Recent Decline in Age at Breast Development: The Copenhagen Puberty Study
Recent Decline in Age at Breast Development: The Copenhagen Puberty Study
复制标题
DOI：
10.1542/peds.2008-2491
复制
发表时间：
2009-05-01
期刊：
影响因子：
8
通讯作者：
Juul, Anders
中科院分区：
文献类型：
--
作者：
Aksglaede, Lise;Sorensen, Kaspar;Juul, Anders
OBJECTIVE.最近的出版物显示，美国女孩的乳房发育出乎意料地早，这在世界范围内引起了争论。然而，长期趋势分析往往受到不同研究人员在不同时间段和人群中进行的研究之间数据可比性差的限制。在这里，我们提出了新的欧洲数据系统地收集从同一地区和1个研究小组在最近的15年期间的开始和结束。在1991-1993年（1991年队列; n = 1100）和2006-2008年（2006年队列; n = 995）研究了5.6至20.0岁的女孩（N = 2095）。通过触诊乳腺腺体、测量身高和体重以及采血（用于雌二醇、促黄体激素和促卵泡激素）对所有女孩进行评估。估计了2组进入青春期乳房阶段2至5、阴毛阶段2至5和初潮时的年龄分布。与1991年队列（估计平均年龄：10.88岁）相比，2006年队列（估计平均年龄：9.86岁）的青春期开始时间（定义为达到乳腺腺体组织时的平均估计年龄（坦纳乳腺2+期））显著提前。在调整BMI后，差异仍然显著。1991年和2006年的估计初潮年龄分别为13.42岁和13.13岁。血清促卵泡激素和促黄体激素在任何年龄段的两个队列之间均无差异，而与1991年队列中相同年龄的女孩相比，2006年队列中8- 10岁女孩的雌二醇水平显著降低。我们发现最近出生的女孩乳房发育明显提前。生殖激素和体重指数的改变不能解释这些显著的变化，这表明可能涉及其他尚未确定的因素。儿科2009; 123：e932-e939
OBJECTIVE. Recent publications showing unexpectedly early breast development in American girls created debate worldwide. However, secular trend analyses are often limited by poor data comparability among studies performed by different researchers in different time periods and populations. Here we present new European data systematically collected from the same region and by 1 research group at the beginning and end of the recent 15-year period.METHODS. Girls (N = 2095) aged 5.6 to 20.0 years were studied in 1991-1993 (1991 cohort; n = 1100) and 2006-2008 (2006 cohort; n = 995). All girls were evaluated by palpation of glandular breast, measurement of height and weight, and blood sampling (for estradiol, luteinizing hormone, and follicle-stimulating hormone). Age distribution at entering pubertal breast stages 2 through 5, pubic hair stages 2 through 5, and menarche was estimated for the 2 cohorts.RESULTS. Onset of puberty, defined as mean estimated age at attainment of glandular breast tissue (Tanner breast stage 2+), occurred significantly earlier in the 2006 cohort (estimated mean age: 9.86 years) when compared with the 1991 cohort (estimated mean age: 10.88 years). The difference remained significant after adjustment for BMI. Estimated ages at menarche were 13.42 and 13.13 years in the 1991 and 2006 cohorts, respectively. Serum follicle-stimulating hormone and luteinizing hormone did not differ between the 2 cohorts at any age interval, whereas significantly lower estradiol levels were found in 8- to 10-year-old girls from the 2006 cohort compared with similarly aged girls from the 1991 cohort.CONCLUSIONS. We found significantly earlier breast development among girls born more recently. Alterations in reproductive hormones and BMI did not explain these marked changes, which suggests that other factors yet to be identified may be involved. Pediatrics 2009; 123: e932-e939