目的探讨童年期不良经历与青春发动时相提前的关联及其可能的性别差异。方法以安徽省某九年一贯制小学3~5年级自愿参加的男女生为研究对象,进行问卷调查、体格和第二性征发育(男生睾丸容积和女生乳房)检查。问卷调查主要包括童年期不良经历和视频时间、体力活动情况。青春发动时相提前的判定标准按“中国儿童青春期发育研究协作组”建立的中国儿童青少年青春期发育里程碑事件年龄界值。结果共调查1744名8.2~12.2岁学生,其中男生957人,女生787人。男生青春发动时相提前检出率为7.5%,女生为14.6%,差异有统计学意义(X2=11.671,P〈0.001)。报告家庭不良事件的男生,其青春发动时相提前检出率较高;报告躯体虐待经历的女生,其青春发动时相提前检出率也较高。多因素logistic回归分析表明,家庭不良事件是男生青春发动时相提前的危险因素(OR=2.531,95%CI:1.276~5.020),躯体虐待经历是女生青春发动时相提前的危险因素(OR=2.453,95%CI:1.588-3.788)。结论躯体虐待和家庭不良事件均与青春发育提前有关,但该关联的本质及其性别差异尚需纵向研究进一步阐明。
Objective To explore the association of adverse childhood events with early puberty timing and possible gender differences. Methods Data was gathered through questionnaires, physical and secondary sexual characteristics, examination with breast stage in girls and testicular volume in boys measured under informed consent among children in grade 3 to grade 5 from a large- scale primary school. Information regarding adverse childhood experiences (ACEs), time of screening and physical activity was included in the questionnaire. Age limits on secondary sexual characteristics for defining early puberty established under the "China Puberty Research Collaboration Project" were used to classify early puberty timing. Body mass index was calculated and used to classify both overweight and obesity, in each gender. Results Among the 1744 children aged 8.2-12.2 years old (957 boys), the prevalence rates of early puberty timing among boys and girls were 7.5% and 14.6%, respectively, with gender differences (x2= 11.671, P〈 0.001 ). Boys who reported having experienced serious adverse family events and girls with physical abuse were more likely to develop early puberty. Results from multivariate logistic regression analysis showed that family life events were associated with a higher risk of early puberty timing in boys (odds ratio: 2.531,95% CI: 1.276-5.020) while experience related to physical abuse appeared a risk factor of early puberty timing in girls (odds ratio: 2.453,95% CI: 1.588-3.788). Conclusion Physical abuse and adverse family life events seemed to be associated with early puberty timing, suggesting further longitudinal study should be carried out to understand the nature of these findings and gender differences.