北京市儿童青少年男性青春期性征发育流行病学研究

Update pubertal development in Beijing school-aged boys

目的 了解北京市6～18岁学龄男性青春期第二性征发育现状，以及人群性早熟发生率。方法 利用2004年北京市儿童代谢综合征调查总样本中9815名6～18岁中、小学儿童青少年男性的青春期第二性征发育数据，用单位概率回归法计算首次遗精年龄、外生殖器、阴毛、睾丸开始发育年龄。9岁前阴毛达TannerⅡ期（P2），或睾丸体积〉4mL者被定义为性早熟。结果 9815名6～18岁男性儿童青少年中城区4958人，占总样本50．5％，郊区（县）4857人，占总样本量的49．5％：北京市学龄男性首次遗精年龄为（14．4±1．2）岁，其中城区男性（14．1±1．1）岁，郊区（县）男性（14．8±1．2）岁；睾丸体积达4mL时的中位年龄总体、城区和郊区（县）分别为：（10．7±1．2）岁、（10．8±1．2）岁和（10．7±1．2）岁；阴毛开始发育（P2）中位年龄总体、城区和郊区（县）分别为：（12．2±1．1）岁、（12．0±1．1）岁和（12．4±1．1）岁。城区男性首次遗精年龄、睾丸及阴毛开始发育的年龄均早于郊区（县）男性，差异有统计学意义。依据阴毛和睾丸体积来诊断的性早熟率分别为1．92％和0．17％。结论 北京学龄男性首次遗精、睾丸及阴毛开始发育的年龄存在城区和郊区（县）差别。需要广泛开展男性青春期发育规律的研究，尽早建立适合我国儿童青少年的评价标准。

Objective To determine the current status of pubertal development and prevalence of sexual precocity among Beijing school-aged boys. Methods As part of the Beijing Child and Adolescent Metabolic Syndrome Study （BCAMS） , a crosssectional study on the presence of secondary sexual characteristics among 9 815 school-aged boys aged 6 - 18 years old was undertaken in Beijing city from April to October 2004. All participants completed a questionnaire on demographic variables. The stages of genital and pubic hair development were assessed through visual inspection using standardized drawings and descriptions based on Tanner criteria. The larger-sided testicular size was measured using Prader orchidometer and recorded in milliliters. Age at spermarche was collected by self-report. Status quo method and probit transformation analysis were used to calculate the median age at spermarche and at onset of pubic hair （ P2 ） , gentile （ G2 ） and the age at testicular volume 4 mL. Sexual precocity was defined as onset of P2 or one-sided testicular volume 4 mL before 9 years old. Results Data were analyzed for 9 815 boys,of whom 50. 5% were residing in urban areas and 49. 5 % in rural areas. Spermarche was at age of （ 14. 4 ± 1.2） years old in all boys, （ 14. 1 ± 1.1 ） years old in urban boys and （ 14. 8 ± 1.2） years old in rural boys. The median age of P2 was （ 12. 2 ± 1.2） years old for all, （ 12. 0 ± 1.2） years old for urban boys and （ 12. 4 ± 1.2） years old for rural boys. Testicular development （ ≥4 mL） was observed at age of （ 10. 7 ± 1.2） years old for all, （ 10. 8 ± 1.2） years old for urban boys and （ 10. 7 ± 1.2） years old for rural boys. The prevalence rates of sexual precocity according to pubic hair and testicular size were 1.92% and 0. 17%, respectively. Conclusions Difference of pubertal development staging between urban boys and rural boys was observed in this study. More studies on pubertal development in boys are necessary.