Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (3): 418-423. doi: 10.19723/j.issn.1671-167X.2024.03.007

Previous Articles     Next Articles

Associations between puberty timing and cardiovascular metabolic risk factors among primary and secondary students

Zuhong ZHANG,Tianjiao CHEN*(),Jun MA   

  1. Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
  • Received:2022-04-28 Online:2024-06-18 Published:2024-06-12
  • Contact: Tianjiao CHEN E-mail:tianjiao.chen@hsc.pku.edu.cn
  • Supported by:
    the Specific Research Project of Health Pro Bono Secters, Ministry of Health, China(201202010)

RICH HTML

  

Abstract:

Objective: To explore the relationship between puberty timing and cardiovascular metabolic risk factors among primary and secondary students with different genders in Beijing. Methods: Using the method of stratified cluster sampling by urban and rural areas and school sections, 3 067 students from 16 primary and secondary schools in Fangshan District of Beijing were selected in October 2012, with questionnaire survey, physical examination and serum laboratory testing. In this study, we controlled for confounding factors such as school segments, current residence of the family, birth weight, feeding method, only child, highest educational level of parents, and monthly family income, and then the associations between cardiovascular metabolic risk factors and puberty timing among the primary and secondary students was analyzed by multivariate Logistic analysis. To ensure the reliability of the data, this study adopted strict quality control. Results: A total of 3 067 primary and middle school students aged 7 to 16 years were included in this study, including 1 575 boys and 1 492 girls. The prevalence of premature puberty was 14.73% among the boys and 12.89% among the girls, respectively. The prevalence of delayed puberty was 9.49% among the boys and 10.99% among the girls, respectively. The detection rates of central obesity, hypertension, hyperglycemia, and dyslipidemia among the primary and secondary students were 35.87%, 19.95%, 2.54% and 26.31%, respectively. The detection rates of 1 risk factor clustering, 2 risk factors clustering and more than 3 risk factors clustering were 29.21%, 16.17% and 9.36%, respectively. The difference in the detection rate of cardiovascular and metabolic risk factors in different youth stages was insignificant (P>0.05), the detection rate of risk factor aggregation of 0 was lower than that of the timely group and delayed group, and the detection rate of risk factors aggregation of 2 was higher than that of the timely group (P < 0.05).After adjusting the effects of learning stage, region, birth weight, feeding patterns, one-child, family income and the parents' educational levels, multivariate Logistic regression analysis showed that, compared with the on-time puberty group, the risk of 1 risk factor clustering, 2 risk factors clustering and more than 3 risk factors clustering increased by 1.94 times (95% CI=1.29-2.91), 2.97 times (95% CI=1.89-4.67) and 2.02 times (95% CI= 1.13-3.63) among the girls; It had not been found that the relationship between puberty timing and cardiovascular risk factor clustering among the boys (P>0.05). Conclusion: Premature puberty is an independent risk factor for the clustering of cardiometabolic risk factors in girls, and primary prevention strategies should be implemented to reduce the burden of cardiovascular metabolic diseases in the population.

Key words: Cardiovascular metabolic risk factors, Puberty timing, Primary and secondary students

CLC Number: 

  • R179

Table 1

Detection of cardiovascular metabolic risk factors and clusters in boys and girls"

Risk factors Boys, n (%) Girls, n (%) Total, n (%) χ2 P
Central obesity 542 (34.41) 558 (37.40) 1100 (35.87) 2.97 0.09
Hypertension 335 (21.27) 277 (18.57) 612 (19.95) 13.06 0.01
Hyperglycaemia 48 (3.05) 30 (2.01) 78 (2.54) 3.32 0.07
High TG 307 (19.49) 313 (20.98) 620 (20.22) 1.05 0.31
High TC 68 (4.32) 70 (4.69) 138 (4.50) 0..25 0.62
Low HDL-C 85 (5.40) 70 (4.69) 155 (5.05) 0.79 0.37
High LDL-C 63 (4.00) 76 (5.09) 139 (4.53) 2.12 0.15
Dyslipidemia 407 (25.84) 400 (16.81) 807 (26.31) 0.37 0.54
Numbers of risk factor 6.83 0.08
  0 737 (46.79) 651 (43.63) 1388 (45.26)
  1 429 (27.24) 467 (31.30) 896 (29.21)
  2 254 (16.13) 242 (16.22) 496 (16.17)
  ≥3 155 (9.84) 132 (8.85) 287 (9.36)

