文献快报(2):女童月经初潮提前可能是童年期创伤经历精神病理症状风险的预警症状

正生命早期应激(early life stress, ELA)会增加精神病理症状风险,但发生机制尚不清楚。Colich等提出2种ELA维度:威胁和剥夺,并试图探讨青春期发育加速在联结不同维度ELA与青少年精神病理症状发生风险关联中的作用。笔者基于美国国家共病调查——青少年补充调查(National Comorbidity Survey Adolescence Supplement, NCS-A),选取全国代表性的4 937名青少年女童,     

女童月经初潮提前可能是童年期创伤经历精神病理症状风险的预警症状

正生命早期应激(early life stress,ELA)增加精神病理症状风险,但发生机制尚不清楚。Colich等提出2种ELA维度:威胁和剥夺,并试图探讨青春期发育加速在联结不同维度ELA与青少年精神病理症状发生风险关联中的作用。笔者基于美国国家共病调查——青少年补充调查(National Comorbidity Survey Adolescence Supplement,NCS-A),选取全国代表性的     

蒙古族地区1951年至2005年间出生的汉族和蒙古族女性月经初潮年龄变化趋势研究

目的研究中国蒙古族地区1951年至2005年期间出生的汉族和蒙古族女性月经初潮年龄的变化及趋势。方法通过横断面整群抽样调查方法, 在规范调查流程和质量控制标准下, 于2003年至2019年在通辽地区的3个旗县对16～46岁汉族及蒙古族女性人群进行回顾性调查, 获得1951年至2005年55年间出生女性月经初潮年龄的基础数据, 以每年、每5年、每10年为节点, 分析其变化情况及规律。结果本研究共完成46 928例(汉族24 450例, 蒙古族22 478例)的调查, 调查有效率为96.09%(46 928/48 836)。1951年至2005年55年间出生女性月经初潮发生年龄逐渐提前;平均月经初潮年龄, 在以每年为节点的分析中, 汉族和蒙古族分别由1951年的(16.22±0.52)岁和(15.86±1.24)岁变化为2005年的(12.37±1.15)岁和(12.33±0.98)岁, 分别提前3.85岁和3.54岁(平均每年分别提前0.84个月和0.77个月), 变化趋势表现出与年代呈显著负相关(均P<0.000 1);在以每5年为节点的分析中, 汉族和蒙古族分别由1951年至1...     

文献快报(2):跨文化背景数据未发现父爱缺失与青春期发育提前的关联

本文回顾了关于父爱缺失和青春期发育提前的实证研究,试图阐明二者间真实关联。自1982年人类学家Draper和Harpending博士首次提出早期生活环境影响个体生殖发育进程后,很多学者在此基础上提出了多种假说,包括"心理社会加速"假说和"父亲投资"假说。2014年。Webster等通过分析33个研究样本,提出父爱缺失与女童月经初潮提前的显著关联,在学术界影响巨大。然而研究样本多来自"WEIRD(Western/Educated/Industrilized/Rich/Democratic)"家庭,即西方、受教育、工业化、高收入和民主人群,而非早期生育集中的经济弱势群体,结论不具代表性。     

文献快报(9):创伤经历的发生时间预测女童不同类型精神病理障碍

正青春期前后神经发育可塑性增加,这一时期发生的应激或创伤会对心理健康产生长远的影响。美国宾夕法尼亚州立大学Marshall博士利用美国国家共病复测调查——青少年补充样本(National Comorbidity Survey Replication-Adolescent Supplement),探讨创伤经历发生时间(相对于青春期的早晚),对不同类型精神病理障碍的预测效应,包括创伤后应激综合征(posttraumatic stress disorder,PTSD)、抑郁障碍和焦虑障碍。2 899名女性青少年的精神病理症状用WHO复合性国际诊断访谈表     

Earlier age at menarche in girls with rapid early life growth: cohort and within sibling analyses

PurposeThe purpose of the article was to examine the association of early life growth with age at menarche.MethodsUsing data from a prospective birth cohort (n = 1134 women, 290 sibling sets), we assessed the association between postnatal growth at 4 months, 1 year, and 4 years and age at menarche, using generalized estimating equations and generalized linear random effects models.ResultsOverall, 18% of the cohort experienced early menarche (<12 years). After accounting for postnatal growth in length, faster postnatal change in weight (per 10-percentile increase) in all three periods was associated with an increase (range 9%–20%) in the likelihood of having an early menarche. In adjusted linear models, faster weight gains in infancy and childhood were associated with an average age at menarche that was 1.1–1.3 months earlier compared with stable growth. The overall results were consistent for percentile and conditional growth models. Girls who experienced rapid growth (defined as increasing across two major Centers for Disease Control and Prevention growth percentiles) in early infancy had an average age at menarche that was 4.6 months earlier than girls whose growth was stable.ConclusionsFaster postnatal weight gains in infancy and early childhood before the age of 4 years are associated with earlier age at menarche.     

