Department of Pediatrics, Cheng Hsin General Hospital, Taipei, Taiwan, ROC.
Department of Radiology, Cardinal Tien Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2020 Sep;83(9):870-875. doi: 10.1097/JCMA.0000000000000360.
International studies have reported an early age of onset of puberty in girls and boys. However, the current situation of puberty onset in Taiwanese children is unknown. In this study, the timing of menarche and pubertal change in testicular volume (TV) in Taiwanese children was examined, and bone age (BA) was used as an internal somatic maturity scale and compared with the chronological age (CA) at pubertal timing.
Clinical data from October 1, 2010, to March 31, 2018, were retrospectively collected from a general hospital in Taipei. The data of patients who were diagnosed with endocrine/genetic disorders were excluded. Clinical data included CA, timing of menarche, and X-ray images of TV and BA. BA was determined by a senior pediatrician and a senior pediatric radiologist. The reliability and validity of BA readings were tested. Collected data were analyzed statistically.
Overall, TV records of 241 boys and the menarche timing data of 98 girls were collected from 1823 children. CA for menarche was 11.35 ± 1.06 years (mean ± SD), and BA for menarche was 12.95 ± 0.80 years. CA and BA at TV = 15 mL in male puberty was 12.32 ± 1.22 and 13.46 ± 0.68 years, respectively. A stronger correlation was observed between TV and BA than between TV and CA during the pubertal period.
The secular trend of earlier puberty timing continues. The decline rate of menarche timing was approximately 0.43 years per decade in the past 30 years. Among boys, an advance of more than 1 year in pubertal timing age was observed over the past 20 years. BA and TV showed high correlation during puberty.
国际研究报告称，女孩和男孩的青春期开始年龄提前。然而，目前尚不清楚台湾儿童的青春期开始情况。本研究旨在探讨台湾儿童初潮和睾丸体积（TV）青春期变化的时间，并将骨龄（BA）作为内部躯体成熟度指标，与青春期时间的实际年龄（CA）进行比较。
回顾性收集 2010 年 10 月 1 日至 2018 年 3 月 31 日期间台北一家综合医院的临床数据。排除诊断为内分泌/遗传疾病的患者。临床数据包括 CA、初潮时间以及 TV 和 BA 的 X 射线图像。BA 由一名资深儿科医生和一名资深儿科放射科医生确定。测试 BA 读数的可靠性和有效性。对收集的数据进行统计学分析。
总体而言，从 1823 名儿童中收集了 241 名男孩的 TV 记录和 98 名女孩的初潮时间数据。初潮的 CA 为 11.35±1.06 岁（平均值±标准差），BA 为 12.95±0.80 岁。男性青春期 TV=15mL 时的 CA 和 BA 分别为 12.32±1.22 岁和 13.46±0.68 岁。在青春期期间，TV 与 BA 之间的相关性强于 TV 与 CA 之间的相关性。
青春期提前的趋势仍在继续。在过去的 30 年中，初潮时间的下降速度约为每 10 年 0.43 年。在过去的 20 年中，男孩的青春期开始年龄提前了 1 年以上。BA 和 TV 在青春期期间具有高度相关性。
