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北京大学学报（医学版） ›› 2022, Vol. 54 ›› Issue (5): 961-970. doi: 10.19723/j.issn.1671-167X.2022.05.025

• 论著 • 上一篇    下一篇

青春期启动提前与儿童肥胖类型的关联研究: 基于横断面调查和队列调查

马涛1,李艳辉1,陈曼曼1,马莹1,高迪1,陈力1,马奇1,张奕1,刘婕妤1,王鑫鑫2,董彦会1,马军1,*()   

  1. 1. 北京大学公共卫生学院, 北京大学儿童青少年卫生研究所, 北京 100191
    2. 宁夏医科大学公共卫生与管理学院, 银川 750004
  • 收稿日期:2022-06-13 出版日期:2022-10-18 发布日期:2022-10-14
  • 通讯作者: 马军 E-mail:majunt@bjmu.edu.cn
  • 作者简介:马军，北京大学儿童青少年卫生研究所所长，北京大学长聘教授，博士生导师；主要从事儿童青少年生长发育及其影响因素、成年期疾病早期预防及学校卫生管理等方面的研究，主持和参与了包括GB 40070—2021《儿童青少年学习用品近视防控卫生要求》在内的17项全国儿童青少年健康相关标准的制定，出版教学书籍13部。现任中国疾病预防控制中心学校/儿少卫生中心主任，国家卫生健康标准委员会学校卫生专业委员会主任委员，中华预防医学会儿少卫生分会主任委员，全国公共卫生与预防医学名词编写委员会儿少与学校卫生名词编写与审定委员会主任，全国学生体质与健康调研组副组长，教育部首届全国中小学健康教育教学指导委员会主任委员等社会工作和学术兼职，并曾受邀作为健康中国行动专家咨询委员会首批委员、国家儿童青少年视力健康管理专家咨询委员会委员，为儿童青少年卫生促进工作提供政策支持。承担包括卫生行业科研专项、国家自然科学基金、国家卫生健康委员会和教育委托科研项目等80余项，作为第一作者或通信作者发表论文300余篇，包括BMJ、Circulation、Lancet Diabetes and Endocrinology、Lancet Global Health、JAMA Pediatrics等国际顶尖学术期刊，曾先后获得宋庆龄儿科医学奖和中华预防医学会科学技术奖一等奖和三等奖等，研究成果在儿童青少年卫生领域产生了重要影响
  • 基金资助:
    国家自然科学基金(81673192);卫生部卫生行业科研专项(201202010)

Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study

Tao MA1,Yan-hui LI1,Man-man CHEN1,Ying MA1,Di GAO1,Li CHEN1,Qi MA1,Yi ZHANG1,Jie-yu LIU1,Xin-xin WANG2,Yan-hui DONG1,Jun MA1,*()   

  1. 1. Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
    2. School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China
  • Received:2022-06-13 Online:2022-10-18 Published:2022-10-14
  • Contact: Jun MA E-mail:majunt@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(81673192);the Research Special Fund for Public Welfare Industry of Health of the Ministry of Health of China(201202010)

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摘要：

目的: 青春期启动及其提前与儿童肥胖的关联一直存在争议，本研究通过将大样本横断面调查数据与长期纵向队列数据相结合，探索并分析青春期启动提前与儿童不同肥胖类型的关联，为进一步明确青春期启动提前的健康危害和肥胖防控提供线索。方法: 研究资料来源于中国7个省(自治区、直辖市)横断面调查数据和厦门市青少年青春期发育队列数据，先通过对横断面数据进行Logistic回归分析发现青春期启动与肥胖的关联，然后使用泊松回归(Poisson regression)分析青春期启动提前与各类型肥胖风险之间的关联。结果: 横断面调查和队列调查研究分别纳入儿童43 137人和1 266人，横断面研究发现，女生青春期启动提前与单纯性肥胖、中心性肥胖和复合型肥胖均呈正相关关系，OR值(95%CI)分别为1.86(1.42~2.44)、1.95(1.65~2.32)和1.86(1.41~2.45)，男生未发现显著关联。通过研究队列数据发现，在女生中，与青春期启动未提前组相比，提前组发生单纯性肥胖的风险为6.00倍[RR (95%CI)：6.00 (1.07~33.60)]，发生中心性肥胖的风险为3.30倍[RR (95%CI)：3.30 (1.22~8.92)]，发生复合型肥胖的风险为5.76倍[RR (95%CI)：5.76 (1.03~32.30)]，而在男生中未发现青春期启动提前与肥胖存在关联。结论: 同时基于横断面调查和纵向队列调查证实，女生青春期启动提前可能增加单纯性肥胖、中心性肥胖和复合型肥胖的发生风险，而在男生中未发现青春期启动提前与肥胖存在显著关联。

