目的 探讨婴儿期快速生长对青春期性发育的影响,对预防未来青春期提早发育提供依据。方法 选择2004年1月-2005年1月在温州市儿童医院及本院体检的198例生长过快的婴儿为观察组,另选择175名正常婴儿为对照组。根据出现月经初潮/遗精的时间点,把观察组分成性早熟组和正常发育组。采用Spearman相关性分析观察组婴儿1周岁的身高Δ值、体重Δ值与青春期性早熟的相关性。结果 观察组婴儿1周岁的身高Δ值、体重Δ值均显著大于对照组,差异有统计学意义(t＝2.085,2.146,P＜0.05);观察组儿童的身高、体重、体脂、骨龄值均显著大于对照组儿童,观察组儿童的T、E2、FSH、LH水平均显著高于对照组儿童,差异均有统计学意义(P＜0.05)。对照组无性早熟患儿。观察组、早熟组和正常组的男女比例对比,差异无统计学意义(P＞0.05)。早熟组身高、体重、体脂、骨龄值均显著大于正常组,早熟组T、E2、FSH、LH水平均显著高于正常组,差异有统计学意义(P＜0.05)。观察组婴儿1周岁的身高Δ值、体重Δ值与青春期性早熟呈正相关(r=0.816,0.872,P<0.001)。结论 婴儿期快速生长可造成儿童青春期前肥胖和体脂过度,使青春期早发。控制婴儿期过快生长对预防未来青春期提早发育有重要意义。
Abstract
Objective To explore the effect of rapid growth in infancy on puberty sexual development, in order to provide reference for preventing early puberty in the future. Methods From January 2004 to January 2005, 198 infants who grew too fast were selected as the observation group and 175 normal infants were selected as the control group from Wenzhou Children's Hospital and Shiyan People's Hospital. According to the time point of menarche/ spermatorrhea, the observation group was divided into precocious puberty group and normal development group. Spearman correlation analysis was used to analyze the correlation between height Δvalue, weight Δvalue and puberty precocious puberty in the observation group. Results The height Δvalue and weight Δvalue of one-year-old infants in the observation group were significantly higher than those in the control group (t=2.085,2.146,P<0.05). The height, weight, body fat and bone age of children in the observation group were significantly higher than those in the control group, and the levels of testosterone(T), estradiol(E2), follicle stimulating hormone(FSH) and luteinizing hormone(LH) in the observation group were significantly higher than those in the control group (P<0.05). There were no sexual precocious children in the control group. There was no significant difference in gender among the precocious group,the normal group and the observation group (P>0.05). The height, weight, body fat and bone age of the precocious group were significantly higher than those of the normal group, and the levels of T, E2, FSH and LH in the precocious group were significantly higher than those in the normal group (P<0.05).There was a positive correlation between the height Δvalue and the weight Δvalue of one year old infants in the observation group and puberty precocious puberty (r=0.816, 0.872, P<0.001). Conclusions Rapid growth in infancy can lead to pre-puberty obesity and excessive body fat, and early puberty. It is of great significance to control the overgrowth during infancy for the prevention of early puberty in the future.
关键词
婴儿期 /
快速生长 /
青春期早发 /
性早熟 /
肥胖
Key words
infant period /
rapid growth /
early puberty /
sexual precocity /
obesity
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参考文献
[1] 李丽,娄晓民,张彦勤.青少年心理行为问题与青春期发动时相提前以及肥胖的相关性[J].中国心理卫生杂志,2018,32(7):569-573.
[2] 彭刚,丁明,张琴,等.性早熟GnRH-a治疗后与青春期多囊卵巢综合征发生的相关性[J].中国妇幼健康研究,2016,27(7):808-810.
[3] 张婷婷,张立琴,杜玮.先天性甲状腺功能减低症患儿青春期生长发育研究进展[J].中国优生与遗传杂志,2015,23(12):121-122,12.
