Associations between infant growth and pubertal onset timing in a multiethnic prospective cohort of girls.
Associations between infant growth and pubertal onset timing in a multiethnic prospective cohort of girls.
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DOI：
10.1186/s12887-022-03242-0
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发表时间：
2022-03-31
期刊：
影响因子：
2.4
通讯作者：
Kubo A
中科院分区：
文献类型：
--
作者：
Aghaee S;Quesenberry CP Jr;Deardorff J;Kushi LH;Greenspan LC;Ferrara A;Kubo A
青春期提前会增加整个生命过程中出现不良健康状况的风险。美国女孩正在经历青春期提前，但没有明确的原因。研究表明，早期生活因素，如婴儿的生长，可能会影响青春期的时间。我们评估了婴儿生长与女孩乳房发育（乳房发育）、阴毛发育（阴毛发育）和月经初潮开始之间的关系。使用了2005-11年出生于北方加州凯撒医疗机构的女孩的前瞻性队列。在出生和24个月时计算年龄别体重z评分。z分数的差异大于0.67表示快速“追赶”增长，小于-0.67表示延迟的“追赶”增长，并且在-0.67和0.67之间表示“正常”增长。使用临床医生评估的性成熟度评级（SMR）测量青春期开始，并定义为乳房初长和阴毛初长从SMR 1过渡到SMR 2 +的年龄。SMR数据收集至2020年6月。月经初潮作为次要结局进行分析。使用Weibull和改良Poisson回归模型。调整模型的潜在混杂因素。共有15,196名女孩参与了这项研究。大约30.2%的人经历了追赶式增长，25.8%的人经历了追赶式增长，44%的人正常增长。追赶性生长的女孩乳房早发育的风险增加（风险比= 1.26，95%置信区间（CI）：1.18，1.35），阴毛初长（1.38，95%CI：1.28，1.48）和初潮（<12岁，相对危险度= 1.52，95%CI：1.36，1.69）与正常生长的人相比，调整协变量后。这些关联部分由儿童体重指数介导。追赶性生长与青春期开始较晚有关。与正常生长的女孩相比，经历婴儿追赶性生长的女孩有更高的青春期提前发育的风险，这种关联部分是由儿童肥胖引起的。这些信息可能有助于临床医生监测那些处于早期发展高风险的女孩。
Early puberty increases risk of adverse health conditions throughout the life course. US girls are experiencing earlier puberty without clear reasons. Studies suggest early life factors, such as infant growth, may influence pubertal timing. We assessed the associations between infant growth and onset of breast development (thelarche), pubic hair development (pubarche), and menarche in girls. A prospective cohort of girls born at a Kaiser Permanente Northern California medical facility in 2005–11 was used. Weight-for-age z-scores were calculated at birth and 24 months. Difference in z-scores greater than 0.67 represent rapid “catch-up” growth, less than -0.67 represent delayed “catch-down” growth, and between -0.67 and 0.67 represent “normal” growth. Pubertal onset was measured using clinician-assessed sexual maturity ratings (SMRs) and defined as the age at transition from SMR 1 to SMR 2 + for both thelarche and pubarche. SMR data was collected through June 2020. Menarche was analyzed as a secondary outcome. Weibull and modified Poisson regression models were used. Models were adjusted for potential confounders. There were 15,196 girls included in the study. Approximately 30.2% experienced catch-up growth, 25.8% experienced catch-down growth, and 44% had normal growth. Girls with catch-up growth had increased risk of earlier thelarche (hazard ratio = 1.26, 95% confidence interval (CI): 1.18, 1.35), pubarche (1.38, 95% CI: 1.28, 1.48), and menarche (< 12y, relative risk = 1.52, 95% CI: 1.36, 1.69) compared to those with normal growth, after adjusting for covariates. These associations were partially mediated by childhood body mass index. Catch-down growth was associated with later pubertal onset. Girls who experience infant catch-up growth have higher risk of earlier pubertal development compared to girls with normal growth and the associations are partially explained by childhood obesity. This information may help clinicians to monitor girls who are at high risk of developing earlier.
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