Earlier onset of puberty in girls: Relation to increased body mass index and race
Earlier onset of puberty in girls: Relation to increased body mass index and race
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DOI：
10.1542/peds.108.2.347
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发表时间：
2001-08-01
期刊：
影响因子：
8
通讯作者：
Herman-Giddens, ME
中科院分区：
文献类型：
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作者：
Kaplowitz, PB;Slora, EJ;Herman-Giddens, ME
Objective.办公室环境儿科研究网络最近进行的一项研究提供了证据，表明美国女孩，特别是黑人女孩，比早期研究发现的更早开始青春期，但原因尚不清楚。由于营养状况已知会影响青春期的时间，并且在过去的25年中，美国儿童的肥胖症有明显的增加趋势，因此假设青春期的提前可能归因于年轻女孩肥胖症的患病率增加。因此，本研究的目的是通过比较乳房或阴毛发育的女孩与仍处于青春期前的女孩的年龄标准化体重指数（BMI-ZS;肥胖的粗略估计），重新检查办公室设置青春期数据的儿科研究，观察年龄和种族的影响。对于白色女孩，BMI-ZS在青春期明显高于青春期前6- 9岁的孩子;对于黑人女孩，差异较小，仅对9岁的孩子有意义。与既没有阴毛也没有乳房发育的女孩相比，有阴毛但没有乳房发育的女孩的BMI-ZS也更高。多变量分析证实，肥胖（以BMI测量）与白色女孩的青春期提前显著相关，与黑人女孩的青春期提前也相关，但程度较轻。研究结果与肥胖是导致女孩青春期提前的一个重要因素相一致。然而，肥胖以外的因素，可能是遗传和/或环境因素，需要解释黑人女孩比白色女孩青春期提前的患病率更高。
Objective. A recent study conducted by the Pediatric Research in Office Settings network provided evidence that girls in the United States, especially black girls, are starting puberty at a younger age than earlier studies had found, but the reasons for this are not known. Because nutritional status is known to affect timing of puberty and there is a clear trend for increasing obesity in US children during the past 25 years, it was hypothesized that the earlier onset of puberty could be attributable to the increasing prevalence of obesity in young girls. Therefore, the objective of this study was to reexamine the Pediatric Research in Office Settings puberty data by comparing the age-normalized body mass index (BMI-ZS; a crude estimate of fatness) of girls who had breast or pubic hair development versus those who were still prepubertal, looking at the effects of age and race.Results. For white girls, the BMI-ZS were markedly higher in pubertal versus prepubertal 6- to 9-year-olds; for black girls, a smaller difference was seen, which was significant only for 9-year-olds. Higher BMI-ZS also were found in girls who had pubic hair but no breast development versus girls who had neither pubic hair nor breast development. A multivariate analysis confirms that obesity (as measured by BMI) is significantly associated with early puberty in white girls and is associated with early puberty in black girls as well, but to a lesser extent.Conclusions. The results are consistent with obesity's being an important contributing factor to the earlier onset of puberty in girls. Factors other than obesity, however, perhaps genetic and/or environmental ones, are needed to explain the higher prevalence of early puberty in black versus white girls.