月经初潮年龄对女性成年后近期和远期肥胖的影响

目的 探讨月经初潮年龄与女性成年后近、远期肥胖的关系。方法 以中国慢性病前瞻性研究项目苏州点2004-2008年调查的具有完整初潮与身体测量数据信息的30 895名女性为研究对象,将初潮年龄分为3组：≤ 12、13~16、≥ 17岁,其中≤ 12岁初潮年龄为过早。采用多因素logistic回归分析月经初潮年龄对女性成年后近、远期肥胖的影响。结果 调查对象月经初潮年龄为（15.64±1.92）岁,1 421人（4.6%）月经初潮过早。随着出生年代的推迟,女性月经初潮年龄有不断提前的趋势。调查对象成年后近期肥胖803人（2.6%）,远期肥胖3 738人（12.1%）。调整年龄、生活方式、高血压、糖尿病、绝经状态等因素后,月经初潮年龄过早是女性成年后发生近、远期肥胖的危险因素,OR值（95% CI）分别为2.45（1.74~3.45）和1.99（1.69~2.34）。月经初潮年龄与绝经状态对远期肥胖无相乘交互作用（P=0.324）。结论 月经初潮过早是女性成年后发生近期肥胖和远期肥胖的危险因素。     

女性月经初潮年龄与肥胖关系的研究

目的:探讨中国中老年女性中,月经初潮年龄与一般性肥胖（基于BMI）和中心性肥胖［基于腰围（WC）与腰围身高比（WHtR）］之间的关系。方法:以中国健康与养老追踪调查的6 363名中老年女性为研究对象,采用限制性立方样条分析初潮年龄与肥胖的关系类型,采用二分类logistic回归模型分析初潮年龄（分为≤13、14~、16...     

单纯性肥胖对儿童青春期发育的影响

近年来 ,儿童单纯性肥胖症的发生率有迅速增加的趋势。肥胖对儿童的生长发育和心理健康有着重要的影响 ,并与多种成人疾病关系密切。作者试图探讨单纯性肥胖对儿童生长发育、机能素质、青春期性发育以及智力发育水平的影响 ,从而预防儿童期的肥胖症 ,为提高儿童健康水平提供预见性资料。1　对象和方法1.1　对象　选择济南市 7所中小学 11～ 14岁儿童为观察对象 ,其中 30名单纯性肥胖儿童为肥胖组。肥胖度均在中度以上 (身高标准体重比≥ 130 % ) ;30名正常体重儿童为对照组(身高标准体重比 90 %～ 110 %之间 )。男女人数各半。1.2　方法　形…     

儿童期肥胖对青春初期形态发育影响的追踪观察

为探讨儿童肥胖对青春期发育的影响，对太原市2所小学8~13岁学生1679名（正常儿童940名，肥胖儿童739名）进行了连续3年的追踪观察。观察指标包括身高、坐高和胸围3项形态指标。结果表明，男女生各年龄组中，肥胖儿童的身高、坐高和胸围的发育水平均高于正常儿童（个别年龄组例外）；中重度肥胖组发育水平高于轻度肥胖组（个别年龄组例外）。说明肥胖组儿童青春初期形态发育速度明显高于正常组；3项指标年增长值的峰值增高，峰龄提前。肥胖儿童的身高坐高指数和身高胸围指数与正常儿童相比，均无差异。     

儿童肥胖对青春初期性发育影响的追踪研究

对４７８名小学生的月经初潮（首次遗精）出现率、乳房、阴毛、腋毛和睾丸体积等性发育指标进行连续３年的追踪观察。结果指出：女生各年龄组肥胖儿童月经初潮出现率高于正常组，而男生各年龄组肥胖儿童首次遗精出现率低于正常组；男生组肥胖儿童睾丸体积较正常组小，并且在１２～１３岁组与肥胖程度呈负相关；男生体征指数在１１～１４岁组与肥胖程度相关，而女生仅在１３岁组与肥胖程度相关。提示肥胖儿童青春初期性发育在女孩有提早而在男孩有落后的趋势。     