关键词: 儿童肥胖, 青春期,  , 横断面研究, 队列研究

Abstract:

Objective: To explore and analyze the relationship between early onset of puberty and different types of obesity in children, by combining large sample cross-sectional survey data with long-term longitudinal cohort data, so as to provide clues for further clarifying the health hazards of early onset of puberty and obesity prevention and control. Methods: The research data were from the cross-sectional survey data of seven provinces(autonomous regions, municipalities) in China and the cohort data of adolescent development in Xiamen. The study first found the association between early onset of puberty and obesity by Logistic regression on the cross-sectional data, and then used Poisson regression to analyze the association between early puberty initiation and various types of obesity risk. Results: In the study, 43 137 and 1 266 children were included in the cross-sectional survey and cohort survey respectively. The cross-sectional study found that among the girls aged 10-13 years, compared with the girls of the same age who did not start puberty, the body mass index (BMI)-Z score of the girls in the puberty start group was 0.5-0.8 higher, and the waist circumference Z score was 0.4-0.7 higher, and the risk of various types of obesity was higher. At the same time, the early onset of puberty was positively correlated with simple obesity, central obesity and compound obesity, the OR (95%CI) were 1.86 (1.42-2.44), 1.95 (1.65-2.32) and 1.86 (1.41-2.45), respectively. No significant association was found in boys. According to the cohort data, in girls, the risk of simple obesity was 6.00 times [RR (95%CI): 6.00 (1.07-33.60)], the risk of central obesity was 3.30 times [RR (95%CI): 3.30 (1.22-8.92)], and the risk of compound obesity was 5.76 times [RR (95%CI): 5.76 (1.03-32.30)], compared with the group without early puberty initiation, while no association between early puberty initiation and obesity was found in boys. Conclusion: Based on the cross-sectional survey and longitudinal cohort survey, it is confirmed that the early onset of puberty in girls may increase the risk of simple obesity, central obesity and compound obesity, while there is no significant correlation between puberty onset and obesity in boys.

Key words: Pediatric obesity, Puberty, Children, Cross-sectional studies, Cohort studies

中图分类号: 

  • R723.14

图1

本研究技术路线图"

表1

研究对象基本情况"

Subjects Cross-sectional data of seven provinces (autonomous regions, municipalities) in China Last follow-up data of Xiamen cohort
Boys Girls P value Boys Girls P value
Sample size, n (%) 21 094 (48.9) 22 043 (51.1) 613 (48.4) 653 (51.6)
Age group, n (%) < 0.001 < 0.001
  6-12 years 13 206 (62.6) 12 710 (57.7) 456 (74.4) 651 (99.7)
  13-15 years 5 093 (24.1) 5 965 (27.1) 157 (25.6) 2 (0.3)
  16-18 years 2 795 (13.3) 3 368 (15.3)
Residence area, n (%) < 0.001
  Urban 11 446 (54.3) 12 935 (58.7) 613 (48.4) 653 (51.6)
  Rural 9 648 (45.7) 9 108 (41.3)
Simple obesity, n (%) < 0.001 126 (20.5) 27 (4.1) < 0.001
  Yes 16 064 (76.6) 16 719 (76.3) 487 (79.4) 626 (95.9)
  No 3 370 (16.0) 1 910 (8.7)
Central obesity, n (%) 0.369 < 0.001
  Yes 17 971 (85.3) 20 210 (91.8) 173 (28.2) 54 (8.3)
  No 4 896 (23.4) 5 201 (23.7) 440 (71.8) 599 (91.7)
Compound obesity, n (%) < 0.001 < 0.001
  Yes 0 (0) 10 908 (49.5) 120 (19.6) 26 (4.0)
  No 3 094 (14.7) 1 816 (8.2) 493 (80.4) 627 (96.0)
Puberty onset, n (%) < 0.001 0.011
  Yes 5 605 (26.6) 10 908 (49.5) 531 (86.6) 595 (91.1)
  No 15 489 (73.4) 11 135 (50.5) 82 (13.4) 58 (8.9)
Breast-feeding, n (%) 0.016 0.470
  Yes 5 241 (32.9) 5 247 (31.6) 189 (34.9) 75 (32.2)
  No 0 (0) 0 (0) 353 (65.1) 158 (67.8)
BMI, ${\bar x}$±s 19.29±4.10 18.63±3.62 < 0.001 20.44±3.78 16.91±2.64 < 0.001
WC, ${\bar x}$±s 67.56±11.70 65.12±9.64 < 0.001 70.11±10.71 58.91±6.78 < 0.001
BMI-Z, ${\bar x}$±s 0.42±1.42 0.00±1.14 < 0.001 0.79±1.33 -0.44±1.18 < 0.001
WC-Z, ${\bar x}$±s 0.32±1.03 0.20±1.01 < 0.001 0.42±0.99 -0.44±0.79 < 0.001
Fruit and vegetable intake/(portions/day), ${\bar x}$±s 3.17±2.19 3.17±2.06 0.994 3.23±2.34 3.42±2.34 0.155
Meat intake/(portions/day), ${\bar x}$±s 1.36±1.38 1.05±1.10 < 0.001 1.12±0.89 1.05±0.74 0.177
Moderate and high intensity exercise/(h/d), ${\bar x}$±s 1.20±1.48 0.94±1.22 < 0.001 1.04±0.99 0.88±0.92 0.005
Puberty onset age/years, M (P25, P75) 13.08 (12.33, 13.92) 12.25 (11.58, 12.92) < 0.001 11.10 (10.41, 11.58) 9.65 [8.95, 10.38] < 0.001

