EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
J Adolesc Health. 2019 Oct;65(4):558-563. doi: 10.1016/j.jadohealth.2019.05.014. Epub 2019 Jul 31.
Early timing of pubertal development is associated with worse cardiometabolic health in adulthood. We aimed to evaluate this association in 10-year-old girls and boys and clarify if it is independent of previous body mass index (BMI).
Pubertal development was evaluated through the Tanner scale in 4,548 children from the birth cohort Generation XXI. Data on anthropometrics, body composition, blood pressure, lipid profile, fasting plasma glucose, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein were collected. Bonferroni correction was applied, using an alpha of .004 for statistical significance. Regression coefficients and 99.6% confidence intervals were computed using linear regression models.
Girls with a Tanner stage ≥2 presented statistically significant higher values of BMI, waist circumference (WC), waist-to-height ratio, fat mass index, blood pressure, glucose, insulin, HOMA-IR, triglycerides, and high-sensitivity C-reactive protein and lower values of high-density lipoprotein cholesterol. Boys with a Tanner stage ≥2 presented statistically significant higher values of BMI, WC, systolic blood pressure, and HOMA-IR and lower values of high-density lipoprotein cholesterol. After adjustment, including previous BMI, a Tanner stage ≥2 remained associated with BMI z-score (girls β = .41 [.32, .50]; boys β = .10 [.01, .19]) and WC (girls β = 2.64 cm [1.86, 3.43]; boys β = .81 cm [.11, 1.51]), and only in girls with waist-to-height ratio (β = .01 [.00, .01]), fat mass index (β = .31 kg/m [.08; .54]), glucose (β = 1.59 mg/dL [.85, 2.33]), insulin (β = 1.73 μU/mL [.68, 2.78]), and HOMA-IR (β = .40 [.16, .64]).
Independently of previous BMI, preteens with early puberty already had more adiposity at age 10 years. In addition, girls had higher glucose, insulin, and HOMA-IR, which may predict a worse glucose metabolism. These preteens should be a target for public health interventions.
青春期发育的早期与成年后患心血管代谢健康状况较差有关。我们旨在评估 10 岁女孩和男孩的这种关联，并阐明其是否独立于之前的体重指数（BMI）。
通过出生队列 XXI 中的 4548 名儿童的 Tanner 量表评估青春期发育情况。收集了体格测量、身体成分、血压、血脂谱、空腹血糖、胰岛素、稳态模型评估-胰岛素抵抗（HOMA-IR）和高敏 C 反应蛋白的数据。采用 Bonferroni 校正，统计学显著性水平为.004。使用线性回归模型计算回归系数和 99.6%置信区间。
Tanner 分期≥2 的女孩的 BMI、腰围（WC）、腰高比、脂肪质量指数、血压、血糖、胰岛素、HOMA-IR、甘油三酯和高敏 C 反应蛋白值显著较高，而高密度脂蛋白胆固醇值显著较低。Tanner 分期≥2 的男孩的 BMI、WC、收缩压和 HOMA-IR 值显著较高，而高密度脂蛋白胆固醇值显著较低。调整包括之前的 BMI 后，Tanner 分期≥2 仍与 BMI z 评分相关（女孩β=.41 [.32，.50]；男孩β=.10 [.01，.19]）和 WC（女孩β= 2.64 cm [1.86，3.43]；男孩β=.81 cm [.11，1.51]），并且仅在女孩的腰高比（β=.01 [.00，.01]）、脂肪质量指数（β=.31 kg/m [.08；.54]）、血糖（β= 1.59 mg/dL [.85，2.33]）、胰岛素（β= 1.73 μU/mL [.68，2.78]）和 HOMA-IR（β=.40 [.16，.64]）中。
独立于之前的 BMI，青春期提前的青少年在 10 岁时已经有更多的肥胖。此外，女孩的血糖、胰岛素和 HOMA-IR 更高，这可能预示着葡萄糖代谢更差。这些青少年应该成为公共卫生干预的目标。