女孩月经初潮与其它发育指标的观察

女孩青春期发育的研究,同内外均有大量报道。许多资料证实,人体的形成发育、骨骼发育同性成熟相关密切,并将其归因于统一受神经、内分泌激素调控的结果。但有关研究多对时间年龄控制不够严格,又横育指标涉及较少。为此,我们选择青春发育前期基本为整周岁的子孩、兼顾长育、横育、量育的体格发育指标同月经初潮、骨龄状况进行综合观察。现将结果报告如下。1 对象与方法在哈尔滨市南岗区奋斗小学、大成小学六年级,69中学初一、初二年级发育调查基础上,选取12、13、14周岁的健康女学生为观     

血清瘦素对青春期女生月经初潮的影响

【目的】　探讨血清瘦素在女生青春期发育中的作用。　【方法】　健康女生 13 2名 ,调查月经初潮时间 ,测定血清瘦素、雌二醇、促卵泡成熟激素、黄体生成激素、胰岛素水平 ,采用多元Logistic回归模型分析女生青春期发育的影响因素 ;同时连续两年观察 ,分析血清瘦素对女生月经初潮的影响。　【结果】　末次研究已初潮组血清瘦素( 180 5 .6± 13 2 .1)pmol/L、促卵泡成熟激素 ( 5 .9± 0 .3 )lU/L、黄体生成激素水平 ( 8.9± 0 .4)IU/L、胰岛素 ( 6.8± 0 .5 )mIU /L均明显高于未来潮组 ( 12 11.1± 88.1) pmol/L、( 3 .5± 0 .3 )IU /L、( 6.4± 0 .3 )IU/L (P <0 .0 1)、( 3 .5± 0 .4)mIU /L(P <0 .0 5 ) ,雌二醇 ( 13 .7± 0 .8) pmol/L则无明显变化 ( 12 .6± 0 .7)pmol/L(P >0 .0 5 )。多因素分析显示血清瘦素 (OR =1.193 ,P <0 .0 5 )、黄体生成激素 (OR =1.2 5 3 ,P <0 .0 1)、胰岛素 (OR =1.3 18,P <0 .0 1)、体重 (OR =1.2 81,P <0 .0 1)为女生青春期发育的独立影响因素。初次资料分析 ,初潮前组血清瘦素 ( 10 3 4.9± 13 2 .1) pmol/L、黄体生成激素水平 ( 2 .9± 0 .5 )IU/L、体重 ( 2 6.8± 0 .8)kg明显高于未来潮组 ( 70 4.5± 66.0 ) pmol/L、( 1.6± 0 .3 )IU /L、( 2 3 .5± 0 .5 )kg (P     

中国青春期女生月经初潮较早与形态发育的关系

目的 探讨中国青春期女生月经初潮较早与身体形态发育的关系.方法 资料均来自2010年全国学生体质与健康调查数据,采用概率单位回归法计算月经初潮年龄的第10百分位数(P10)概率界值,将界值以前已来月经者定义为月经初潮较早(9.0～11.6岁),共筛选出初潮较早女生1072名,按城乡、年龄(精确到0.1岁)1∶2频数匹配未来潮女生2144名,并选取其身高、体重、坐高、胸围、BMI和身高坐高指数进行分析.采用t检验、wilcoxon秩和检验分析9.0～11.6岁各组中月经初潮较组与未来潮女生各项指标的差异,采用x2检验分析超重、肥胖率的差异;采用多水平模型分析月经初潮较早与各项形态指标及超重肥胖的关系.结果 纳入1072名月经初潮较早者以及2144名未来潮者.初潮较早组女生身高、坐高、胸围、体重和BMI分别为(151.42±7.46) cm、(80.86±4.21)cm、(73.88 ±7.72)cm、(44.32±9.35)kg和(19.18 ±3.03) kg/m2,未来潮组分别为(144.86±7.55)cm、(76.96±4.05)cm、(67.25±6.94) cm、(36.07 ±7.88)kg和(16.64±2.48) kg/m2,差异均有统计学意义(Z值分别为-22.20、-23.69、-24.38、-23.12、-20.17、-6.33,P值均＜0.01);多水平分析结果显示,9.0～11.6岁组月经初潮较早与各项身体形态发育指标均具有相关性(P值均＜0.05),初潮较早组女生与未来潮组比较,身高、坐高、胸围、体重和BMI分别高5.28 cm、3.37 cm、5.53 cm、6.37 kg、1.79 kg/m2;分年龄段分析,发现初潮较早组与未来潮组之间身高、坐高和体重的差异随年龄增加呈抛物线型变化趋势,胸围呈“U”形变化;9.0～10.8、10.9～11.0、11.1 ～11.2岁组初潮较早女生出现超重肥胖的风险分别是未来潮组的2.98倍(95％ CI:1.92 ～4.63)、6.76倍(95％ CI:2.79 ～16.39)、2.99倍(95％CI:1.40～6.40).结论 中国青春期女生月经初潮较早与身高、坐高、体重和胸围等生长发育指标有关,且与超重肥胖密切相关.     