表2

7个省(自治区、直辖市)横断面调查中10~18岁学生青春期启动与身体指标的关联"

Age group Boys Girls
BMI-Z WC-Z BMI-Z WC-Z
10 years-
  Puberty started 0.7±1.1 0.7±1.0
  Puberty does not start 0.1±1.2 0.2±1.0
  P value < 0.001 < 0.001
11 years-
  Puberty started 0.6±1.0 0.5±0.9
  Puberty does not start -0.1±1.3 0.1±1.0
  P value < 0.001 < 0.001
12 years-
  Puberty started 0.6±1.2 0.4±1.0 0.3±1.1 0.4±1.0
  Puberty does not start 0.5±1.4 0.3±1.0 -0.5±1.2 -0.3±0.9
  P value 0.151 0.446 < 0.001 < 0.001
13 years-
  Puberty started 0.5±1.3 0.4±1.0 0.1±1.1 0.3±1.0
  Puberty does not start 0.4±1.4 0.3±1.0 -0.7±1.2 -0.3±0.9
  P value 0.056 0.014 < 0.001 < 0.001
14 years-
  Puberty started 0.1±1.3 0.4±1.1 -0.1±1.0 0.2±1.0
  Puberty does not start 0.0±1.3 0.2±1.1 -0.6±1.0 -0.3±1.0
  P value 0.368 0.080 < 0.001 0.001
15 years-
  Puberty started 0.0±1.3 0.4±1.1
  Puberty does not start 0.1±1.4 0.3±1.1
  P value 0.732 0.703
16 years-
  Puberty started 0.0±1.3 0.3±1.0
  Puberty does not start 0.0±1.4 0.4±1.1
  P value 0.525 0.323
17 years-
  Puberty started -0.2±1.3 0.3±1.1
  Puberty does not start -0.2±1.3 0.3±1.2
  P value 0.950 0.944

表3

7个省(自治区、直辖市)横断面调查中10~18岁学生青春期启动与肥胖类型的关联*"