Table 2

Distribution of cardiovascular metabolic risk factor clusters among different puberty timing students"

Gender Puberty timing Total, n (%) Numbers of risk factor, n (%) χ2 P
0 1 2 ≥3
Boy Delay 149 (9.46) 68 (45.64) 40 (26.85) 30 (20.13) 11 (7.38) 7.45 0.282
On-time 1 194 (75.81) 570 (47.74) 313 (26.21) 187 (15.66) 124 (10.38)
Early 232 (14.73) 99 (42.67) 76 (32.76) 37 (15.95) 20 (8.61)
Girl Delay 164 (10.99) 79 (48.17a) 46 (28.05) 25 (15.24) 14 (8.54) 30.43 <0.001
On-time 1 136 (76.14) 521 (45.86a) 348 (30.63) 168 (14.79a) 99 (8.71)
Early 192 (12.87) 51 (26.56) 73 (38.02) 49 (25.52) 19 (9.90)

Table 3

Multivariate Logistic-analysis of puberty timing and cardiovascular metabolic risk factors among students with different genders"

Numbers of risk factor Gender Puberty timing β OR 95% CI
1 Boys Early 0.28 1.33 0.93-1.88
Delay -0.04 0.96 0.60-1.53
Girls Early 0.66 1.94 1.29-2.91
Delay -0.19 0.83 0.55-1.25
2 Boys Early 0.09 1.10 0.71-1.69
Delay 0.15 1.16 0.68-1.97
Girls Early 1.09 2.97 1.89-4.67
Delay -0.07 0.94 0.56-1.56
≥3 Boys Early -0.15 0.86 0.49-1.52
Delay -0.14 0.87 0.43-1.78
Girls Early 0.71 2.02 1.13-3.63
Delay -0.02 0.98 0.53-1.83
1 陶芳标. 青春发动时相提前与青少年卫生系列述评(1): 早期生长模式与青春发动时相提前[J]. 中国学校卫生, 2008, 29 (3): 193- 195.
doi: 10.3969/j.issn.1000-9817.2008.03.001
2 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36(6): 521-545.
3 Prentice P , Viner RM . Pubertal timing and adult obesity and cardiometabolic risk in women and men: A systematic review and meta-analysis[J]. Int J Obes (Lond), 2013, 37 (8): 1036- 1043.
doi: 10.1038/ijo.2012.177
4 Ajala O , Mold F , Boughton C , et al. Childhood predictors of cardiovascular disease in adulthood. A systematic review and meta-analysis[J]. Obes Rev, 2017, 18 (9): 1061- 1070.
doi: 10.1111/obr.12561
5 席波. 预防成年期心血管疾病应始于儿童期[J]. 中华预防医学杂志, 2019, 53 (7): 657- 660.
6 Petersen AC , Crockett L , Richards M , et al. A self-report measure of pubertal status: Reliability, validity, and initial norms[J]. J Youth Adolesc, 1988, 17 (2): 117- 133.
doi: 10.1007/BF01537962
7 李丹, 史慧静, 张越, 等. 青春发育事件自我评定量表在城市青少年人群中的适用性研究[J]. 中华流行病学杂志, 2012, 33 (6): 580- 583.
doi: 10.3760/cma.j.issn.0254-6450.2012.06.008
8 韩慧, 汤建军, 华海晨, 等. 蚌埠市青少年青春发动时相与进食行为的关系[J]. 中国学校卫生, 2019, 40 (8): 1166- 1168.
9 赵志雅, 徐慧琼, 汪姗姗, 等. 初中生青春发动时相与心理亚健康相关性及性别差异[J]. 中国公共卫生, 2021, 37 (2): 270- 274.
10 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: 32- 47.
11 中华医学会儿科学分会内分泌遗传代谢学组, 中华医学会儿科学分会心血管学组, 中华医学会儿科学分会儿童保健学组, 等. 中国儿童青少年代谢综合征定义和防治建议[J]. 中华儿科杂志, 2012, 50 (6): 420- 422.
doi: 10.3760/cma.j.issn.0578-1310.2012.06.005
12 American Academy of Pediatrics . Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report[J]. Pediatrics, 2011, 128 (Suppl 5): 213- 256.
13 高梅影, 薛琨, 郭红卫, 等. 不同方法、标准评价上海市浦东新区学龄儿童超重肥胖率[J]. 中国儿童保健杂志, 2020, 28 (2): 131- 134.
14 陈华, 杨丽丽, 梁亚军, 等. 济南市城区7~17岁儿童青少年腹型肥胖流行现状分析[J]. 中国儿童保健杂志, 2018, 26 (5): 496- 499.