肥胖对儿童少年青春期性发育影响探讨

肥胖对儿童少年青春期性发育影响探讨山东医科大学儿少卫生教研室（济南２５００１２）张亨菊山东医科大学济南临床学院内分泌科李耀烟台市芝罘区卫生防疫站学校卫生科尉建华在青春期生长发育研究中体脂的含量与性成熟的关系已引起各国学者的兴趣［１，２］，但脂肪含量与...     

The effects of phthalate and nonylphenol exposure on body size and secondary sexual characteristics during puberty

BackgroundSome phthalic acid esters (PAEs) and nonylphenol (NP) are endocrine-disrupting chemicals (EDCs) that are widely used in consumer products. Consequently, the general population is exposed simultaneously to both groups of chemicals.ObjectiveTo investigate the single- and co-exposure effects of PAEs (DMP, DEP, DnBP, DiBP, BBzP, and DEHP) and NP on obesity and pubertal maturity to compare the body sizes of general adolescents with the complainants of the phthalate-tainted foods scandal that occurred in Taiwan.MethodsThis study included 270 general adolescents aged 6.5–15.0 years and 38 complainants aged 6.5–8.5 years. Nine metabolites of the five PAEs and of NP were measured in urine. We used a questionnaire to evaluate pubertal maturity, measured anthropometric indices (APs) to assess body size, and collected urine samples to measure the two groups of chemicals.ResultsWe found that urinary PAE metabolite concentrations (specifically, metabolites of DEP, DnBP, DiBP, and DEHP) were positively associated with the APs for abdominal obesity (including skinfold thickness, waist circumference, waist-to-height ratio, and waist-to-hip) and indicated a dose–response relationship. Mono-methyl phthalate (MMP) exposure was inversely associated with pubarche among boys. The daily intake of DEHP in general adolescents exceeded the reference doses (RfD-20 μg/kg bw/day) and tolerable daily intake (TDI-50 μg/kg bw/day) by 3.4% and 0.4%, respectively. No associations were observed between NP exposure or co-exposure and the APs or pubertal maturity. No significant differences were observed between general adolescents and the complainants with regard to weight, height, or BMI.ConclusionsThe study suggests that PAE (specifically, DEP, DnBP, DiBP, and DEHP) exposure is associated with abdominal obesity in adolescents and that the APs for abdominal obesity are more sensitive than BMI for measuring obesity among adolescents. We suggest that the RfD and TDI for PAEs should be revised to provide sufficient protection.     