Age group Obesity type Boys Girls
Adolescent, n (%) Preadolescent, n (%) OR (95%CI) Adolescent, n (%) Preadolescent, n (%) OR (95%CI)
10 years- Non obesity Ref.
Simple obesity 22 (21.8) 209 (10.4) 2.39 (1.46-3.92)
Central obesity 48 (47.5) 522 (26.1) 2.56 (1.71-3.83)
Compound obesity 21 (20.8) 202 (10.1) 2.34 (1.42-3.87)
11 years- Non obesity Ref.
Simple obesity 19 (16.4) 37 (8.1) 2.22 (1.23-4.03)
Central obesity 39 (33.6) 96 (21.1) 1.89 (1.21-2.95)
Compound obesity 17 (14.7) 36 (7.9) 2.01 (1.08-3.72)
12 years- Non obesity Ref. Ref.
Simple obesity 36 (13.2) 287 (15.6) 0.82 (0.57-1.20) 204 (11.6) 39 (4.6) 2.72 (1.91-3.87)
Central obesity 70 (25.8) 497 (27.1) 0.94 (0.70-1.26) 493 (28.1) 96 (11.4) 3.05 (2.41-3.87)
Compound obesity 36 (13.2) 282 (15.3) 0.84 (0.58-1.22) 191 (10.8) 38 (4.5) 2.60 (1.82-3.72)
13 years- Non obesity Ref. Ref.
Simple obesity 123 (14.6) 239 (14.0) 1.04 (0.83-1.32) 196 (7.7) 8 (2.3) 3.63 (1.78-7.43)
Central obesity 212 (25.3) 403 (23.9) 1.08 (0.89-1.31) 658 (26.0) 34 (9.6) 3.30 (2.30-4.76)
Compound obesity 116 (13.8) 226 (13.3) 1.04 (0.82-1.33) 192 (7.6) 8 (2.3) 3.55 (1.74-7.27)
14 years- Non obesity Ref. Ref.
Simple obesity 43 (9.8) 33 (9.2) 1.07 (0.67-1.73) 44 (5.6) 1 (2.1) 2.72 (0.37-20.16)
Central obesity 85 (19.4) 66 (18.5) 1.06 (0.74-1.51) 171 (21.8) 4 (8.5) 2.99 (1.06-8.44)
Compound obesity 42 (9.6) 30 (8.3) 1.16 (0.71-1.90) 43 (5.4) 1 (2.1) 2.65 (0.36-19.69)
15 years- Non obesity Ref.
Simple obesity 150 (10.2) 31 (11.4) 0.88 (0.59-1.33)
Central obesity 326 (22.2) 68 (25.1) 0.85 (0.63-1.15)
Compound obesity 149 (10.1) 31 (11.4) 0.88 (0.58-1.32)
16 years- Non obesity Ref.
Simple obesity 186 (9.9) 27 (13.4) 0.71 (0.46-1.09)
Central obesity 409 (21.9) 48 (24.1) 0.88 (0.63-1.24)
Compound obesity 180 (9.6) 26 (12.9) 0.71 (0.46-1.11)
17 years- Non obesity Ref.
Simple obesity 62 (9.4) 4 (7.0) 1.38 (0.48-3.94)
Central obesity 134 (20.6) 10 (17.5) 1.22 (0.60-2.48)
Compound obesity 59 (9.0) 4 (7.0) 1.31 (0.46-3.75)

表4

7个省(自治区、直辖市)横断面调查中青春期启动提前与肥胖类型的关系"

Obesity type Early onset of puberty Boys, OR (95%CI) Girls, OR (95%CI)
Unadjusted Adjusted* Unadjusted Adjusted*
Simple obesity No 0 (reference) 0 (reference) 0 (reference) 0 (reference)
Yes 1.41 (1.08-1.83) 1.32 (0.94-1.86) 1.91 (1.56-2.33) 1.86 (1.42-2.44)
Central obesity No 0 (reference) 0 (reference) 0 (reference) 0 (reference)
Yes 1.10 (0.90-1.34) 1.07 (0.83-1.39) 1.91 (1.68-2.17) 1.95 (1.65-2.32)
Compound obesity No 0 (reference) 0 (reference) 0 (reference) 0 (reference)
Yes 1.38 (1.06-1.81) 1.27 (0.90-1.80) 1.87 (1.52-2.29) 1.86 (1.41-2.45)

表5

队列研究中青春期启动提前与肥胖类型的关系"

