Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland.
PLoS One. 2021 Nov 18;16(11):e0260137. doi: 10.1371/journal.pone.0260137. eCollection 2021.
Growth-based determination of pubertal onset timing would be cheap and practical. We aimed to determine this timing based on pubertal growth markers. Secondary aims were to estimate the differences in growth between cohorts and identify the role of overweight in onset timing.
This multicohort study includes data from three Finnish cohorts-the Type 1 Diabetes Prediction and Prevention (DIPP, N = 2,825) Study, the Special Turku Coronary Risk Factor Intervention Project (STRIP, N = 711), and the Boy cohort (N = 66). Children were monitored for growth and Tanner staging (except in DIPP).
The growth data were analyzed using a Super-Imposition by Translation And Rotation growth curve model, and pubertal onset analyses were run using a time-to-pubertal onset model.
The time-to-pubertal onset model used age at peak height velocity (aPHV), peak height velocity (PHV), and overweight status as covariates, with interaction between aPHV and overweight status for girls, and succeeded in determining the onset timing. Cross-validation showed a good agreement (71.0% for girls, 77.0% for boys) between the observed and predicted onset timings. Children in STRIP were taller overall (girls: 1.7 [95% CI: 0.9, 2.5] cm, boys: 1.0 [0.3, 2.2] cm) and had higher PHV values (girls: 0.13 [0.02, 0.25] cm/year, boys: 0.35 [0.21, 0.49] cm/year) than those in DIPP. Boys in the Boy cohort were taller (2.3 [0.3, 4.2] cm) compared with DIPP. Overweight girls showed pubertal onset at 1.0 [0.7, 1.4] year earlier compared with other girls. In boys, there was no such difference.
The novel modeling approach provides an opportunity to evaluate the Tanner breast/genital stage-based pubertal onset timing in cohort studies including longitudinal data on growth but lacking pubertal follow-up.
基于青春期生长标志来确定青春期启动时间既经济又实用。本研究旨在基于青春期生长标志物来确定这一时间。次要目的是估计不同队列之间的生长差异，并确定超重对启动时间的作用。
这项多队列研究包括来自三个芬兰队列的数据：1 型糖尿病预测和预防研究（DIPP，N=2825）、特殊图尔库冠状动脉危险因素干预项目（STRIP，N=711）和男孩队列（N=66）。除 DIPP 外，所有队列都对儿童的生长和 Tanner 分期进行了监测。
使用 Super-Imposition by Translation And Rotation 生长曲线模型对生长数据进行分析，并使用青春期启动模型对青春期启动分析进行运行。
青春期启动模型使用峰值身高速度（aPHV）、身高速度（PHV）和超重状态作为协变量，女孩中还包括 aPHV 和超重状态之间的相互作用，成功确定了启动时间。交叉验证显示观察到的和预测的启动时间之间有很好的一致性（女孩为 71.0%，男孩为 77.0%）。STRIP 中的儿童总体上更高（女孩：1.7[95%CI：0.9，2.5]cm，男孩：1.0[0.3，2.2]cm），PHV 值更高（女孩：0.13[0.02，0.25]cm/年，男孩：0.35[0.21，0.49]cm/年），而 DIPP 中的儿童则较低。Boy 队列中的男孩比 DIPP 中的男孩更高（2.3[0.3，4.2]cm）。超重女孩的青春期启动时间比其他女孩早 1.0[0.7，1.4]年。男孩中没有这种差异。
这种新的建模方法为评估包括纵向生长数据但缺乏青春期随访的队列研究中的基于 Tanner 乳房/生殖器阶段的青春期启动时间提供了机会。