Declines in late-life disability: the role of early- and mid-life factors

Investigations into the reasons for declines in late-life disability have largely focused on the role of contemporaneous factors. Adopting a life-course perspective as a backdrop, in this paper we ask whether there also has been a role for selected early- and mid-life factors in the decline, and if so whether these factors have been operating through changes in the risks of disability onset or recovery. Drawing on five waves from 1995 to 2004 of the U.S. Health and Retirement Study, we found for the 75 years and older population in the United States that the prevalence of difficulty with activities of daily living (ADL) declined from 30.2% in 1995 to 26.0% in 2004, whereas the trend in difficulty with instrumental activities of daily living (IADL) was flat. Onset of ADL limitations also was reduced during this period while recovery increased. Changes in the educational composition of the older population were linked to declines in the prevalence of ADL limitations, but there were also modest contributions of changes in mother's education, self-rated childhood health, and lifetime occupation. Declines in late-life vision impairments and increases in wealth also contributed substantially to the downward trend, and had chronic conditions not increased, it would have been even larger. Reductions in the onset of ADL limitations were partly driven by changes in educational attainment of respondents and their mothers and, in late-life, better vision and wealth. In contrast, the recovery trend was not accounted for by changes in early- or mid-life factors. We conclude that early- and mid-life factors have contributed along with late-life factors to U.S. late-life disability trends mainly through their influence on the onset of, rather than recovery from, limitations.     

特发性中枢性性早熟女童乳房发育年龄与母亲初潮年龄及身高相关性研究

【目的】 探讨特发性中枢性性早熟(idiopathic central precocious puberty, ICPP)女童乳房发育年龄与母亲初潮年龄及母亲身高间的关系。 【方法】 采用回顾性调查方法,并测查身高、体重第二性征、子宫卵巢、B超及促性腺激素释放激素刺激实验,对ICPP组、单纯性乳房早发育(simple premature thelarche, SPT)组及正常对照组进行研究,并进行相关性分析。 【结果】 1)ICPP女童的母亲月经初潮年龄(11.66±1.35)岁显著低于SPT组(12.93±1.66)岁和正常对照组(14.03±0.58)岁(P＜0.01);2)ICPP女童母亲身高(154.13±3.61)cm显著低于SPT组(159.80±4.71)cm及正常对照组(159.50±2.33)cm(P＜0.01);SPT组与正常对照组比较差异无统计学意义;3)ICPP组女童的乳房开始发育年龄与母亲月经初潮年龄、母亲身高均具有显著直线正相关(P＜0.01)。 【结论】 特发性中枢性性早熟女童乳房发育年龄与母亲初潮年龄及身高关联性大;特发性中枢性性早熟女童及母亲的身材矮小与性早熟或青春期提前有关。     

女生月经初潮早发与负性生活事件的关系

目的研究月经初潮早发与负性生活事件的关系,为采取干预措施和健康教育提供理论依据。方法在无锡市市区调查26所小学四、五年级学生3 865名,筛选出192名初潮早发女生(初潮年龄<11岁),采用1∶2配对的对比研究方法,对192例初潮早发女孩及对照女孩进行问卷调查。结果单因素分析显示,两组间10项负性生活事件中有9项差异有统计学意义,其中考试失败或不理想、感到受人歧视或冷遇、经常与同学发生纠纷、预期评选(如三好学生)落空、感到升学压力大等均进入多因素模型。结论女性月经初潮早发与负性生活事件有关。     

Impact of weight loss on Health-Related Quality of Life

To examine the effect of treatment-induced weight loss on Health-Related Quality of Life (HRQL), 38 mildly-to-moderately overweight persons recruited to participate in a study to examine the efficacy of a lifestyle modification treatment program completed a sociodemographic questionnaire, the Beck Depression Inventory (BDI), the Medical Outcomes Study Short-Form Health Survey (SF-36, as an assessment of HRQL), and underwent a series of clinical evaluations prior to treatment. After baseline evaluations, participants were randomly assigned to either a program of lifestyle physical activity or a program of traditional aerobic activity. Participants again completed the SF-36 and BDI after the 13-week treatment program had ended. Weight loss averaged 8.6 ± 2.8 kg over the 13-week study. We found that weight loss was associated with significantly higher scores (enhanced HRQL), relative to baseline, on the physical functioning, role-physical, general health, vitality and mental health domains of the SF-36. The largest improvements were with respect to the vitality, general health perception and role-physical domains. There were no significant differences between the lifestyle and aerobic activity groups on any of the study measures. These data indicate that, at least in the short-term, weight loss appears to profoundly enhance HRQL.     