Obesity type Early onset of puberty n/N Unadjusted relative risk (95%CI) Adjusted relative risk (95%CI)*
Boys Simple obesityNo 26/459 0 (reference) 0 (reference)
Yes 4/38 1.83 (0.65-5.16) 1.82 (0.61-5.49)
Central obesity No 22/401 0 (reference) 0 (reference)
Yes 4/55 1.30 (0.47-3.59) 1.29 (0.45-3.69)
Compound obesity No 28/482 0 (reference) 0 (reference)
Yes 4/33 2.08 (0.73-5.92) 2.38 (0.77-7.38)
Girls Simple obesityNo 113/613 0 (reference) 0 (reference)
Yes 5/8 7.10 (1.70-29.73) 6.00 (1.07-33.60)
Central obesity No 104/587 0 (reference) 0 (reference)
Yes 10/24 3.11 (1.38-7.01) 3.30 (1.22-8.92)
Compound obesity No 118/619 0 (reference) 0 (reference)
Yes 5/8 6.83 (1.63-28.58) 5.76 (1.03-32.30)
1 Patton GC , Viner R . Pubertal transitions in health[J]. Lancet, 2007, 369 (9567): 1130- 1139.
doi: 10.1016/S0140-6736(07)60366-3
2 Veldhuis JD , Roemmich JN , Richmond EJ , et al. Endocrine control of body composition in infancy, childhood, and puberty[J]. Endocr Rev, 2005, 26 (1): 114- 146.
doi: 10.1210/er.2003-0038
3 Vijayakumar N , Op de Macks Z , Shirtcliff EA , et al. Puberty and the human brain: Insights into adolescent development[J]. Neurosci Biobehav Rev, 2018, 92, 417- 436.
doi: 10.1016/j.neubiorev.2018.06.004
4 Day FR , Elks CE , Murray A , et al. Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: The UK Biobank study[J]. Sci Rep, 2015, 5, 11208.
doi: 10.1038/srep11208
5 Day FR , Thompson DJ , Helgason H , et al. Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk[J]. Nat Genet, 2017, 49 (6): 834- 841.
doi: 10.1038/ng.3841
6 Kennedy D , Norman C . What don't we know?[J]. Science, 2005, 309 (5731): 75.
doi: 10.1126/science.309.5731.75
7 Biro FM , Greenspan LC , Galvez MP , et al. Onset of breast deve-lopment in a longitudinal cohort[J]. Pediatrics, 2013, 132 (6): 1019- 1027.
doi: 10.1542/peds.2012-3773
8 Kaplowitz PB , Slora EJ , Wasserman RC , et al. Earlier onset of puberty in girls: Relation to increased body mass index and race[J]. Pediatrics, 2001, 108 (2): 347- 353.
doi: 10.1542/peds.108.2.347
9 Rosenfield RL , Lipton RB , Drum ML . Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index[J]. Pediatrics, 2009, 123 (1): 84- 88.
doi: 10.1542/peds.2008-0146
10 Mamun AA , Hayatbakhsh MR , O'Callaghan M , et al. Early overweight and pubertal maturation: Pathways of association with young adults' overweight: A longitudinal study[J]. Int J Obes (Lond), 2009, 33 (1): 14- 20.
doi: 10.1038/ijo.2008.220
11 Wang Y . Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls[J]. Pediatrics, 2002, 110 (5): 903- 910.
doi: 10.1542/peds.110.5.903
12 Crocker MK , Stern EA , Sedaka NM , et al. Sexual dimorphisms in the associations of BMI and body fat with indices of pubertal development in girls and boys[J]. J Clin Endocrinol Metab, 2014, 99 (8): E1519- E1529.
doi: 10.1210/jc.2014-1384
13 孙莹. 中国儿童青春发动时相评定标准的建立及应用研究[D]. 合肥: 安徽医科大学, 2013.
14 Ribeiro J , Santos P , Duarte J , et al. Association between overweight and early sexual maturation in Portuguese boys and girls[J]. Ann Hum Biol, 2006, 33 (1): 55- 63.
doi: 10.1080/00207390500434135
15 Tomova A , Robeva R , Kumanov P . Influence of the body weight on the onset and progression of puberty in boys[J]. J Pediatr Endocrinol Metab, 2015, 28 (7/8): 859- 865.
16 Sørensen K , Aksglaede L , Petersen JH , et al. Recent changes in pubertal timing in healthy Danish boys: Associations with body mass index[J]. J Clin Endocrinol Metab, 2010, 95 (1): 263- 270.
doi: 10.1210/jc.2009-1478
17 Cole TJ , Bellizzi MC , Flegal KM , et al. Establishing a standard definition for child overweight and obesity worldwide: International survey[J]. BMJ, 2000, 320 (7244): 1240- 1243.
doi: 10.1136/bmj.320.7244.1240
