Am J Epidemiol. 2021 May 4;190(5):766-778. doi: 10.1093/aje/kwaa240.
Earlier pubertal development is only partially explained by childhood body mass index; the role of other factors, such as childhood infections, is less understood. Using data from the LEGACY Girls Study (North America, 2011-2016), we prospectively examined the associations between childhood viral infections (cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) 1, HSV2) and pubertal timing. We measured exposures based on seropositivity in premenarcheal girls (n = 490). Breast and pubic hair development were classified based on mother-reported Tanner Stage (TS) (TS2+ compared with TS1), adjusting for age, body mass index, and sociodemographic factors. The average age at first blood draw was 9.8 years (standard deviation, 1.9 years). The prevalences were 31% CMV+, 37% EBV+, 14% HSV1+, 0.4% HSV2+, and 16% for both CMV+/EBV+ coinfection. CMV+ infection without coinfection was associated with developing breasts an average of 7 months earlier (hazard ratio (HR) = 2.12, 95% confidence interval (CI): 1.32, 3.40). CMV infection without coinfection and HSV1 and/or HSV2 infection were associated with developing pubic hair 9 months later (HR = 0.41, 95% CI: 0.24, 0.71, and HR = 0.42, 95% CI: 0.22, 0.81, respectively). Infection was not associated with menarche. If replicated in larger cohorts with blood collection prior to any breast development, this study supports the hypothesis that childhood infections might play a role in altering pubertal timing.
青春期发育提前仅部分由儿童时期的体重指数解释；其他因素的作用，如儿童感染，了解较少。利用来自 LEGACY 女孩研究（北美，2011-2016）的数据，我们前瞻性地检查了儿童时期病毒感染（巨细胞病毒（CMV）、EB 病毒（EBV）、单纯疱疹病毒 1 型（HSV1）、单纯疱疹病毒 2 型（HSV2））与青春期开始时间之间的关联。我们根据青春期前女孩的血清阳性检测（n=490）来测量暴露情况。根据母亲报告的坦纳分期（TS）（TS2+比 TS1）来对乳房和阴毛发育进行分类，同时调整年龄、体重指数和社会人口因素。首次采血的平均年龄为 9.8 岁（标准差为 1.9 岁）。CMV+的患病率为 31%，EBV+为 37%，HSV1+为 14%，HSV2+为 0.4%，CMV+/EBV+合并感染为 16%。无合并感染的 CMV+感染与乳房发育提前平均 7 个月相关（危险比（HR）=2.12，95%置信区间（CI）：1.32，3.40）。无合并感染的 CMV 感染和 HSV1 和/或 HSV2 感染与阴毛发育推迟 9 个月相关（HR=0.41，95%CI：0.24，0.71 和 HR=0.42，95%CI：0.22，0.81）。感染与月经初潮无关。如果在更大的队列中复制，在任何乳房发育之前采集血液样本，这项研究支持了这样一种假设，即儿童感染可能在改变青春期开始时间方面发挥作用。
