青春期启动提前与儿童肥胖类型的关联研究:基于横断面调查和队列调查

Associations between early onset of puberty and obesity types in children:Based on both the cross-sectional study and cohort study

目的:青春期启动及其提前与儿童肥胖的关联一直存在争议,本研究通过将大样本横断面调查数据与长期纵向队列数据相结合,探索并分析青春期启动提前与儿童不同肥胖类型的关联,为进一步明确青春期启动提前的健康危害和肥胖防控提供线索。方法:研究资料来源于中国7个省(自治区、直辖市)横断面调查数据和厦门市青少年青春期发育队列数据,先通过对横断面数据进行Logistic回归分析发现青春期启动与肥胖的关联,然后使用泊松回归(Poisson regression)分析青春期启动提前与各类型肥胖风险之间的关联。结果:横断面调查和队列调查研究分别纳入儿童43137人和1266人,横断面研究发现,女生青春期启动提前与单纯性肥胖、中心性肥胖和复合型肥胖均呈正相关关系,OR值(95%CI)分别为1.86(1.42~2.44)、1.95(1.65~2.32)和1.86(1.41~2.45),男生未发现显著关联。通过研究队列数据发现,在女生中,与青春期启动未提前组相比,提前组发生单纯性肥胖的风险为6.00倍[RR(95%CI):6.00(1.07~33.60)],发生中心性肥胖的风险为3.30倍[RR(95%CI):3.30(1.22~8.92)],发生复合型肥胖的风险为5.76倍[RR(95%CI):5.76(1.03~32.30)],而在男生中未发现青春期启动提前与肥胖存在关联。结论:同时基于横断面调查和纵向队列调查证实,女生青春期启动提前可能增加单纯性肥胖、中心性肥胖和复合型肥胖的发生风险,而在男生中未发现青春期启动提前与肥胖存在显著关联。

Objective:To explore and analyze the relationship between early onset of puberty and different types of obesity in children,by combining large sample cross-sectional survey data with long-term longitudinal cohort data,so as to provide clues for further clarifying the health hazards of early onset of puberty and obesity prevention and control.Methods:The research data were from the cross-sectional survey data of seven provinces(autonomous regions,municipalities)in China and the cohort data of adolescent development in Xiamen.The study first found the association between early onset of puberty and obesity by Logistic regression on the cross-sectional data,and then used Poisson regression to analyze the association between early puberty initiation and various types of obesity risk.Results:In the study,43137 and 1266 children were included in the cross-sectional survey and cohort survey respectively.The cross-sectional study found that among the girls aged 10-13 years,compared with the girls of the same age who did not start puberty,the body mass index(BMI)-Z score of the girls in the puberty start group was 0.5-0.8 higher,and the waist circumference Z score was 0.4-0.7 higher,and the risk of various types of obesity was higher.At the same time,the early onset of puberty was positively correlated with simple obesity,central obesity and compound obesity,the OR(95%CI)were 1.86(1.42-2.44),1.95(1.65-2.32)and 1.86(1.41-2.45),respectively.No significant association was found in boys.According to the cohort data,in girls,the risk of simple obesity was 6.00 times[RR(95%CI):6.00(1.07-33.60)],the risk of central obesity was 3.30 times[RR(95%CI):3.30(1.22-8.92)],and the risk of compound obesity was 5.76 times[RR(95%CI):5.76(1.03-32.30)],compared with the group without early puberty initiation,while no association between early puberty initiation and obesity was found in boys.Conclusion:Based on the cross-sectional survey and longitudinal cohort survey,it is confirmed that the early onset of puberty in girls may increase the risk of simple obesity,central obesity and compound obesity,while there is no significant correlation between puberty onset and obesity in boys.