15 杨清梅, 马萍, 董洋洋, 等. 2017—2019年银川市12~18岁青少年心血管代谢危险因素的流行现状[J]. 卫生研究, 2021, 50 (3): 454- 459.
16 胡霄, 姜红如, 张兵, 等. 中国十五省7~17岁儿童青少年心血管代谢性危险因素的流行特征[J]. 环境与职业医学, 2021, 38 (8): 833- 838.
17 程红, 陈芳芳, 叶佩玉, 等. 2013—2015年中国7城市6~17岁儿童青少年心血管代谢危险因素的流行特征[J]. 中华预防医学杂志, 2018, 52 (11): 1130- 1135.
doi: 10.3760/cma.j.issn.0253-9624.2018.11.007
18 Le-Ha C , Beilin LJ , Burrows S , et al. Age at menarche and childhood body mass index as predictors of cardio-metabolic risk in young adulthood: A prospective cohort study[J]. PLoS One, 2018, 13 (12): e209355.
19 Chan NP , Choi KC , Nelson EA , et al. Associations of pubertal stage and body mass index with cardiometabolic risk in Hong Kong Chinese children: A cross-sectional study[J]. BMC Pediatr, 2015, 15 (1): 136.
doi: 10.1186/s12887-015-0446-0
20 Remsberg KE , Demerath EW , Schubert CM , et al. Early menarche and the development of cardiovascular disease risk factors in adolescent girls: The fels longitudinal study[J]. J Clin Endocrinol Metab, 2005, 90 (5): 2718- 2724.
doi: 10.1210/jc.2004-1991
21 Ramírez-Vélez R , García-Hermoso A , Agostinis-Sobrinho C , et al. Pubertal stage, body mass index, and cardiometabolic risk in children and adolescents in Bogotá, Colombia: The cross-sectional fuprecol study[J]. Nutrients, 2017, 9 (7): 644.
doi: 10.3390/nu9070644
22 许媛媛, 孙丽, 郭欣, 等. 超重肥胖与青少年青春发动时相的相关性及性别差异研究[J]. 中华预防医学杂志, 2017, 51 (9): 792- 795.
doi: 10.3760/cma.j.issn.0253-9624.2017.09.004
23 Fonseca MJ , Oliveira A , Azevedo I , et al. Association of pubertal development with adiposity and cardiometabolic health in girls and boys-findings from the generation XXI birth cohort[J]. J Adolesc Health, 2019, 65 (4): 558- 563.
doi: 10.1016/j.jadohealth.2019.05.014
24 Berentzen NE , Wijga AH , van Rossem L , et al. Pubertal timing and cardiometabolic markers at age 16 years[J]. J Pediatr, 2017, 187, 158- 164.
doi: 10.1016/j.jpeds.2017.04.008
25 Loomba-Albrecht LA , Styne DM . Effect of puberty on body composition[J]. Curr Opin Endocrinol Diabetes Obes, 2009, 16 (1): 10- 15.
doi: 10.1097/MED.0b013e328320d54c
[1] Chengyue LI, Hao WANG, ALIMUJIANG·Yimiti·tarken. Secular trend in growth of Uygur primary and middle school students aged 7-18 years in Xinjiang from 1985 to 2019 [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 802-808.
[2] Zhihan YUE,Na HAN,Zheng BAO,Jinlang LYU,Tianyi ZHOU,Yuelong JI,Hui WANG,Jue LIU,Haijun WANG. A prospective cohort study of association between early childhood body mass index trajectories and the risk of overweight [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 390-396.
[3] Shan CAI,Yihang ZHANG,Ziyue CHEN,Yunfe LIU,Jiajia DANG,Di SHI,Jiaxin LI,Tianyu HUANG,Jun MA,Yi SONG. Status and pathways of factors influencing physical activity time among elementary and junior high school students in Beijing [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 403-410.
