Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning (PGCRL), 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4, Canada; Department of Nutritional Sciences, University of Toronto, 1 King's Circle College, Toronto, Ontario, M5S 1A8, Canada.
Centre of Excellence in Women and Child Health, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.
J Adolesc. 2021 Apr;88:58-66. doi: 10.1016/j.adolescence.2021.02.002. Epub 2021 Feb 19.
Sexual development in females and males are routinely measured according to the Tanner Stages. Sparse data exist on the timing of pubertal milestones in Pakistan. To fill this gap, the age of attainment of pubertal milestones and their relationship with nutritional status was explored among children and adolescents living in the rural district of Matiari, Pakistan.
Anthropometry, nutrition biomarkers and Tanner Stage were assessed among girls aged 9.0-14.9 years (n = 723) and boys aged 10.0-15.9 years (n = 662) who were free from known disease in the rural District of Matiari, Pakistan. Median age was calculated for all Tanner Stages and menarche. Multivariable linear regressions were undertaken to determine covariates associated with the timing (age) of pubertal milestones.
Among participants living in this rural community, the median age of puberty onset for girls was 11.9 years (95%CI:10.9; 12.5) and boys was 12.3 years (95%CI:11.5; 12.9). Age at first menarche was 12.9 years (95%CI:12.1; 13.3). Undernutrition was widespread among adolescents in this community. Thirty-seven percent of females and 27.0% of males were stunted while 20.5% of females and 31.3% of males were thin. Only 8% (n = 58) of females and 12% (n = 78) of males were free from any nutrient deficiency with most adolescents having two or three nutrient deficiencies.
Undernutrition (stunting or thinness) was associated with relatively older ages for early puberty stages but not puberty completion. This may decrease the duration of the pubertal growth spurt and curtail potential catch-up growth that may occur during puberty. Efforts to decrease nutrient deficiencies, stunting and thinness beyond childhood should be made in rural Pakistan.
女性和男性的性发育通常按照 Tanner 阶段进行测量。在巴基斯坦，关于青春期里程碑的时间的数据很少。为了填补这一空白，我们在巴基斯坦马蒂阿里地区的农村地区，对儿童和青少年的青春期里程碑的出现年龄及其与营养状况的关系进行了研究。
在巴基斯坦马蒂阿里地区的农村地区，对 723 名 9.0-14.9 岁的女孩和 662 名 10.0-15.9 岁的男孩进行了人体测量学、营养生物标志物和 Tanner 阶段的评估，这些儿童和青少年没有已知疾病。计算了所有 Tanner 阶段和月经初潮的中位数年龄。采用多元线性回归来确定与青春期里程碑出现时间（年龄）相关的协变量。
在这个农村社区的参与者中，女孩青春期开始的中位数年龄为 11.9 岁（95%CI：10.9；12.5），男孩为 12.3 岁（95%CI：11.5；12.9）。初潮年龄为 12.9 岁（95%CI：12.1；13.3）。在这个社区的青少年中，营养不良现象普遍存在。37%的女孩和 27.0%的男孩发育迟缓，而 20.5%的女孩和 31.3%的男孩消瘦。只有 8%（n=58）的女孩和 12%（n=78）的男孩没有任何营养缺乏症，大多数青少年有两种或三种营养缺乏症。
营养不良（发育迟缓或消瘦）与青春期早期阶段相对较晚的年龄有关，但与青春期完成无关。这可能会缩短青春期生长突增的持续时间，并限制青春期可能发生的潜在追赶生长。在巴基斯坦农村地区，应该努力减少儿童期以后的营养缺乏、发育迟缓及消瘦。