18 Freedman DS , Wang J , Maynard LM , et al. Relation of BMI to fat and fat-free mass among children and adolescents[J]. Int J Obes (Lond), 2005, 29 (1): 1- 8.
doi: 10.1038/sj.ijo.0802735
19 van Dijk SB , Takken T , Prinsen EC , et al. Different anthropometric adiposity measures and their association with cardiovascular disease risk factors: A meta-analysis[J]. Neth Heart J, 2012, 20 (5): 208- 218.
doi: 10.1007/s12471-011-0237-7
20 Lee CM , Huxley RR , Wildman RP , et al. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: A meta-analysis[J]. J Clin Epidemiol, 2008, 61 (7): 646- 653.
doi: 10.1016/j.jclinepi.2007.08.012
21 Xi B , Zong X , Kelishadi R , et al. International waist circumfe-rence percentile cutoffs for central obesity in children and adolescents aged 6 to 18 years[J]. J Clin Endocrinol Metab, 2020, 105 (4): e1569- e1583.
doi: 10.1210/clinem/dgz195
22 马传伟, 羊柳, 赵敏, 等. 儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度的关系[J]. 中华流行病学杂志, 2020, 41 (9): 1450- 1454.
23 中国学生体质与健康研究组. 2010年中国学生体质与健康调研报告[M]. 北京: 高等教育出版社, 2012: 31- 86.
24 Lian Q , Mao Y , Luo S , et al. Puberty timing associated with obesity and central obesity in Chinese Han girls[J]. BMC Pediatr, 2019, 19 (1): 1.
doi: 10.1186/s12887-018-1376-4
25 Guo X , Ji C . Earlier menarche can be an indicator of more body fat: study of sexual development and waist circumference in Chinese girls[J]. Biomed Environ Sci, 2011, 24 (5): 451- 458.
26 田璐, 郑涵, 李岩志, 等. 女性月经初潮年龄与肥胖关系的研究[J]. 中华流行病学杂志, 2021, 42 (7): 1231- 1234.
27 韦晓淋, 华钰洁, 陆艳, 等. 月经初潮年龄对女性成年后近期和远期肥胖的影响[J]. 中华流行病学杂志, 2019, 40 (2): 142- 146.
28 Gill D , Brewer CF , Del Greco MF , et al. Age at menarche and adult body mass index: A Mendelian randomization study[J]. Int J Obes (Lond), 2018, 42 (9): 1574- 1581.
doi: 10.1038/s41366-018-0048-7
29 Mendle J , Turkheimer E , Emery RE . Detrimental psychological outcomes associated with early pubertal timing in adolescent girls[J]. Dev Rev, 2007, 27 (2): 151- 171.
doi: 10.1016/j.dr.2006.11.001
30 Blaine B . Does depression cause obesity? A meta-analysis of longitudinal studies of depression and weight control[J]. J Health Psychol, 2008, 13 (8): 1190- 1197.
doi: 10.1177/1359105308095977
31 Marshall WA , Tanner JM . Variations in pattern of pubertal changes in girls[J]. Arch Dis Child, 1969, 44 (235): 291- 303.
doi: 10.1136/adc.44.235.291
32 Marshall WA , Tanner JM . Variations in the pattern of pubertal changes in boys[J]. Arch Dis Child, 1970, 45 (239): 13- 23.
doi: 10.1136/adc.45.239.13
33 史慧静. 青少年健康研究应关注青春发动时相[J]. 中国学校卫生, 2008, 29 (4): 289- 291.
34 Reinehr T , Bosse C , Lass N , et al. Effect of weight loss on puberty onset in overweight children[J]. J Pediatr, 2017, 184, 143- 150.e1.
doi: 10.1016/j.jpeds.2017.01.066
35 Marcovecchio ML , Chiarelli F . Obesity and growth during childhood and puberty[J]. World Rev Nutr Diet, 2013, 106, 135- 141.
36 李科琼, 王宏, 郭靖, 等. 重庆市中小学生首次遗精与月经初潮现状及相关因素研究[J]. 中华流行病学杂志, 2016, 37 (2): 169- 173.
37 Sørensen K , Juul A . BMI percentile-for-age overestimates adiposity in early compared with late maturing pubertal children[J]. Eur J Endocrinol, 2015, 173 (2): 227- 235.
doi: 10.1530/EJE-15-0239
38 Scacchi M , Pincelli AI , Cavagnini F . Growth hormone in obesity[J]. Int J Obes Relat Metab Disord, 1999, 23 (3): 260- 271.
39 Malik IA , Durairajanayagam D , Singh HJ . Leptin and its actions on reproduction in males[J]. Asian J Androl, 2019, 21 (3): 296- 299.
40 付连国, 阳益德, 马军, 等. 中国青春期女生月经初潮较早与身体素质的关系[J]. 中华预防医学杂志, 2013, 47 (8): 707- 711.
41 Cheng TO . Central obesity is a more sensitive predictor of cardiovascular disease than body mass index in the Chinese population[J]. Int J Cardiol, 2009, 135 (3): 385.
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