[4] 陈亚华,毛华芬.鄞州区0～2岁婴幼儿超重和肥胖现状及影响因素分析[J].中国慢性病预防与控制,2018,26(1):31-33.
[5] 林良明.WHO标准参照人群及标准参照曲线[J].中华儿童保健杂志,1996,4(2):103-104.
[6] Lee DS, Choi JB, Sohn DW. Impact of sleep deprivation on the hypothalamic-pituitary-gonadal axis and erectile tissue[J]. J Sex Med, 2019,16(1):5-16.
[7] Oyola MG, Handa RJ. Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes:sex differences in regulation of stress responsivity[J]. Stress, 2017,20(5):476-494.
[8] Jeje SO,Akindele OO,Balogun ME,et al. Maternal treatment with dexamethasone during lactation delays male puberty and disrupts reproductive functions via hypothalamic-pituitary-gonadal axis alterations[J].Pathophysiology,2016,23(1):43-49.
[9] 陶月红,曾碧荷,沙里夫.下丘脑-垂体-性腺轴抑制程度对中枢性性早熟女童成年预测身高的影响[J].中国当代儿科杂志,2015,17(10):1093-1097.
[10] 吴静,雷文芬,周娇妹,等.促性腺激素释放激素类似物治疗特发性中枢性性早熟女童的临床疗效及其对下丘脑-垂体-性腺轴激素水平的影响[J].中国全科医学,2015,18(18):2158-2162.
[11] 冯安萍,李波,胡海燕,等.儿童性早熟诊断中性激素检测的临床应用研究[J].中国妇幼健康研究,2017,28(Suppl 1):493-494.
[12] 林晓松.儿童性早熟诊断中性激素检测的临床应用价值探讨[J].医学理论与实践,2017,30(15):2296-2297.
[13] Narla RR,Ott SM. Bones and the sex hormones[J]. Kidney Int, 2018,94(2):239-242.
[14] 王彩云.性早熟儿童体内瘦素与性激素水平的变化及其相关性分析[J].中国妇幼保健,2017,32(11):2382-2384.
[15] Ho HJ,Sora P,Kyung JM,et al. Insulin resistance and bone age advancement in girls with central precocious puberty[J]. Ann Pediatr Endocrinol Metab, 2017,22(3):176-182.
[16] Xu YQ, Li GM, Li Y. Advanced bone age as an indicator facilitates the diagnosis of precocious puberty[J]. J Pediatr (Rio J), 2018,94(1):69-75.
[17] 邓荣,李迎,黄仁.儿童青少年骨龄分析在临床工作中的应用[J].中国临床新医学,2018,11(4):376-378.
[18] 王英,任小玲,周忠义.不同喂养方式对早产新生儿生长发育及健康状况的影响[J].检验医学与临床,2015,12(17):2520-2522,2525.
[19] Huang J, Zhang Z, Wu Y, et al. Early feeding of larger volumes of formula milk is associated with greater body weight or overweight in later infancy[J]. Nutr J, 2018,17(1):12.
[20] Bichteler A, Gershoff ET. Identification of Children's BMI trajectories and prediction from weight gain in infancy[J].Obesity (Silver Spring), 2018,26(6):1050-1056.
[21] Eckhardt CL, Eng H, Dills JL, et al. The prevalence of rapid weight gain in infancy differs by the growth reference and age interval used for evaluation[J]. Ann Hum Biol, 2016,43(1):85-90.
[22] 李楠楠. 青春期前肥胖儿童尿促性腺激素、性激素水平及特点[D].无锡:江南大学,2017.
[23] Lian Q, Mao Y, Luo S, et al. Puberty timing associated with obesity and central obesity in Chinese Han girls[J]. BMC Pediatr, 2019,19(1):1.
[24] 刘慧然,陆大江.3～6岁肥胖儿童身体素质体成分与骨龄发育的关系[J].中国学校卫生,2018,39(9):1354-1356.
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