男性青春期体格发育和性征发育的关系研究

Relationship of physical growth and sexual characteristics for males at puberty

目的探讨男性青春期体格发育和性征发育的关系,为制定青春期分时相生长标准提供依据。方法利用2004年北京市青春期发育调查样本中9 767名6-19岁男性儿童的体格发育和性征发育数据。比较分析阴毛和睾丸发育不同Tanner分期和青春期不同发育时相身高、体重增长的变化规律。结果 1）已遗精组身高、体重均高于未遗精组,在11-16岁两组间差异随年龄呈缩小趋势。2）与不分发育分期的生长规律相比,在PH1或TV〈4mL,身高、体重在11-13岁均明显偏低,在PH2、PH3或4mL≤TV〈20mL,身高、体重均有先高后低的现象,在PH4、PH5或TV≥20mL,身高、体重基本上略微偏高。3）青春期不同发育时相身高、体重的变化规律亦不同于不分发育时相的变化情况,正常人群中,青春前期有部分人身高偏矮、体重偏低,青春中期及青春后期有部分人身高偏高、体重偏重。4）基于青春期分时相的身高、体重P3或P97基本上仍处在不分时相的P1或P99之内。结论基于阴毛和睾丸不同发育分期将青春期划分为青春前期、中期、后期3个发育时相对建立青春期分时相生长标准具有重要价值。采用不分发育时相的年龄别标准进行生长评价时可按性发育时相下调或上调一个主要百分位线粗略校正性发育对身高、体重的影响。

Objective To describe the relationship between physical growth and sex characteristics for males at pu-berty in order to add to the mounting evidence for the development of growth charts based on puberty phases. MethodsData about physical growth and sexual development of 9 767 school-aged males at age 6-19 years were obtained from part of the Beijing Child and Adolescent Metabolic Syndrome Study conducted in 2004. General characteristics of height andweight gains were compared and analyze based on the different Tanner stages of pubic hair and testicular volume and the dif-ferent phases of puberty,respectiwdy. Results 1） Height is taller and weight heavier in spermatorrhea adolescents thanno-spermatorrhea, showing a narrowing trend in difference of the two groups from the age of 11 to 16 years. 2）Comparingwith the growth pattern without developmental stages, both height and weight are significantly lower at age 11 - 13 years instage of PH1 or TV-4 mL,following a cross with higher then lower in stages of PH2,PH3 or 4 mLTV-20 mL,andslightly higher in stages of P H4, Plt5 or TV-20 mL. 3） The growth patterns of height and weight at different puberty pha-ses are different from those of ignoring puberty phases. Height is shorter and weight lighter for some of normal population atpre-puberty, and taller and heavier trends are observed among another of normal population at in-puberty and completing pu-berty. 4） P3 and P97 percentiles of height and weight based on different puberty phases do not shift cross corresponding P1and P99 percentiles based on ignoring puberty phase,respectively. Conclusions The classification method of pre-puberty,in puberty and completing puberty based on pubic hair and testicular volume is useful to construct the growth references ofpuberty phases. Shifting up or down a major empirical percentile may be helpful to adjust the effect of sex development onheight and weight when using conventional growth chart for age to assess growth level of adolescents.