目的:了解并分析儿童性早熟的相关危险因素,为预防儿童性早熟提供依据。方法:选择蚌埠医学院第一附属医院2019年7月至2020年12月收治的70例性早熟患儿作为观察组,另选同期的70例发育正常儿童作为对照组,比较两组儿童的一般资料、生长发育指标,对两组儿童膳食模式、生活情况、家庭状况进行问卷调查,使用单因素分析和多因素Logistic回归分析。结果:两组儿童性别、年龄、居住地和是否独生子女之间的比较,差异均无统计学意义(P＞0.05);观察组身高、体重、身体质量指数均大于对照组,差异均有统计学意义(P＜0.05);经单因素分析,平衡膳食模式、高热量高脂膳食模式、午睡习惯、运动时间、亮灯睡觉、课业负担、经常使用塑料制品、成人洗漱护肤品、观看情感类电视,母亲学历、职业、初潮年龄,父母关系、陪伴均与儿童性早熟有关(P＜0.05);经多因素Logistic回归分析,高热量高脂膳食模式、母亲初潮年龄小、父母关系不和睦、父母陪伴少均是儿童性早熟的危险因素(P＜0.05)。结论:儿童性早熟受多种因素影响,与高热量高脂膳食模式、母亲初潮年龄、父母关系和陪伴密切相关,应改善家庭关系,帮助儿童养成平衡膳食、午睡和运动的良好习惯,有益于儿童正常的生长发育。
Objective: To analyze the clinical risk factors of precocious puberty in children, with the purpose of providing evidence for the prevention of precocious puberty in children. Methods: A total of 70 children with precocious puberty admitted the First Affiliated Hospital of Bengbu Medical College from July 2019 to December 2020 were selected into the observation group and 70 normal children into the control group. The general information, growth and development indicators of the two groups of children were compared. A questionnaire survey was conducted on the two groups of children’s dietary patterns, living conditions, and family status. The obtained data were analyzed using univariate analysis and multivariate logistic regression analysis. Results: There were no statistically significant differences between the two groups of children in gender, age, place of residence, and whether they were the only children(P＞0.05). Height, weight, and body mass index (BMI) of the observation group were greater than those of the control group, and the differences were statistically significant (P＜0.05). Univariate analysis showed that balanced diet, high-calorie and high-fat diet, nap habits, exercise time, sleep with light on, schoolwork burden, frequently using of plastic products and adult toiletries, watching emotional TV, mother’s menarche age, mother’s education level and occupation, parental relationship, and companionship were all related to precocious puberty in children. Multivariate logistic regression analysis showed that high-calorie and high-fat dietary patterns, mothers’ menarche age, disharmony relationship between parents, and lacking of companionship were risk factors for precocious puberty in children. Conclusion: Precocious puberty in children is affected by many factors, which are closely related to the high-calorie and high-fat diet, mothers’ menarche age, parental relationship and companionship. Family relationships should be improved to help children develop a balanced diet, nap and exercise habits, which is beneficial to children’s normal growth and development.
[1] 马晓宇, 倪继红, 杨露露, 等. GnRHa治疗对特发性中枢性性早熟和快速进展型早发育儿童的远期影响[J]. 中华内分泌代谢杂志, 2020, 36(1):58-62.
[2] 朱铭强, 傅君芬, 梁黎, 等. 中国儿童青少年性发育现状研究[J]. 浙江大学学报(医学版), 2013, 42(4):396-402.
[3] Lee S, Kim G. Factors influencing the quality of life in mothers of children with precocious puberty[J]. Child Health Nurs Res, 2017, 23(3):312-318.
[4] 冼雄辉, 张龙江, 杨俏文, 等. 快速进展型中枢性性早熟女性儿童的病情随访标志物分析[J]. 中国现代医学杂志, 2018, 28(34):103-107.
[5] 李存桂, 邹德颖, 杨浩, 等. 生长激素联合促性腺激素类似物对真性性早熟女孩性激素及生长发育的影响[J]. 实用医学杂志, 2018, 34(7):1220-1221.
[6] Flom JD, Cohn BA, Tehranifar P, et al. Earlier age at menarche in girls with rapid early life growth:cohort and within sibling analyses[J]. Ann Epidemiol, 2017, 27(3):187-193.
[7] 方波, 刘琴, 杨博, 等. 男童青春期体格生长与性发育的关系[J]. 中国学校卫生, 2020, 41(6):821-823, 829.
[8] 孟凡顺, 谌丁艳, 吴宇, 等. 深圳市学龄女童膳食模式和性早熟的相关性研究[J]. 中华流行病学杂志, 2020, 41(5):738-742.
[9] Chen C, Chen Y, Zhang YT, et al. Association between dietary patterns and precocious puberty in children:a population-based study[J]. Int J Endocrinol, 2018, 16(6):1-7.
[10] Watkins AJ, Sirovica S, Stokes B, et al. Paternal low protein diet programs preimplantation embryo gene expression, fetal growth and skeletal development in mice[J]. Biochim Biophys Acta Mol Basis Dis, 2017, 1863(6):1371-1381.
[11] Landgraf K, Schuster S, Meusel A, et al. Short-term overfeeding of zebrafish with normal or high-fat diet as a model for the development of metabolically healthy versus unhealthy obesity[J]. BMC Physiol,2017,17(1):4.
[12] 冯凡, 曹卫平, 白玲, 等. 镇江市城区4~10岁儿童性早熟发育的现状调查及其危险因素分析[J]. 中国儿童保健杂志, 2018, 26(6):651-653.
[13] 蓝建芳. 学龄前儿童微量元素及营养摄入对身高体重的影响[J]. 中华全科医学, 2017, 15(2):274-274.
[14] Alrashidi AG, Ahmed HG, Alshammeri KJK, et al. Knowledge and perceptions of common breast cancer risk factors in Northern Saudi Arabia[J]. Asian Pac J Cancer Prev,2017, 18(10):2755-2761.
