School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China.
BMC Pediatr. 2023 May 1;23(1):207. doi: 10.1186/s12887-023-04013-1.
Recently the prevalence of precocious puberty development is increasing among Chinese children. Proper understanding of the risk factors for precocious puberty in children is pivotal as could help to improve children's health. This study aims to evaluate the effect of environmental factors on precocious puberty in children.
We matched the cases and controls by age at the ratio of 1:1 (201 cases and 201 controls) for girls and 1:4 (24 cases and 96 controls) for boys. We used conditional logistic regression to explore the effect of environmental factors on precocious puberty, and a random forest model to identify the most important risk factor.
In the multivariate regression, cesarean section (OR = 1.99, 95% CI: 1.05, 3.76), child body mass index [BMI] (OR = 1.25, 95% CI: 1.10, 1.43), maternal BMI (OR = 1.13, 95%CI: 1.01, 1.26), and exposure to secondhand smoke several times a month but less than once a week (OR = 4.09, 95%CI: 1.79,9.35), and almost every day (OR = 6.48, 95% CI: 2.14, 19.56) were risk factors for precocious puberty in girls. While maternal height (OR = 0.82, 95% CI: 0.75, 0.88), paternal height (OR = 0.91, 95% CI: 0.85, 0.98), bedtime at night (OR = 0.30, 95% CI: 0.17, 0.51), and night sleep (OR = 0.43, 95% CI: 0.21, 0.86) were protective factors. In boys, only exposure to secondhand smoke several times a month but less than once a week (OR = 7.94, 95% CI: 1.25, 50.33) was a risk factor for precocious puberty. In the random forest model, Child BMI was the most important risk factor for precocious puberty in girls.
Our findings suggest that environmental factors were associated with precocious puberty in children, particularly in girls.
最近,中国儿童性早熟的发病率呈上升趋势。正确认识儿童性早熟的危险因素对于改善儿童健康至关重要。本研究旨在评估环境因素对儿童性早熟的影响。
我们按照年龄 1:1(女孩 201 例,对照组 201 例;男孩 1:4,病例 24 例,对照组 96 例)进行病例对照匹配。采用条件 logistic 回归分析探讨环境因素对性早熟的影响,采用随机森林模型识别最重要的危险因素。
在多变量回归中,剖宫产(OR=1.99,95%CI:1.05,3.76)、儿童体重指数(OR=1.25,95%CI:1.10,1.43)、母亲体重指数(OR=1.13,95%CI:1.01,1.26)、每月接触二手烟数次但每周不到一次(OR=4.09,95%CI:1.79,9.35)和几乎每天(OR=6.48,95%CI:2.14,19.56)是女孩性早熟的危险因素。而母亲身高(OR=0.82,95%CI:0.75,0.88)、父亲身高(OR=0.91,95%CI:0.85,0.98)、夜间入睡时间(OR=0.30,95%CI:0.17,0.51)和夜间睡眠时间(OR=0.43,95%CI:0.21,0.86)是保护性因素。在男孩中,只有每月接触二手烟数次但每周不到一次(OR=7.94,95%CI:1.25,50.33)是性早熟的危险因素。在随机森林模型中,儿童 BMI 是女孩性早熟的最重要危险因素。
我们的研究结果表明,环境因素与儿童性早熟有关,尤其是在女孩中。