目的 探究儿童睡眠与性早熟之间的关联性,以期为性早熟的预防和早期干预提供科学依据。方法 本研究通过病例对照研究,招募2022年10月—2024年2月于武汉儿童医院被首次诊断为性早熟的儿童,以及体检中心的健康儿童作为对照,与性早熟儿童1∶1进行匹配。采用儿童家庭健康问卷调查受试者的一般人口资料及生活习惯,儿童睡眠障碍量表(SDSC)评估研究对象的睡眠障碍程度。使用二元Logistic回归模型分析睡眠障碍程度与性早熟的关系。结果 共274位受试者被纳入研究,年龄为(8.75±1.12)岁。性早熟儿童与正常儿童在睡眠环境(χ2=2.279)、开夜灯入睡(χ2=0.769)方面的差异无统计学意义(P＞0.05);两组儿童在出生方式(χ2=5.500)、母亲初潮年龄(χ2=4.202)、父母性早熟史(χ2=9.460)和儿童性教育普及(χ2=7.831)、启动和维持睡眠障碍得分(Z=2.968)、过度嗜睡(Z=2.384)、SDSC总分(Z=1.968)方面差异有统计学意义(P＜0.05)。对基线资料进行校正后,二分类Logistic回归分析提示启动和维持睡眠障碍程度越严重,患性早熟(OR=2.30,95%CI:1.06~5.00,P=0.036)和中枢性性早熟(OR=3.20,95%CI:1.23~8.35,P=0.017)的风险越大;过度嗜睡越严重,性早熟的风险越高(OR=2.13,95%CI:1.09~4.14,P=0.026)。结论 启动和维持睡眠障碍、过度嗜睡均与性早熟有关,得分越高患病风险越大,临床应引起重视并采取科学干预措施。
Abstract
Objective To investigate the association between sleep and precocious puberty in children, in order to provide a scientific basis for the prevention and early intervention of precocious puberty. Methods This case-control study recruited children diagnosed with precocious puberty for the first time at Wuhan Children's Hospital between October 2022 and February 2024, along with healthy children from the health examination center as controls, matched 1∶1 with the precocious puberty group. A family health questionnaire was used to collect general demographic data and lifestyle habits, and the Sleep Disturbance Scale for Children (SDSC) was employed to assess the degree of sleep disturbances. A binary Logistic regression model was used to analyze the relationship between sleep disturbances and precocious puberty. Results A total of 274 participants were included in the study, with a mean age of (8.75±1.12) years. There were no statistically significant differences between the precocious puberty group and the control group in terms of sleep environment (χ2= 2.279) or the habit of sleeping with a night light (χ2=0.769) (P>0.05). However, significant differences were observed between the two groups in terms of mode of delivery (χ2=5.500), maternal age at menarche (χ2=4.202), parental history of precocious puberty (χ2=9.460), sex education exposure (χ2= 7.831), disorders of initiating and maintaining sleep (Z=2.968), excessive daytime sleepiness (Z=2.384), and total SDSC score (Z=1.968) (P<0.05). After adjusting for baseline characteristics, binary Logistic regression analysis indicated that more severe disorders of initiating and maintaining sleep were associated with a higher risk of precocious puberty(OR=2.30,95%CI: 1.06 - 5.00, P=0.036) and central precocious puberty (OR=3.20,95%CI: 1.23 - 8.35, P=0.017),and severity of excessive daytime sleepiness positively correlated with precocious puberty risk (OR=2.13, 95%CI: 1.09 - 4.14, P=0.026). Conclusions Both initiation and maintenance of sleep disorders and excessive daytime sleepiness are associated with an increased risk of precocious puberty in children, with higher scores correlating with greater risk.It warrants clinical attention and requires evidence-based interventions.
关键词
性早熟 /
睡眠 /
儿童睡眠障碍量表 /
中枢性性早熟
Key words
precocious puberty /
sleep /
Sleep Disturbance Scale for Children /
central precocious puberty
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