Euling Susan Y, Herman-Giddens Marcia E, Lee Peter A, Selevan Sherry G, Juul Anders, Sørensen Thorkild I A, Dunkel Leo, Himes John H, Teilmann Grete, Swan Shanna H
National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Washington, DC 20460, USA.
Pediatrics. 2008 Feb;121 Suppl 3:S172-91. doi: 10.1542/peds.2007-1813D.
Whether children, especially girls, are entering and progressing through puberty earlier today than in the mid-1900s has been debated. Secular trend analysis, based on available data, is limited by data comparability among studies in different populations, in different periods of time, and using different methods. As a result, conclusions from data comparisons have not been consistent. An expert panel was asked to evaluate the weight of evidence for whether the data, collected from 1940 to 1994, are sufficient to suggest or establish a secular trend in the timing of puberty markers in US boys or girls. A majority of the panelists agreed that data are sufficient to suggest a trend toward an earlier breast development onset and menarche in girls but not for other female pubertal markers. A minority of panelists concluded that the current data on girls' puberty timing for any marker are insufficient. Almost all panelists concluded, on the basis of few studies and reliability issues of some male puberty markers, that current data for boys are insufficient to evaluate secular trends in male pubertal development. The panel agreed that altered puberty timing should be considered an adverse effect, although the magnitude of change considered adverse was not assessed. The panel recommended (1) additional analyses of existing puberty-timing data to examine secular trends and trends in the temporal sequence of pubertal events; (2) the development of biomarkers for pubertal timing and methods to discriminate fat versus breast tissue, and (3) establishment of cohorts to examine pubertal markers longitudinally within the same individuals.
如今儿童,尤其是女孩,进入青春期以及在青春期发育进程是否比20世纪中叶更早,一直存在争议。基于现有数据的长期趋势分析受到不同人群、不同时间段以及不同方法研究的数据可比性的限制。因此,数据比较得出的结论并不一致。一个专家小组被要求评估从1940年到1994年收集的数据是否足以表明或确定美国男孩或女孩青春期标志出现时间的长期趋势。大多数小组成员一致认为,数据足以表明女孩乳房发育开始和月经初潮有提前的趋势,但其他女性青春期标志则不然。少数小组成员得出结论,目前关于女孩任何青春期标志时间的数据都不足。几乎所有小组成员基于少数研究以及一些男性青春期标志的可靠性问题得出结论,目前关于男孩的数据不足以评估男性青春期发育的长期趋势。该小组一致认为,青春期时间的改变应被视为一种不良影响,尽管未评估被视为不良的变化幅度。该小组建议:(1) 对现有的青春期时间数据进行额外分析,以研究长期趋势以及青春期事件时间顺序的趋势;(2) 开发用于青春期时间的生物标志物以及区分脂肪组织和乳房组织的方法;(3) 建立队列,对同一批个体的青春期标志进行纵向研究。