苏州市中小学生不同类型肥胖与青春发动时相的关联

Association between different types of obesity and puberty timing in primary and secondary school students in Suzhou City

目的探讨儿童青少年不同类型肥胖与青春发动时相的关联,为控制肥胖和改善青春期发育提供线索。方法于2022年10—11月,采用分层整群随机抽样方法从苏州市4所小学和4所初中共抽取2009名学生,使用标准化问卷收集学生基本信息、饮食、运动行为、户外活动、睡眠、视屏情况和青春期发育状况等,测量学生身高、体重和腰围,利用Logistic回归分析不同类型肥胖与青春发动时相的关联。结果苏州市中小学女生月经初潮中位年龄为11.64岁,男生首次遗精中位年龄为14.43岁。调整协变量后,Logistic回归分析结果显示,在女生中,超重组和单纯性肥胖、中心型肥胖、混合型肥胖组与青春期启动均呈正相关[OR值(95%CI)分别为3.20(1.63~6.29),4.15(2.18~7.91),2.70(1.52~4.79)和2.42(1.23~4.76)],与青春发动时相提前均呈正相关[OR值(95%CI)分别为2.41(1.54~3.75),2.46(1.55~3.90),1.59(1.05~2.40)和1.72(1.06~2.81)],超重组和单纯性肥胖、中心型肥胖组与青春发动时相延迟呈负相关[OR值(95%CI)分别为0.45(0.24~0.85),0.48(0.25~0.92)和0.44(0.24~0.80)](P值均<0.05)。在男生中,超重肥胖与青春期启动、青春发动时相的关联均无统计学意义(P值均>0.05)。结论儿童青少年不同类型肥胖与青春期启动和青春发动时相的关联存在性别差异。应采取干预措施控制儿童青少年肥胖,尤其是女童,进而改善其青春期发育。

Objective To explore the association between obesity types and puberty timing,in order to provide clues for healthy development in children and adolescents.Methods From October to November 2022,a stratified cluster random sampling method was used to select a total of 2009 students from 4 primary schools and 4 middle schools in Suzhou City.The basic information,diet,exercise behaviors,outdoor activities,sleep,view screen and pubertal development of students were collected through standardized questionnaires.Height,weight and waist circumference were measured.The association between different types of obesity and pubertal development was analyzed using Logistic regression model.Results The median age of menarche for girls in primary and middle schools in Suzhou was 11.64 years old,the median age of first spermatorrhea in boys was 14.43 years old.After adjusting the covariates,the Logistic regression analysis results showed that overweight and simple obesity,central obesity,and mixed obesity groups were positively correlated with puberty onset among girls[OR(95%CI)=3.20(1.63-6.29),4.15(2.18-7.91),2.70(1.52-4.79),2.42(1.23-4.76)],as well as early puberty onset[OR(95%CI)=2.41(1.54-3.75),2.46(1.55-3.90),1.59(1.05-2.40),1.72(1.06-2.81)](P<0.05).The overweight,simple obesity and central obesity group were negatively correlated with delayed onset of puberty[OR(95%CI)=0.45(0.24-0.85),0.48(0.25-0.92),0.44(0.24-0.80),respectively](P<0.05).There was no statistically significant association between overweight and obesity among boys and the onset and phase of puberty(P>0.05).Conclusions There are gender differences in the association between different types of obesity and the onset and timing of puberty among children and adolescents.Intervention measures should be taken to control obesity in children and adolescents,especially in girls,in order to improve their adolescent development.