[4] Hejun SHEN,Chongyan SHI,Qing ZHENG,Yu HUANG,Tao JING. Investigation on the current situation and influencing factors of sitting time and health literacy among high school students in China [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 239-246.
[5] Xiao-yi MI,Shan-shan HOU,Zi-yuan FU,Mo ZHOU,Xin-xuan LI,Zhao-xue MENG,Hua-fang JIANG,Hong Zhou. Reliability and validity of the Chinese version of adverse childhood experiences international questionnaire in parents of preschool children [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 408-414.
[6] Jia-jia DANG,Shan CAI,Pan-liang ZHONG,Ya-qi WANG,Yun-fei LIU,Di SHI,Zi-yue CHEN,Yi-hang ZHANG,Pei-jin HU,Jing LI,Jun MA,Yi SONG. Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 421-428.
[7] Wen YUAN,Yi ZHANG,Li CHEN,Jia-nuo JIANG,Man-man CHEN,Jie-yu LIU,Tao MA,Qi MA,Meng-jie CUI,Tong-jun GUO,Xin-xin WANG,Yan-hui DONG,Jun MA. Association of body fat distribution with depression and social anxiety in children and adolescents: A cross-sectional study based on dual-energy X-ray detection [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 429-435.
[8] Jing CHEN,Wu-cai XIAO,Rui SHAN,Jie-yun SONG,Zheng LIU. Influence of rs2587552 polymorphism of DRD2 gene on the effect of a childhood obesity intervention: A prospective, parallel-group controlled trial [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 436-441.
[9] Yun-fei LIU,Jia-jia DANG,Pan-liang ZHONG,Ning MA,Di SHI,Yi SONG. Injury mortality among Chinese aged 5 to 24 years from 1990 to 2019 [J]. Journal of Peking University (Health Sciences), 2022, 54(3): 498-504.
[10] HU Di,ZHANG Miao,KANG Hui-ying,PENG Yun. Investigation and validation of magnetic resonance white matter atlas for 0 to 2 years old infants [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 341-347.
[11] Zhao-nian WANG,Wen-jing GAO,Bi-qi WANG,Wei-hua CAO,Jun LV,Can-qing YU,Zeng-chang PANG,Li-ming CONG,Hua WANG,Xian-ping WU,Yu LIU,Li-ming LI. Correlation between fasting plasma glucose, HbA1c and DNA methylation in adult twins [J]. Journal of Peking University (Health Sciences), 2020, 52(3): 425-431.
[12] Yi SONG,Dong-mei LUO,Pei-jin HU,Xiao-jin YAN,Jing-shu ZHANG,Yuan-ting LEI,Bing ZHANG,Jun MA. Trends of prevalence of excellent health status and physical fitness among Chinese Han students aged 13 to 18 years from 1985 to 2014 [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 317-322.
[13] CHEN Tian-qi, DONG Bin, ZHANG Wen-jing, GAO Di-si, DONG Yan-hui, MA Jun, MA Ying-hua. Association between speed and endurance performance with sleep duration in children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 429-435.
[14] SONG Yi,LEI Yuan-ting, HU Pei-jin, ZHANG Bing, MA Jun. Situation analysis of physical fitness among Chinese Han students in 2014 [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 436-442.
[15] . [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 580-封三.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!