作　　者： (孙莹）; (方姣）; (杨蓉）; (来亚平）; (胡晶晶）; (段晓楠）; (苏普玉）; (万宇辉）; (陶芳标）;

机构地区： 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系人口健康与优生安徽省重点实验室,合肥230032

出　　处： 《中华预防医学杂志》 2017年第9期796-800,共5页

摘　　要： 目的 探讨脂肪重积聚提前与女童青春期发育的关联.方法 于2010年9月至2012年9月整群选取安徽省蚌埠市2所幼儿园中班儿童队列,排除已确诊患有器质性病变、慢性疾病及糖皮质激素用药的儿童,根据进入队列的时间,将调查对象分为队列1（2010年）、队列2（2011年）和队列3（2012年）,共有802名女童纳入队列.随访至小学,观察调查对象体格发育情况.在幼儿园期间每隔3个月对调查对象进行一次体格发育评估（共8次）,小学阶段为每年1次.截至2015年9月,队列1、2、3分别含12、11、10次体格发育评估.采用问卷调查评价调查对象家庭经济状况和儿童体力活动情况,以视诊与触诊相结合的方法评估乳房发育Tanner分期.按Rolland-Cachera标准确定每个儿童脂肪重积聚年龄,比较脂肪重积聚提前组与未提前组女童不同指标的差异.采用多因素logistic回归模型分析脂肪重积聚提前与女童乳房发育的关系.结果 802名女童的年龄为（8.90±0.87）岁,BMI为（17.48±2.70）kg/m^2.脂肪重积聚年龄为（6.16±0.90）岁,脂肪重积聚时BMI为（15.33±1.82）kg/m^2.脂肪重积聚提前组女童乳房发育提前检出率为27.8％（54/194）,高于脂肪重积聚未提前组女童[13.7％（75/547）]（P〈0.001）.调整当前体重状态、年龄、家庭经济状况、体力活动后,脂肪重积聚提前组女童乳房发育提前OR值为2.41（95％CI：1.41～4.12）.结论 脂肪重积聚发生过早可能增加女童青春期发育提前风险. Objective To determine possible relations between early adiposity rebound and adolescent development. Methods Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 （2010）, Cohort 2 （2011） and Cohort 3 （2012） according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera＆#39;s method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using t test andχ2 test. Multivariate regression analysis was applied to explore the association between early adiposity rebound and breast development. Results The average age of participants was （8.90±0.87） years old and the BMI was （17.48±2.70） kg/m^2. The average age at adiposity rebound was （6.16±0.90） years old and the BMI was （15.33±1.82） kg/m2. Premature breast development was found significantly higher in girls in early adiposity rebound group （27.8%, 54/802） than it in normal adiposity rebound group （13.7%） （P〈0.001）. After current adiposity, age, household economic status, childhood physical activity adjusted, the OR of premature beast development in early adiposity rebound group was 2.41（95%CI：1.41-4.12）. Conclusion Early adiposity rebound increases the risk of premature puberty in girls.

关 键 词： 青春期 乳房 人体质量指数 队列研究 脂肪重积聚