出现睾丸发育的比例为1.74%。女孩呈现乳房发育B2的中位年龄是9.69(95%CI:9.63~9.75)岁,男孩睾丸达G2期的中位年龄为11.25(95%CI:11.19~11.30)岁。共有80例儿童诊断为性早熟,女孩43例,男孩37例,其患病率为0.43%。北部地区较西南地区发病率高(0.736% vs 0.282%,P<0.05)。三个地区女孩性早熟的发病年龄没有差异,男孩性早熟华东地区发病年龄较早(7.4±0.28)岁。性早熟儿童其BMI的SD值及腰臀比(W/H)较正常同龄儿童高,不同地区性早熟儿童BMI、腰围、腰臀比比较差异均无统计学意义。结论:目前的性早熟诊断标准适合于评估调查地区的儿童性早熟状况。性早熟发病率及发病年龄在不同地区存在一定差异。肥胖与性早熟之间存在正相关。

关键词: 肥胖症/流行病学性发育青春期发育性早熟肥胖中国    
Abstract:

Abstract]Objective: To survey the current status of pubertal development of Chinese children and to compare the precocious puberty prevalence of different regions. Methods: A cross-sectional epidemiological study was conducted on 18 707 children and adolescents aged 6~18 y with male/female ratio of 9 812/8 895 from 6 representative geographical areas in China,including Beijing,Tianjin,Hangzhou,Shanghai,Chongqing and Nanning.The height,weight,waist circumference (WC),hip circumference(HC) and sexual maturation states (Tanner stages:breast stages for girls and testicular volume for boys) of children and adolescents were measured.Probit analysis was used to calculate the median age and 95%confidence interval (CI) for onset of breast and testicular development.The prevalence of precocious puberty of different regions and BMI,waist circumference of different groups were compared. Results: Breast development before 8 y was observed in 2.91%of girls,and testicular volume 4 ml or more before 9 y was observed in 1.74% of boys.The median age of onset of Tanner stages 2 for breast development in girls was 9.69 y (95%CI:9.63~9.75); the median age of onset of puberty as indicated by Tanner stages 2 for testicular development in boys was 11.25 y (95%CI:11.19~11.30).The prevalence of precocious puberty (43 girls and 37 boys) was 0.43% (80/18 707).The prevalence of precocious puberty in northern region was higher than that in southwest region(0.736% vs 0.282%,P<0.05).There was no difference in onset age of precocious puberty in girls among three regions; but the onset age of precocious puberty in boys was earlier in east China [(7.4±0.28)y].The SD values of BMI and waist-to-hip ratio (W/H) in precocious puberty children were higher than those in the peer normal children.There was no difference in BMI,waist circumference and waist-to-hip ratio in the precocious puberty children among different regions. Conclusions: The current diagnostic criteria of precocious puberty are suitable for the children in the survey areas.The prevalence and the onset age of precocious puberty are various in different regions.A positive association between obesity and precocious puberty is found both in boys and girls.

Key words: Obesity/epidemiology    Sexual development    Adolescent development    Precocious puberty    Obesity    China
收稿日期: 2013-03-25 出版日期: 2013-08-07
:  R 725.8  
基金资助:

支撑基金项目(2012BAI02B03);浙江省医学重点学科(创新学科) 基金项目(11-CX24);浙江省重点科技创新团队基金项目(2010R50050);985工程/三期“涉海国际交流与合作”基金项目(S20120001534)

作者简介: 朱铭强(1986-),男,硕士,住院医师,从事儿内科专业.
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朱铭强,傅君芬,梁黎,巩纯秀,熊丰,刘戈力,罗飞宏,陈少科. 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-.

ZHU Mingqiang,FU Junfen,LIANG Li,GONG Cunxiu,XIONG Feng,LIU Geli,LUO Fei. Epidemiologic study on current pubertal development in Chinese school-aged children

 
. Journal of ZheJiang University(Medical Science), 2013, 42(4): 396-.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2013.04.005        http://www.zjujournals.com/med/CN/Y2013/V42/I4/396

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