性早熟女童早期成长逆境暴露与非稳态负荷的关联

  目的  探讨性早熟女童早期成长逆境(early life adversity, ELA)与非稳态负荷(allostatic load, AL)的关联，为早期识别性早熟女童中具有ELA相关健康风险的个体提供依据。  方法  于2019年9月至2021年9月，在安徽省儿童医院儿童保健科门诊招募150名性早熟女童，采用父母问卷和儿童访谈收集基本信息和早期成长逆境经历。采集血样150份，使用4个生理系统状态的13种血液指标检测非稳态负荷相关指标。采用多元线性回归分析早期成长逆境经历与AL评分的关联。  结果  父母受教育程度低与AL总分呈正相关(β=1.02，95%CI=0.21~1.83，P=0.01);父母离婚与心血管AL评分呈正相关(β=0.65，95%CI=0.13~1.17，P=0.01)，同伴欺凌与AL总分呈负相关(β=-0.89，95%CI=-1.64~-0.14，P=0.02)。相比于无ELA经历的性早熟女童，经历过1种ELA经历的性早熟女童AL总分以及代谢系统AL评分分别增加0.75(95%CI=0.04~1.47，P=0.04)和0.67(95%CI=0.16~1.18，P=0.01)。  结论  性早熟女童早期成长逆境暴露与生理系统损耗存在关联，应重点关注报告同伴欺凌、父母受教育水平低和父母离婚的个体。

Association of early life adversity with allostatic load in girls with precocious puberty

  Objective  To explore the relationship between early life adversity (ELA) and allostatic load (AL) in girls with precocious puberty, to provide a theoretical basis for early identification of girls at risk of ELA-related disease.  Methods  From September 2019 to September 2021, 150 girls with precocious puberty were recruited in the department of child health of Anhui Provinal Children's Hospital. Parents' questionnaires and child interviews were used to collect basic information and early growth adversity experiences. Among 150 blood samples were collected, and 13 biomarkers representing 4 regulatory systems were used to detect unsteady load related indexes. Multivariate linear regression was used to analyze the correlation between early growth adversity experience and AL scores.  Results  The low education level of parents was positively correlated with the total score of AL(β=1.02, 95%CI=0.21-1.83, P=0.01). The divorce of parents was positively correlated with cardiovascular AL score(β=0.65, 95%CI=0.13-1.17, P=0.01). Peer bullying was negatively correlated with the total score of AL(β=-0.89, 95%CI=-1.64--0.14, P=0.02). Compared with girls with precocious puberty without ELA experience, the total AL score and metabolic system AL score of precocious girls who experienced one kind of ELA increased by 0.75(95%CI=0.04-1.47, P=0.04) and 0.67(95%CI=0.16-1.18, P=0.01).  Conclusion  Early-life adversity and physiological wear-and-tear are correlated in girls with precocious puberty. These findings suggest that the effects of early-life adversity might be remediated with interventions that target parental education, divorce and peer bullying.