School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
College of Medical Informatics, Chongqing Medical University, Chongqing, China.
Front Public Health. 2023 Feb 8;11:1025778. doi: 10.3389/fpubh.2023.1025778. eCollection 2023.
This study aims to explore the influence of the trajectory of obesity indicators on the onset age of different pubertal development characteristics and pubertal tempo among girls.
Our longitudinal cohort study recruited 734 girls at baseline in May 2014 from a district of Chongqing and followed them at 6-month intervals. Data were available from baseline to the 14th follow-up with a full record of height, weight, waist circumference (WC), breast development, pubic hair, and armpit hair development, as well as the age of menarche. The Group-Based Trajectory Model (GBTM) was fitted for the optimum trajectory of the body mass index (BMI), WC, and waist-to-height ratio (WHtR) of girls before the pubertal onset and menarche. The ANOVA and multiple linear regression model were conducted to analyze the influence of the trajectory of obesity indicators on the onset age of different pubertal development characteristics and pubertal tempo in girls.
Compared with the healthy (gradual BMI increase) group before pubertal onset, the overweight (persistent BMI increase) group has an earlier onset age of breast development (B: -0.331, 95%CI: -0.515, -0.147) and pubic hair development (B: -0.341, 95%CI: -0.546, -0.136). The B2-B5 development time was shorter in girls in the overweight (persistent BMI increase) group (B: -0.568, 95%CI: -0.831, -0.305) and the obese (rapid BMI increase) group (B: -0.328, 95%CI: -0.524, -0.132). The age of menarche was earlier, and the B2-B5 development time was shorter in girls in the overweight (persistent BMI increase) group than in girls in the healthy (gradual BMI increase) group before menarche (B: -0.276, 95%CI: -0.406, -0.146; B: -0.263, 95%CI: -0.403, -0.123). Girls with high WC (rapid WC increase) before menarche had an earlier age of menarche than normal WC (gradual WC increase) (B: -0.154, 95%CI: -0.301, -0.006), and the B2-B5 development time was shorter in girls in the overweight (gradual WHtR increase) group than in girls in the healthy (persistent WHtR increase) (B: -0.278, 95%CI: -0.529, -0.027) group.
Among girls, overweight and obesity (BMI scale) before pubertal onset can not only influence pubertal onset age but also accelerate B2-B5 pubertal tempo. Overweight (BMI scale) and high WC before menarche also have an impact on the age of menarche. Overweight (WHtR scale) before menarche is significantly associated with B2-B5 pubertal tempo.
本研究旨在探讨肥胖指标轨迹对女孩不同青春期发育特征和青春期速度的起始年龄的影响。
我们的纵向队列研究于 2014 年 5 月在重庆的一个区招募了 734 名基线期的女孩，并每隔 6 个月进行一次随访。从基线到第 14 次随访均有身高、体重、腰围（WC）、乳房发育、阴毛和腋毛发育以及初潮年龄的完整记录。对女孩青春期前和初潮时 BMI、WC 和腰高比（WHtR）的最佳轨迹进行了基于群组的轨迹模型（GBTM）拟合。采用方差分析和多元线性回归模型分析肥胖指标轨迹对女孩不同青春期发育特征和青春期速度起始年龄的影响。
与青春期前健康（BMI 逐渐增加）组相比，超重（BMI 持续增加）组女孩乳房发育（B：-0.331，95%CI：-0.515，-0.147）和阴毛发育（B：-0.341，95%CI：-0.546，-0.136）的起始年龄更早。超重（BMI 持续增加）组（B：-0.568，95%CI：-0.831，-0.305）和肥胖（BMI 快速增加）组（B：-0.328，95%CI：-0.524，-0.132）女孩的 B2-B5 发育时间更短。超重（BMI 持续增加）组女孩初潮年龄更早，B2-B5 发育时间更短（B：-0.276，95%CI：-0.406，-0.146；B：-0.263，95%CI：-0.403，-0.123）。初潮前 WC 较高（WC 快速增加）的女孩初潮年龄早于正常 WC（WC 逐渐增加）（B：-0.154，95%CI：-0.301，-0.006），超重（WHtR 逐渐增加）组女孩的 B2-B5 发育时间短于健康（WHtR 持续增加）组（B：-0.278，95%CI：-0.529，-0.027）。
在女孩中，青春期前超重和肥胖（BMI 标准）不仅会影响青春期起始年龄，还会加速 B2-B5 青春期速度。初潮前超重（BMI 标准）和高 WC 也会对初潮年龄产生影响。初潮前超重（WHtR 标准）与 B2-B5 青春期速度显著相关。