女生月经初潮年龄与家庭环境因素相关性分析

目的了解女生月经初潮年龄与家庭环境因素的关系,为采取干预措施和健康教育提供理论依据。方法整群抽取无锡市普通中小学四至六年级、初中一年级已来潮女生3 122名,进行月经初潮年龄及家庭情况的问卷调查。结果该地区女生月经初潮平均年龄为12.20岁,家庭经济收入、父母文化程度、家庭矛盾性、情感表达、亲密度为影响月经初潮的主要因素。结论女生月经初潮年龄与家庭环境因素密切相关。应加强对儿童及家长的健康教育,改善不良家庭关系,创造良好家庭氛围。     

Relation of childhood diet and body size to menarche and adolescent growth in girls

Adolescent growth and development may be affected by factors such as dietary intake and body size from much earlier in childhood. In a longitudinal study of 67 Caucasian girls in Boston, Massachusetts, data were collected prospectively from birth during the 1930s and 1940s. Heights and weights were measured semiannually, and dietary history interviews were conducted with mothers. Stepwise linear regression methods were used to seek factors which best predicted age at menarche, adolescent peak height growth velocity, and the age at which peak growth velocity occurred. Girls who consumed more (energy-adjusted) animal protein and less vegetable protein at ages 3-5 years had earlier menarche, and girls aged 1-2 years with higher dietary fat intakes and girls aged 6-8 years with higher animal protein intakes became adolescents with earlier peak growth. Controlling for body size, girls who consumed more calories and animal protein 2 years before peak growth had higher peak growth velocity. These findings may have implications regarding adult diseases whose risks are associated with adolescent growth and development factors.     

中国女童初潮年龄与碳水化合物及膳食纤维摄入的关系

目的 探索中国女童初潮前碳水化合物及膳食纤维摄入与初潮年龄的关系,为预防儿童性早熟提供有效干预措施.方法 由中国健康与营养调查数据库获取750名中国女童初潮前膳食信息及初潮年龄,建立多元线性回归及逻辑回归模型,分析女童初潮前膳食碳水化合物及膳食纤维摄入量对初潮年龄的影响,以碳水化合物供能比替代碳水化合物摄人量进行敏感性...     

福建省女生月经初潮年龄变化趋势及与体质的关系

目的了解福建省女生月经初潮的发生现状及其变化规律。探讨月经初潮与形态、机能、素质的关系，为青春期健康教育工作提供依据。方法以分层整群抽样法，对7～18岁3847名女生进行现状调查，采用概率单位回归法计算月经初潮平均年龄（MMA）。结果女生月经初潮平均年龄为12．5岁，城乡月经初潮年龄差异有统计学意义（P〈0、05）。女生形态指标（身高、体质量、胸围、坐高）、维尔维克指数、劳累尔指数、肺活量，均为来潮组明显大于未来潮组，两组差异均有统计学意义（P〈0．01）。马氏躯干腿长指数则表现为未来潮组高于来潮组，差异有统计学意义（P〈0．05）。结论福建省学生月经初潮平均年龄提前趋势依然存在。形态发育、机能指标与青春期发育有密切关系。     

