膳食脂肪摄入对女童初潮影响的前瞻性研究

  目的  探讨初潮前膳食总脂肪及不同类型脂肪酸摄入对女童初潮发生的前瞻性影响，为预防中国儿童青春期发育提前提供理论依据。  方法  利用“中国居民健康与营养调查(CHNS)”数据，选取1997—2015年有初潮信息且具有基线膳食调查数据并至少参与了一次随访调查的1 240名6~13岁女童为研究对象，采用Cox回归模型分析初潮前膳食总脂肪及脂肪酸摄入对女童初潮发生的前瞻性影响。  结果  调查对象的平均基线年龄为(8.3±1.8)岁。调整出生年代、居住地、家庭人均年收入水平、膳食能量摄入量及体质量指数Z评分(BMI SDS)后，膳食总脂肪及多不饱和脂肪酸(PUFA)摄入量最高组女童出现初潮提前的风险分别比最低组高30% 和34%HR值(HR值95%CI)分别为1.30(1.01~1.68)、1.34(1.05~1.70)]；未发现膳食饱和脂肪酸(SFA)、单不饱和脂肪酸(MUFA)摄入量与初潮发生的关联HR值(HR值95%CI)分别为1.24(0.98~1.58)、1.25(0.97~1.62), P值均>0.05]。  结论  初潮前较高的膳食总脂肪及PUFA摄入可能导致女童初潮发生提前；未发现SFA及MUFA摄入与初潮发生的关联。

Prospective effect of dietary intake of fat on menarche among girls

  Objective  To explore the prospective effect of dietary intake of total fat and fatty acids on menarcheal timing among girls, and to provide a theoretical basis for preventing the early puberty development of Chinese children.  Methods  Using the data from 1997-2015 China Health and Nutrition Survey (CHNS), 1 240 girls aged 6-13 with menarche information, baseline dietary survey data and at least one follow-up assessment were selected. Cox regression analysis was performed to examine the prospective effect of dietary intake of total fat and fatty acids before menarche on age at menarche.  Results  The mean baseline age of the participants was (8.3±1.8). After adjustment for year of birth, residence, household income, dietary energy intake and body mass index Z-score at baseline, girls in the highest quartile of intake of total fat and polyunsaturated fatty acid (PUFA) had a 30% and 34% higher probability of experiencing menarche at an earlier age than those in the lowest quartile HR(HR 95%CI)=1.30 (1.01~1.68), 1.34(1.05~1.70)]. After adjusting for the confounders, there were no correlations between the intake of saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) and the onset of menarche HR(HR 95%CI)=1.24(0.98~1.58), 1.25(0.97~1.62)](P>0.05).  Conclusion  Higher dietary intake of total fat and PUFA before menarche may lead to earlier age at menarche and no correlation between intake of SFA and MUFA before menarche with age at menarche is found among Chinese girls.