Zhu Mingqiang, Fu Junfen, Liang Li, Gong Cunxiu, Xiong Feng, Liu Geli, Luo Feihong, Chen Shaoke
Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2013 Jul;42(4):396-402. doi: 10.3785/j.issn.1008-9292.2013.04.005.
To survey the current status of pubertal development of Chinese children and to compare the precocious puberty prevalence of different regions.
A cross-sectional epidemiological study was conducted on 18 707 children and adolescents aged 6≊18 y with male/female ratio of 9 812/8 895 from 6 representative geographical areas in China, including Beijing, Tianjin, Hangzhou, Shanghai, Chongqing and Nanning. The height, weight, waist circumference (WC), hip circumference(HC) and sexual maturation states (Tanner stages: breast stages for girls and testicular volume for boys) of children and adolescents were measured. Probit analysis was used to calculate the median age and 95% confidence interval (CI) for onset of breast and testicular development. The prevalence of precocious puberty of different regions and BMI, waist circumference of different groups were compared.
Breast development before 8 y was observed in 2.91% of girls, and testicular volume 4 ml or more before 9 y was observed in 1.74% of boys. The median age of onset of Tanner stages 2 for breast development in girls was 9.69 y (95% CI: 9.63≊ 9.75); the median age of onset of puberty as indicated by Tanner stages 2 for testicular development in boys was 11.25 y (95%CI:11.19≊ 11.30). The prevalence of precocious puberty (43 girls and 37 boys) was 0.43% (80/18 707). The prevalence of precocious puberty in northern region was higher than that in southwest region (0.736% compared with 0.282% P<0.05). There was no difference in onset age of precocious puberty in girls among three regions; but the onset age of precocious puberty in boys was earlier in east China [(7.4±0.28)y]. The SD values of BMI and waist-to-hip ratio (W/H) in precocious puberty children were higher than those in the peer normal children. There was no difference in BMI,waist circumference and waist-to-hip ratio in the precocious puberty children among different regions.
The current diagnostic criteria of precocious puberty are suitable for the children in the survey areas. The prevalence and the onset age of precocious puberty are various in different regions. A positive association between obesity and precocious puberty is found both in boys and girls.
调查中国儿童青春期发育的现状，并比较不同地区性早熟的患病率。
对来自中国6个代表性地理区域（包括北京、天津、杭州、上海、重庆和南宁）的18707名6至18岁儿童及青少年进行横断面流行病学研究，男/女比例为9812/8895。测量儿童及青少年的身高、体重、腰围（WC）、臀围（HC）和性成熟状态（坦纳分期：女孩为乳房分期，男孩为睾丸容积）。采用概率分析计算乳房和睾丸发育开始的中位年龄及95%置信区间（CI）。比较不同地区性早熟的患病率以及不同组别的BMI、腰围。
2.91%的女孩在8岁前出现乳房发育，1.74%的男孩在9岁前睾丸容积达到4ml或更大。女孩乳房发育达坦纳2期的中位年龄为9.69岁（95%CI：9.63至9.75）；男孩睾丸发育达坦纳2期所提示的青春期开始中位年龄为11.25岁（95%CI：11.19至11.30）。性早熟的患病率为0.43%（80/18707）（43名女孩和37名男孩）。北方地区性早熟的患病率高于西南地区（0.736%比0.282%，P<0.05）。三个地区女孩性早熟的开始年龄无差异；但华东地区男孩性早熟的开始年龄较早[（7.4±0.28）岁]。性早熟儿童的BMI和腰臀比（W/H）的标准差高于同龄正常儿童。不同地区性早熟儿童的BMI、腰围和腰臀比无差异。
目前性早熟的诊断标准适用于调查地区的儿童。不同地区性早熟的患病率和开始年龄各不相同。在男孩和女孩中均发现肥胖与性早熟之间存在正相关。
