Abstract: Objective To explore the association between sleeping time and onset of menarche among Chinese girls aged 9 to 14 years,in order to provide scientific reference for further study on the influencing factors of adolescent sexual development. Methods Girls aged 9 to 14 years were selected from database of Chinese National Survey on Students Constitution and Health in 2014 with complete record of height,weight,sleeping time,age at menarche. The subjects were divided into sufficient sleep group and sleepless group. Situation of menarche was asked by female physicians. The expected answer for this question was ′Yes′ or ′No′ without a specific date. Logistic model and multilevel Logistic model were used to investigate the association between age at menarche and sleeping time. Results Totally 48 096 female students were included in this study.The average report rate of sufficient sleep for girls aged 9 to 14 years was 31.34% (15 074/48 096). The average report rate of menarche for girls aged 9 to 14 years was 50.13% (24 112/48 096). The report rate of menarche increased with age,from 0.97% (22/2 258) at the age of 9 years old to 95.87% (1 832/1 911) at the age of 14 years old in sufficient sleep group and 1.52% (52/3 423) at the age of 9 years old to 97.32% (6 720/6 905) at the age of 14 years old in sleepless group. The occurrence rate of menarche in sufficient sleep group was lower than that in the sleepless group in each age group (P<0.05). After controlling for district,height,BMI and other factors,girls aged 10 to 14 years were less likely to have the onset of menarche in sufficient sleep group compared with the sleepless group (OR=0.73,95% CI:0.69-0.77). Multilevel Logistic model indicated that after controlling for other factors,the longer the sleep duration was,the later of the menarche onset would be(OR=0.90,95%CI:0.87-0.92). Besides,the relationship between sleep duration and menarche onset did not have group cohesion at the province level(ICC <0.01),while the group cohesion at the age level was significantly strong(ICC=0.61). Conclusions The sleep duration of adolescents is closely related to the age at menarche and could have influence on the onset of menarche,which may be a key factor of the puberty development and sexual maturation. Effective measures should be taken to ensure the normal sleep duration of children and adolescents,so as to ensure their healthy growth

Key words: menarche, sleeping duration, puberty development, girls

摘要： 目的 探讨2014年中国9~14岁青春期女生月经初潮与睡眠时间的关系,为进一步研究青春期发育的影响因素提供科学依据。方法 选取2014年全国学生体质与健康调研数据中9~14岁青春期女生的身高、体重、月经初潮情况和睡眠时间等数据。将研究对象分为睡眠充足组和睡眠不足组,月经初潮情况由女性内科医师询问,只询问“已”、“未”,不问具体日期。采用Logistic回归模型和多水平模型进行统计学分析。 结果 研究共纳入48 096名女生。其中,9~14岁女生的平均睡眠充足报告率为31.34%(15 074/48 096),平均月经初潮报告率为50.13%(24 112/48 096)。从总体上看,月经初潮报告率随年龄增加而增加。其中,在睡眠充足女生组中,月经初潮报告率从9岁的0.97%(22/2 258)增长到14岁的95.87%(1 832/1 911);睡眠不足女生组中,月经初潮报告率从9岁的1.52%(52/3 423)增长到14岁的97.32%(6 720/6 905)。除9岁外,各年龄段中睡眠不足组的女生月经初潮的比例均高于睡眠充足组,且差异有统计学意义(P<0.05)。在控制片区、身高、BMI等因素后,相对于睡眠不足组,睡眠充足组女生月经初潮发生较晚(OR＝0.73,95%CI:0.69~0.77),在各年龄段(除9岁外)中,相对于睡眠不足组,睡眠充足组女生月经初潮发生较晚(OR<1,P<0.05)。多水平模型分析发现,在控制其他因素后,睡眠时间越长,月经初潮的发生越晚(OR＝0.90,95%CI:0.87~0.92)。同时,月经初潮与睡眠时间的关系在省份水平不具有组内聚集性(ICC<0.01),在年龄水平具有较明显的组内聚集性(ICC=0.61)。 结论 青春期女生的睡眠情况与月经初潮是否发生有着密切联系,进一步影响女生青春期的发育与性成熟。应当采取有效的措施确保儿童青少年的正常睡眠时间,保证儿童青少年的健康成长。

关键词: 月经初潮, 睡眠时间, 青春期发育, 女生