体脂比率及相关指标对女童性早熟的影响  

Influence of body fat ratio and related indicators on precocious puberty of girls

作　　者：满丽娜[1] 王坤[1] 栾馥 吕向阳[1] 李想 刘妍辰 MAN Lina;WANG Kun;LUAN Fu;LV Xiangyang;LI Xiang;LIU Yanchen(Department of Pediatrics,The Second People's Hospital of Dalian,Liaoning Dalian 116011,China)

机构地区：[1]大连市第二人民医院儿科,辽宁大连116011

出　　处：《中国妇幼健康研究》2021年第6期825-829,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析体脂比率及相关指标对女童性早熟的影响。方法回顾性分析2019年1月至2021年1月大连市第二人民医院收治的185例性早熟女童的临床资料,依据中枢性性早熟诊断与治疗共识将其分为A组(中枢性性早熟,n=126)和B组(外周性性早熟,n=59),并纳入100例未发育的正常女童为对照组。比较各组女童体脂率、脂肪分布情况及相关指标,并分析女童性早熟的相关因素。结果 A组、B组女童男性区、女性区、上肢、腿部、躯干、全身的体脂率,以及腿部/全身脂肪比、(上肢+腿部)/躯干脂肪比均高于对照组,A组的内脏脂肪厚度(VFT)、皮下脂肪厚度(SFT)均高于对照组,上述差异均有统计学意义(t=1.997~4.763,P<0.05)。与对照组比较,A组和B组女童的身高、体质量指数(BMI)、全身体脂率、BMI-Z值、骨龄、左侧卵巢容积、右侧卵巢容积、促黄体生成素(LH)基础值、促卵泡刺激素(FSH)基础值、雌二醇(E2)、胰岛素样生长因子-1(IGF-1)、HOMA-IR、空腹血糖(FPG)水平均高,25-羟维生素D3水平低,差异均有统计学有意义(t=2.001~3.098,P<0.05);A组的LH基础值、LH峰值、FSH基础值、FSH峰值、E2水平均高于B组,差异均有统计学意义(t值分别为2.767、2.517、2.317、2.580、2.001,P<0.05)。Logistic回归分析结果提示BMI≥15kg/m^(2)(OR=3.673,95%CI=1.661~8.123)、全身体脂率≥24.5%(OR=2.301,95%CI=1.093~4.843)、LH基础值≥1IU/L(OR=3.012,95%CI=1.208~7.510)、FSH基础值≥3IU/L(OR=1.993,95%CI=1.102~3.603)、FPG≥5mmol/L(OR=2.012,95%CI=1.101~3.678)、25-羟维生素D3<30ng/mL(OR=1.793,95%CI=1.108~2.902)是女童性早熟的危险因素(P<0.05)。结论性早熟女童表现出明显的体脂含量增加,临床上应加强对女童BMI、全身体脂率、LH基础值、FSH基础值、FPG、25-羟维生素D3水平的监测,积极采取干预措施预防性早熟。Objective To analyze the influence of body fat ratio and related indicators on girls′ precocious puberty.Methods Clinical data of 185 girls with precocious puberty admitted to the Second People′s Hospital of Dalian from January 2019 to January 2021 were retrospectively analyzed.According to the consensus of diagnosis and treatment of central precocious puberty, they were divided into group A(central precocious puberty, n=126) and group B(peripheral precocious puberty, n=59).A total of 100 normal undeveloped girls were included as the control group.The body fat percentage, fat distribution and related indexes of girls in each group were compared, and the related factors of girls′ precocious puberty were analyzed.Results The body fat percentage of male area, female area, upper limb, leg, trunk and whole body, leg/whole body fat ratio and(upper limb + leg)/trunk fat ratio of girls in group A and B were higher than those of control group, and the VFT and SFT of group A were higher than those in the control group, the differences were statistically significant(t=1.997-4.763,all P<0.05).Compared with the control group, girls in group A and group B had higher levels of height, BMI,total body fat percentage, BBM-Z value, bone age, left ovarian volume, right ovarian volume, LH basal value, FSH basal value, E2,IGF-1,HOMA-IR and FPG,and lower levels of 25-hydroxyvitamin D3.The differences were statistically significant(t=2.001-3.098,all P<0.05).The basal value, the peak value of LH,the basal value of FSH,the peak value of FSH and the level of E2 in group A were all higher than those of group B,with statistical significance(t=2.767,2.517,2.317,2.580 and 2.001,respectively, all P<0.05).Logistic regression analysis showed that BMI≥15 kg/m^(2)(OR=3.673,95%CI=1.661-8.123),whole body fat percentage≥24.5%(OR=2.301,95%CI=1.093-4.843),LH basal value≥1 IU/L(OR=3.012,95%CI=1.208-7.510),basal FSH value≥3 IU/L(OR=1.993,95%CI=1.102-3.603),FPG≥5 mmol/L(OR=2.012,95%CI=1.101-3.678) and 25-hydroxyvitamin D3< 30 ng/mL(OR=1.793

关 键 词：女童 体脂率 性早熟 危险因素 

分 类 号：R725.8[医药卫生—儿科]