福建地区女童特发性中枢性性早熟危险因素分析

Risk factors for idiopathic central precocious puberty of girls in Fujian province

目的 探讨福建地区女童特发性中枢性性早熟（ICPP）发生的主要危险因素.方法 采用病例-对照研究,选择2011年10月至2013年10月在福建省福州儿童医院内分泌科确诊为ICPP的女童566例以及来源于体检中心的健康女童547例作为研究对象,对儿童的饮食情况、行为方面、父母及家庭情况进行问卷调查,并对相关因素进行Logistic回归分析.结果 单因素分析发现23个变量差异有统计学意义.Logistic回归分析,最终进入模型的变量：母亲初潮年龄＞13岁（B=-1.28,SE =0.17,Wald=59.82,OR=0.278,95％CI：0.201 ～0.384,P＜0.001）、摄入有机水果（B=-1.15,SE=0.36,Wald=10.51,OR=0.316,95％ CI：0.157～0.634,P=0.001）、每天运动时间（B=-0.50,SE=0.11,Wald=19.74,OR=0.609,95％ CI：0.490 ～0.758,P＜0.001）、普通蔬菜（B=0.24,SE=0.08,Wald=9.79,OR=1.275,95％ CI：1.095 ～1.485,P=0.002）、普通家畜（B =0.31,SE =0.07,Wald=22.35,OR=1.364,95％ CI：1.199 ～1.551,P＜0.001）、体质量指数（B =0.47,SE=0.08,Wald=33.74,OR=1.599,95％ CI：1.365 ～1.874,P＜0.001）、父母月收入总和（B=0.51,SE =0.12,Wald=17.89,OR=1.671,95％CI：1.317 ～2.120,P＜0.001）、自觉课业负担沉重（B=0.60,SE=0.25,Wald=5.87,OR=1.818,95％ CI：1.121～2.948,P=0.015）、各种方便食品（快食面）（B=1.10,SE =0.45,Wald=5.96,OR=2.990,95％ CI：1.241～7.203,P=0.015）、服用营养品（B=1.32,SE=0.30,Wald=18.93,OR=3.736,95％ CI：2.063～6.765,P＜0.001）、经常使用成人洗漱护肤品（B=1.67,SE=0.25,Wald =44.5,OR=5.284,95％CI：3.240～8.618,P＜0.001）.其中母亲初潮年龄＞13岁、摄入有机水果、每天运动时间长是ICPP的保护因素,其他均为ICPP的危险因素.结论 福建地区女童ICPP相关因素众多,其发病与母亲初潮年龄、饮食行为习惯、体质量指数、家庭经济状况及学习压力相关.

Objective To investigate the potential risk factors for idiopathic central precocious puberty（ICPP） in girls of Fujian province.Methods Case-control study was conducted in 566 girls who were diagnosed with ICPP at endocrinology department and 547 healthy girls for routine physical examination at Fuzhou Children＇s Hospital of Fujian from Oct.2011 to Oct.2013.Parents were asked to fulfill the questionnaires including children＇s diets,behaviors,parents and family conditions,and Logistic regression analysis was conducted for detecting risk factors.Results Chi square test showed that 23 variables had significantly statistical difference.Logistic regression analysis indicated that some variables were included in the final model：mother＇s age at menarche older than 13 years（B =-1.28,SE =0.17,Wald =59.82,OR =0.278,95 % CI：0.201-0.384,P 〈 0.001）,organic fruits intake （B =-1.15,SE =0.36,Wald =10.51,OR =0.316,95% CI：0.157-0.634,P =0.001）,daily exercise time（B =-0.50,SE =0.11,Wald =19.74,OR =0.609,95% CI：0.490-0.758,P 〈 0.001）,ordinary vegetables intake （B =0.24,SE =0.08,Wald =9.79,OR =1.275,95 % CI：1.095-1.485,P =0.002）,general livestock intake （B =0.31,SE =0.07,Wald =22.35,OR =1.364,95 % CI：1.199-1.551,P 〈 0.001）,body mass index （B =0.47,SE =0.08,Wald =33.74,OR =1.599,95 % CI：1.365-1.874,P 〈 0.001）,income of parents （B =0.51,SE =0.12,Wald =17.89,OR =1.671,95 % CI：1.317-2.120,P 〈 0.001）,heavy study burden （B =0.60,SE =0.25,Wald =5.87,OR =1.818,95 % CI：1.121-2.948,P =0.015）,instant food intake （B =1.10,SE =0.45,Wald =5.96,OR =2.990,95 % CI：1.241-7.203,P =0.015）,nourishment intake （B =1.32,SE =0.30,Wald =18.93,OR =3.736,95 % CI：2.063-6.765,P 〈 0.001）,and adult cosmetics use （B =1.67,SE =0.25,Wald =44.5,OR =5.284,95 % CI：3.240-8.618,P 〈 0.001）.Among the varia bles,factors like mother＇s age at menarche older than 13 years,more organic fruit intake and long-time exercise were found to be the protective factors from ICPP,and others were risk factors for ICPP.Conclusions There were many factors related to ICPP in girls of Fujian province,such as mother＇s age at menarche,diet and behaviors,body mass index,parental income,and heavy study burden.