Ma Hua-Mei, Du Min-Lian, Luo Xiao-Ping, Chen Shao-Ke, Liu Li, Chen Rui-Min, Zhu Cheng, Xiong Feng, Li Tang, Wang Wei, Liu Ge-Li
Department of Pediatrics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Pediatrics. 2009 Aug;124(2):e269-77. doi: 10.1542/peds.2008-2638. Epub 2009 Jul 27.
To determine the current prevalence and mean ages of onset of pubertal characteristics in healthy urban Chinese girls.
A cross-sectional study of sexual maturation of healthy Chinese girls was conducted in 9 representative cities of the eastern, western, southern, and northern parts and central region of China between 2003 and 2005. At examination, stages of breast and pubic hair development were rated on girls 3 through 19.83 years of age, and height and weight were also recorded. Data on menses were collected by the status quo method. Probit analysis was used to calculate the median age and 95% confidence interval (CI) for onset of breast and pubic hair development and menarche.
Data were analyzed for 20654 apparently healthy girls. At age 8 years, 19.57% of these girls had evidence of breast development. The median ages of onset of Tanner stages 2 and 3 for breast development were 9.20 (95% CI: 9.06-9.32) years and 10.37 (95% CI: 10.28-10.45) years, respectively. The median ages of onset of Tanner stages 2 and 3 for pubic hair development were 11.16 (95% CI: 11.03-11.29) years and 12.40 (95% CI: 12.25-12.55) years, respectively. Menses occurred at 12.27 years (95% CI: 12.16-12.39).
These data suggest that urban Chinese girls are actually experiencing earlier breast development than currently used norms. The up-to-date reference for normal pubertal development in urban Chinese girls needs to be established for the purpose of determining precocious puberty or pubertal delay.
确定中国城市健康女孩青春期特征的当前患病率及平均初发年龄。
2003年至2005年期间,在中国东部、西部、南部、北部及中部地区的9个代表性城市开展了一项关于中国健康女孩性成熟的横断面研究。检查时,对3至19.83岁女孩的乳房和阴毛发育阶段进行评分,并记录身高和体重。月经数据通过现状法收集。采用概率分析计算乳房和阴毛发育及月经初潮的中位年龄和95%置信区间(CI)。
对20654名表面健康的女孩的数据进行了分析。8岁时,这些女孩中有19.57%有乳房发育迹象。乳房发育Tanner 2期和3期的中位初发年龄分别为9.20岁(95%CI:9.06 - 9.32)和10.37岁(95%CI:10.28 - 10.45)。阴毛发育Tanner 2期和3期的中位初发年龄分别为11.16岁(95%CI:11.03 - 11.29)和12.40岁(95%CI:12.25 - 12.55)。月经初潮发生在12.27岁(95%CI:12.16 - 12.39)。
这些数据表明,中国城市女孩实际上比目前使用的标准更早经历乳房发育。为了确定性早熟或青春期延迟,需要建立中国城市女孩正常青春期发育的最新参考标准。