A prospective study of childhood social hardships and age at menarche

PurposeTo determine the role of type, timing, and cumulative childhood hardships on age at menarche in a prospective cohort study.MethodsA longitudinal analysis was undertaken of 4524 female participants of the National Child Development Study cohort (1958–2003). Six types of childhood hardships were identified with a factor analysis methodology. Paternal absence/low involvement in childhood was an a priori hardship. Retrospective reports of abuse in childhood also were explored in relation to age at menarche. Generalized logit regression analyses explored the impact of type, timing, and cumulative hardships on age at menarche (≤11, 12–13, ≥14 years).ResultsCumulative childhood hardships were associated with a graded increase in risk for later menarche with adjusted odds ratio [AOR] of 1.37 (95% confidence interval [95% CI], 1.10–1.70), 1.50 (95% CI, 1.18–1.91), and 1.58 (95% CI, 1.29–1.92) among those with two, three, and four or more adversities, respectively. More than two hardships in early life had the strongest association with late menarche (AOR, 2.32; 95% CI, 1.12–4.80). Sexual abuse was most strongly associated with early menarche (AOR, 2.60; 95% CI, 1.40–4.81).ConclusionsCumulative childhood hardships increased risk for later age at menarche. Child abuse was associated with both early and late menarche, although associations varied by type of abuse.     

汉族女生月经初潮年龄BMI最佳临界值研究

目的应用受试者工作特征ROC曲线分析BMI、体重曲线下面积,探讨女性月经初潮BMI的最佳临界值。方法采用分层整群抽样方法,对无锡市10～14岁7 300名汉族女生进行问卷调查,了解月经初潮年龄及身高、体重。绘制ROC曲线,观察曲线下面积,计算BMI、体重最佳临界值的灵敏度和特异度。结果女生月经来潮率为40.45%(2 953/7 300),月经初潮平均年龄为12.26岁;不同年龄组已潮组和未潮组女生体重、BMI差异均有统计学意义(P值均<0.05)。BMI、体重的ROC曲线下面积分别为0.68和0.73;不同年龄组女生体重有不同的最佳临界值,但不同年龄组BMI最佳临界值趋于一致。结论 BMI最佳临界值对预测是否来潮有重要的应用价值,但其效果有待在实际应用中加以进一步验证。     

Serum PBDEs and age at menarche in adolescent girls: analysis of the National Health and Nutrition Examination Survey 2003-2004

Background

Polybrominated diphenyl ethers (PBDEs), widely used as flame retardants since the 1970s, have exhibited endocrine disruption in experimental studies. Tetra- to hexa-BDE congeners are estrogenic, while hepta-BDE and 6-OH-BDE-47 are antiestrogenic. Most PBDEs also have antiandrogenic activity. It is not clear, however, whether PBDEs affect human reproduction.

Objectives

The analysis was designed to investigate the potential endocrine disruption of PBDEs on the age at menarche in adolescent girls.

Methods

We analyzed the data from a sample of 271 adolescent girls (age 12–19 years) in the National Health and Nutrition Examination Survey (NHANES), 2003–2004. We estimated the associations between individual and total serum BDEs (BDE-28, -47, -99, -100, -153, and -154, lipid adjusted) and mean age at menarche. We also calculated the risk ratios (RRs) and 95% confidence intervals (CI) for menarche prior to age 12 years in relation to PBDE exposure.

Results

The median total serum BDE concentration was 44.7 ng/g lipid. Higher serum PBDE concentrations were associated with slightly earlier ages at menarche. Each natural log unit of total BDEs was related to a change of −0.10 (95% CI: −0.33, 0.13) years of age at menarche and a RR of 1.60 (95% CI: 1.12, 2.28) for experiencing menarche before 12 years of age, after adjustment for potential confounders.

Conclusion

These data suggest high concentrations of serum PBDEs during adolescence are associated with a younger age of menarche.     

重庆某区青春期女生月经来潮及其对生活质量的影响

了解月经来潮对女生生活质量的影响,为改善女生生活质量提供依据.方法 采用自编基本情况问卷、青春期生活质量量表,对分层整群抽取的8所中小学校1 690名女生进行问卷调查.结果 在控制混杂因素年龄的情况下,月经来潮对生活质量有影响(F=5.36,P=0.020);月经来潮组女生生活质量在生理维度、社会维度均低于月经未来潮组(F值分别为6.10,11.13,P值均<0.05).视年龄为协变量的偏相关分析发现,月经来潮时间与生活质量得分相关性无统计学意义(r=-0.01,P=0.79);健康教育、主动了解健康信息、能通过父母了解健康信息与月经来潮组生活质量呈正相关(β值分别为0.12,0.13,0.12,P值均<0.05);而与月经未来潮组的相关性无统计学意义(P值均>0.05).结论 月经来潮会降低青春期女生的生活质量,建议有针对性地加强该人群健康干预.