Fan Hsien-Yu, Tsai Wan-Ling, Chien Kuo-Liong, Hsu Shih-Yuan, Huang Li, Hou Jia-Woei, Tsai Meng-Che, Yang Chen, Chen Yang-Ching
Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
Pediatr Res. 2024 Mar;95(4):1147-1152. doi: 10.1038/s41390-023-02908-4. Epub 2023 Nov 24.
Sex differences in blood pressure (BP) appear during childhood and adolescence, but the role of central precocious puberty (CPP) remains unclear. In this study, we aimed to examine the association of CPP with the risk of early hypertension and BP trajectories in girls and boys.
We analyzed trajectories of BP before and after puberty in girls aged 6-13 years (n = 305) and boys aged 10-15 years (n = 153) in the Taiwan Pubertal Longitudinal Study. The timing of puberty onset was defined as the month at which the children reached Tanner stage 2. We examined the association of CPP with the risk of early hypertension and BP trajectories before and after puberty onset.
Among boys, CPP was found to be associated with early hypertension (odds ratio, 7.45 [95% CI, 1.15-48.06]), whereas no such association was observed among girls. Boys with CPP had higher systolic BP than did those with normal puberty onset before puberty onset (mean difference, 6.51 [95% CI, 0.58-12.43]) and after puberty onset (mean difference, 8.92 [95% CI, 8.58-15.26]).
A large proportion of the higher systolic BP observed in boys with CPP compared with in those with normal puberty onset is accrued after puberty.
We examined the sex-specific association of central precocious puberty with blood pressure trajectories to better understand whether central precocious puberty was associated with early hypertension. Central precocious puberty was associated with differences in systolic blood pressure trajectories, especially after puberty onset in boys. For boys only, central precocious puberty was associated with early hypertension. A large proportion of the higher systolic blood pressure observed in boys with central precocious puberty compared with in those with normal puberty onset was accrued after puberty. Interventions targeting central precocious puberty are likely to influence systolic blood pressure in early adulthood.
血压（BP）的性别差异在儿童期和青春期出现，但中枢性性早熟（CPP）的作用仍不清楚。在本研究中，我们旨在探讨CPP与女孩和男孩早期高血压风险及血压轨迹的关联。
我们分析了台湾青春期纵向研究中6 - 13岁女孩（n = 305）和10 - 15岁男孩（n = 153）青春期前后的血压轨迹。青春期开始时间定义为儿童达到坦纳2期的月份。我们研究了CPP与青春期开始前后早期高血压风险及血压轨迹的关联。
在男孩中，发现CPP与早期高血压相关（优势比，7.45 [95%可信区间，1.15 - 48.06]），而在女孩中未观察到这种关联。患有CPP的男孩在青春期开始前收缩压高于青春期开始正常的男孩（平均差异，6.51 [95%可信区间，0.58 - 12.43]），在青春期开始后也是如此（平均差异，8.92 [95%可信区间，8.58 - 15.26]）。
与青春期开始正常的男孩相比，患有CPP的男孩中观察到的较高收缩压大部分是在青春期后积累的。
我们研究了中枢性性早熟与血压轨迹的性别特异性关联，以更好地了解中枢性性早熟是否与早期高血压相关。中枢性性早熟与收缩压轨迹差异相关，尤其是在男孩青春期开始后。仅对于男孩，中枢性性早熟与早期高血压相关。与青春期开始正常的男孩相比，患有中枢性性早熟的男孩中观察到的较高收缩压大部分是在青春期后积累的。针对中枢性性早熟的干预可能会影响成年早期的收缩压。
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