肥胖对小学生健康相关生活质量的影响

目的:探讨肥胖对小学生健康相关生活质量的影响。方法:采用儿科健康相关生活质量普适性核心量表4.0(Pediatric Quality of Life InventoryTM Version4.0,PedsQLTM4.0)调查广州市778名小学生的健康相关生活质量,通过测量身高、体重,计算体重指数进行营养状况的分类。结果:正常体重、超重和肥胖儿童分别为396人、38人和69人。协方差分析表明,肥胖组角色功能评分(xd±sx)较正常体重组降低(5.71±2.08)分(P<0.05)。肥胖组躯体、情感和社交功能评分与正常体重组及超重组间的差异均无统计学意义(P>0.05),仅在后2个维度的评分呈下降趋势。结论:肥胖儿童的健康相关生活质量中角色功能评分低于正常体重儿童。     

The multidimensional relationship between early adult body weight and women's childbearing experiences

This study has three primary goals that make an important contribution to the literature on body weight and childbearing experiences among United States' women. It sheds light on the physiological and social nature of this relationship by examining whether the consequences of early adult weight for lifetime childbearing are shaped by historical social context, women's social characteristics, and their ability to marry. We analyze data from two female cohorts who participated in the National Longitudinal Study of Youth (NLSY79). Cohort 1 entered early adulthood before the U.S. obesity prevalence increased. Cohort 2 entered early adulthood after the obesity prevalence increased. We find that early adult weight is negatively related to the childbearing trajectories and marital status of Cohort 1 but not Cohort 2. Failing to account for race/ethnicity and women's educational background as confounders masks some of these associations, which are evident for both White and Black women. Our results suggest that the health consequences of body weight do not fully drive its impact on childbearing. Rather, the lifetime fertility consequences of early adult weight are malleable, involve social processes, and are dependent on social context.     

孕前BMI和妊娠期糖尿病对儿童脂肪重积聚时相提前的独立和联合效应

目的 探讨孕前BMI、妊娠期糖尿病（GDM）与儿童脂肪重积聚（AR）时相提前的关联。方法 基于已经建立的马鞍山优生优育队列，本研究共纳入2 896对母子对，收集孕妇孕前身高、体重、24~28周GDM情况，在婴儿42天、3月龄、6月龄、9月龄以及1岁后每6个月进行1次随访，连续追踪随访至6岁，获得其身长/高、体重等资料。采用多因素logistic回归分析孕前BMI、GDM与儿童AR时相提前的关联强度，并通过相乘、相加模型分析孕前BMI及GDM对于儿童AR时相提前的发生是否存在交互作用。结果 母亲孕前体重不足、体重正常、超重和肥胖者分别占23.2%（672例）、66.4%（1 923例）、8.7%（251例）和1.7%（50例）；GDM患病率为12.4%。儿童AR年龄为（4.38±1.08）岁，AR时相提前的儿童占39.3%。多因素logistic回归结果显示，孕前超重（OR=1.67，95%CI：1.27~2.19）、肥胖（OR=3.05，95%CI：1.66~5.56）以及孕期患有GDM（OR=1.40，95%CI：1.11~1.76）是AR时相提前发生的危险因素，而孕前体重不足（OR=0.60，95%CI：0.49~0.73）是AR时相提前发生的保护因素。与仅孕前超重/肥胖或孕期患有GDM相比，孕前超重/肥胖与孕期患有GDM并存，AR时相提前的发生风险更高，OR值（95%CI）分别为2.03（1.20~3.44）、3.43（1.06~11.12）。相乘模型和相加模型分析显示，孕前BMI和孕期患有GDM对儿童AR时相提前无交互作用。结论 母亲孕前较高的BMI和孕期患有GDM是儿童AR时相提前发生的独立危险因素，两者并存的风险更高，但无统计学交互作用。