■本研究旨在使用全国人群数据调查快速体重增加(RWG)对中央性早熟(CPP)发生率的影响。
从2007年至2010年,共有253,967名儿童(101,841名男孩和152,126名女孩)接受了国家健康保险服务机构的定期健康咨询,男孩随访至10岁,女孩随访至9岁。我们使用lambda-mu-sigma方法计算了从4-6个月到9-12个月(婴儿期)以及从9-12个月到18-24个月或30-36个月(学步期)的体重Z得分差异。将人群细分为四组:RWGinf/tod(婴儿期>0.67标准偏差评分[SDS],蹒跚学步>0SDS),RWGinf(婴儿期>+0.67SDS,蹒跚学步<0SDS),RWGtod(蹒跚学步>+0.67SDS),和控制(无RWG)。CPP的诊断基于国际疾病分类第10次修订版的诊断代码和促性腺激素释放激素激动剂的处方。使用Kaplan-Meier生存曲线分析基于年龄的CPP累积风险,RWG组与CPP之间的相关性采用多因素logistic回归分析.
■在268名男孩和9,225名女孩中诊断出CPP。对于女孩们来说,对照组无CPP概率最高,紧随其后的是RWGtod,RWGinf,和RWGinf/tod组(对数秩p<0.001)。然而,男孩的CPP发生率没有显著差异.与对照组相比,其他组的女孩CPP风险较高(RWGinf/tod:调整后的比值比[aOR]1.35,95%,置信区间[95%CI]1.13-1.62;RWGinf:aOR1.25,95%CI1.13-1.38;和RWGtod:aOR1.18,95%CI1.09-1.28)。
■这项全国性的基于人群的研究表明,从出生到3岁的任何RWG都会增加女孩的CPP风险,而男孩则没有。在婴儿期和幼儿时期经历RWG的女孩患CPP的风险最高。这些发现表明,早期发现和适当管理早期体重过度增加对于预防女孩的CPP可能很重要。
UNASSIGNED: This
study aimed to investigate the effect of rapid weight gain (RWG) on the incidence of central precocious puberty (CPP) using nationwide population-based data.
UNASSIGNED: A total of 253,967 children (101,841 boys and 152,126 girls) who underwent regular health consultations under the National Health Insurance Service from 2007 to 2010 were followed up until the age of 10 years for boys and 9 years for girls. We calculated differences in the weight Z-scores from 4-6 months to 9-12 months (infancy) and from 9-12 months to 18-24 months or 30-36 months (
toddlerhood) using the lambda-mu-sigma method. The population was subdivided into four groups: RWGinf/tod (infancy > + 0.67 standard deviation score [SDS], toddlerhood > 0 SDS), RWGinf (infancy > + 0.67 SDS,
toddlerhood < 0 SDS), RWGtod (
toddlerhood > + 0.67 SDS), and control (no RWG). The diagnosis of CPP was based on the diagnostic codes of the International Classification of Diseases 10th revision and the prescription of gonadotropin-releasing hormone agonists. The cumulative risk of CPP based on age was analyzed using Kaplan-Meier survival curves, and the association between the RWG groups and CPP was assessed using multivariate logistic regression analysis.
UNASSIGNED: CPP was diagnosed in 268 boys and 9,225 girls. For the girls, the CPP-free probability was the highest in the control group, followed by the RWGtod, RWGinf, and RWGinf/tod groups (log-rank p < 0.001). However, the incidence of CPP did not vary significantly for the boys. Compared to the control group, the other groups had a higher risk of CPP in girls (RWGinf/tod: adjusted odds ratio [aOR] 1.35, 95%, confidence interval [95% CI] 1.13-1.62; RWGinf: aOR 1.25, 95% CI 1.13-1.38; and RWGtod: aOR 1.18, 95% CI 1.09-1.28).
UNASSIGNED: This nationwide population-based
study demonstrated that any RWG from birth to 3 years of age contributed to an increased risk of CPP in girls but not in boys. Girls who experienced RWG during both infancy and
toddlerhood had the highest risk of developing CPP. These findings suggest that early detection and appropriate management of excessive weight gain in early life may be important for preventing CPP in girls.