Schubert Christine M, Chumlea William Cameron, Kulin Howard E, Lee Peter A, Himes John H, Sun Shumei S
Department of Community Health, School of Medicine, Wright State University, Dayton, Ohio, USA.
J Adolesc Health. 2005 Nov;37(5):356-62. doi: 10.1016/j.jadohealth.2005.03.009.
This study investigates the extent to which discordant Tanner stages for sexual maturity indicators are associated with weight and body mass index (BMI) and their variation during adolescence. Discordant children with large differences in weight and BMI may require additional monitoring of their growth during adolescence.
Weight, BMI and Tanner stages, pubic hair in each gender, breast development in girls and genital development in boys, from 2103 boys and 2104 girls aged 8-18 years (average age 13.34 years) from the National Health and Nutrition Examination Survey III (NHANES III, 1988-1994) were analyzed. These cross-sectional data were grouped as concordant: assessed stages for paired indicators were equivalent, or as discordant: assessed stage for one paired indicator was greater or less than the other by one or more stages. Weight and BMI were compared separately by gender and race between concordant and discordant groups using analysis of covariance adjusted for age.
Approximately 65-69% of all children were concordant, genital stage equaled pubic hair stage for boys and breast stage equaled pubic hair stage for girls. For all three racial groups, boys whose genital stage was more advanced than their pubic hair stage had significantly smaller weight and BMI (p<.05) than either concordant boys or boys whose pubic hair stage was more advanced than their genital stage. For all three racial groups, girls whose breast stage was more advanced than their pubic hair stage had significantly greater weight and BMI than girls whose pubic hair stage was more advanced than breast stage. Non-Hispanic black and Mexican-American girls whose breast stage was more advanced than their pubic hair stage had significantly greater weight and BMI that the respective concordant girls.
Substantial and significant differences occur in weight and BMI among discordant and concordant children, and these differences are larger than between early and late maturing children.
本研究调查了性成熟指标的坦纳分期不一致与体重和体重指数（BMI）及其在青春期变化之间的关联程度。体重和BMI差异较大的分期不一致儿童在青春期可能需要额外的生长监测。
分析了来自第三次全国健康和营养检查调查（NHANES III，1988 - 1994）的2103名8 - 18岁男孩（平均年龄13.34岁）和2104名女孩（平均年龄13.34岁）的体重、BMI和坦纳分期，包括各性别的阴毛、女孩的乳房发育和男孩的生殖器发育。这些横断面数据分为一致组：配对指标的评估分期相等；或不一致组：一个配对指标的评估分期比另一个高或低一个或多个分期。使用经年龄调整的协方差分析，按性别和种族分别比较一致组和不一致组之间的体重和BMI。
所有儿童中约65 - 69%分期一致，男孩生殖器分期等于阴毛分期，女孩乳房分期等于阴毛分期。对于所有三个种族群体，生殖器分期比阴毛分期更高级的男孩，其体重和BMI显著低于一致组男孩或阴毛分期比生殖器分期更高级的男孩（p <.05）。对于所有三个种族群体，乳房分期比阴毛分期更高级的女孩，其体重和BMI显著高于阴毛分期比乳房分期更高级的女孩。乳房分期比阴毛分期更高级的非西班牙裔黑人和墨西哥裔美国女孩，其体重和BMI显著高于各自的一致组女孩。
分期不一致和一致的儿童在体重和BMI方面存在显著差异，且这些差异大于早熟和晚熟儿童之间的差异。
