中国城镇儿童不同Tanner分期身高体重现况调查  

Survey of height and weight of children and adolescents at different Tanner stages in urban China

作　　者：濮佳琦 章建伟[2] 陈瑞敏 米热古丽·买买提[4] 罗静思[5] 陈少科[5] 吴迪[6] 朱岷[7] 王春林[8] 苏喆[9] 梁雁 姚辉[11] 卫海燕 郑荣秀[13] 杜红伟[14] 罗飞宏 李嫔[16] 斯淑婷 吴蔚[1] 黄轲[1] 董关萍[1] 余运贤[17] 傅君芬[1] Jiaqi Pu;Jianwei Zhang;Ruimin Chen;Mireguli Maimaiti;Jingsi Luo;Shaoke Chen;Di Wu;Min Zhu;Chunlin Wang;Zhe Su;Yan Liang;Hui Yao;Haiyan Wei;Rongxiu Zheng;Hongwei Du;Feihong Luo;Pin Li;Shuting Si;Wei Wu;Ke Huang;Guanping Dong;Yunxian Yu;Junfen Fu(Department of Endocrinology,the Children′s Hospital of Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310053,China;Department of Pediatrics,Shaoxing Maternity and Child Health Care Hospital,Shaoxing 312000,China;Department of Endocrinology,Fuzhou Children′s Hospital,Fuzhou 350000,China;Department of Pediatrics,the First Affiliated Hospital of Xinjiang Medical University,Urumchi 830054,China;the Central Laboratory of Genetics and Metabolism Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China;Department of Endocrinology,Genetics and Metabolism,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China;Department of Endocrinology,the Children′s Hospital of Chongqing Medical University,Chongqing 400014,China;Department of Pediatrics,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Endocrinology,Shenzhen Children′s Hospital,Shenzhen 518028,China;Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Genetics Metabolism and Endocrinology,Wuhan Children′s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China;Department of Endocrinology,Genetics and Metabolism,Children′s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Pediatrics,Tianjin Medical University General Hospital,Tianjin 350002,China;Department of Pediatrics,the First Bethune Hospital of Jilin University,Changchun 130021;Department of Endocrinology,Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Endocrinology,Shanghai Children′s Hospital,Shanghai Jiao To

机构地区：[1]浙江大学医学院附属儿童医院内分泌科,国家儿童健康与疾病临床医学研究中心,杭州310053 [2]绍兴市妇幼保健院儿内科,312000 [3]福建省福州儿童医院内分泌科,350000 [4]新疆医科大学第一附属医院儿科,乌鲁木齐830054 [5]广西壮族自治区妇幼保健院遗传代谢中心实验室,南宁530003 [6]首都医科大学附属北京儿童医院内分泌遗传代谢科,100045 [7]重庆医科大学附属儿童医院内分泌科,400014 [8]浙江大学医学院附属第一医院儿科,杭州310000 [9]深圳市儿童医院内分泌科,518028 [10]华中科技大学同济医学院附属同济医院儿科,武汉430030 [11]华中科技大学同济医学院附属武汉儿童医院遗传代谢内分泌科,430016 [12]郑州儿童医院内分泌遗传代谢科,450000 [13]天津医科大学总医院儿科,350002 [14]吉林大学白求恩第一医院儿科,长春130021 [15]复旦大学附属儿科医院内分泌科,上海201102 [16]上海市儿童医院内分泌科,200062 [17]浙江大学公共卫生学院,杭州310000

出　　处：《中华儿科杂志》2021年第12期1065-1073,共9页Chinese Journal of Pediatrics

基　　金：国家重点研发计划(2016YFC1305300);浙江省医药卫生科技计划(2021KY1155);浙江省科技厅项目(LGF21H070004)。

摘　　要：目的了解我国城镇3~18岁儿童不同Tanner分期身高、体重的情况,为建立各青春发育期身高、体重的标准化参照值提供依据。方法于2017年1月至2019年12月应用分层随机整群抽样的方法,对中国12个省、自治区、直辖市218185名健康儿童体格发育情况进行横断面调查。调查指标包括体重、身高、腰围、臀围和第二性征。采用基于GAMLSS软件构建各年龄组男、女童的身高、体重百分位数参照值及生长曲线,采用Wilcoxon秩和检验比较各Tanner分期儿童与同年龄同性别不分发育分期组所有儿童的身高、体重第50百分位值。结果绘制出3~18岁儿童男、女各自年龄的身高、体重第3、50、97百分位曲线。绘制出儿童男、女各青春发育期年龄的身高、体重第3、50、97百分位曲线。9岁及以上Tanner 1期男童和7岁及以上Tanner 1期女童身高及体重低于同年龄同性别所有儿童(均P<0.01),男女童身高差值范围分别为-4.0~-0.6、-4.4~-0.5 cm,体重差值范围分别为-4.8~-0.4、-4.0~-0.3 kg。Tanner 2期与3期儿童年龄的身高及年龄的体重呈先高后低趋势,两组曲线呈交叉走势。16岁及以下Tanner 4期男童和14岁以下Tanner 4期女童年龄的身高、体重高于同龄同性别所有儿童(均P<0.01),身高差值范围男女童分别为0.2~10.0、0.2~9.4 cm,体重差值范围分别为0.7~10.9、1.0~11.2 g,曲线各年龄组两组间差异随年龄逐渐缩小。结论建立了我国城镇3~18岁不同性别儿童各青春发育期年龄的身高、体重百分位曲线,可供临床进行青春期体格发育评估使用。Objective To investigate the status of height and weight of 3-18-year-old children and adolescents in urban China,and to provide a basis for establishing puberty phase specific curves for age-specific height and age-specific weight.Methods A cross-sectional survey of 218185 children and adolescents aged 3-18 years in urban China was conducted by using the method of stratified random cluster sampling from January 2017 to December 2019.The sampling areas included 12 provinces municipalities in China and autonomous regions in total.Data were collected on weight,height,waist circumference,hip circumference and secondary sexual characteristics.The generalized additive model for location,scale,and shape(GAMLSS)was employed to establish percentile reference values and growth curves of height and weight for boys and girls aged 3-18 years.Wilcoxon rank sum test was applied to compare the P50 value of height and weight between children of each Tanner stage and children of the same age ignoring the different puberty phase.Results The 3rd,50th,and 97th percentile curves for height and weight for age were developed for boys and girls aged 3-18 years.The 3rd,50th,and 97th percentile curves for age-specific height and age-specific weight for each puberty phase were developed for boys and girls.Compared with all children ignoring the different puberty phase,boys aged 9 and over and girls aged 7 and over who are at Tanner stage 1 showed shorter height and lighter weight than those of the same age group(all P<0.01),the difference ranges of height at P50 are-4.0 to-0.6 cm for boys,and-4.4 to 0.5 cm for girls;the difference ranges of weight are-4.8 to 0.4 kg for boys,and-4.0 to-0.3 kg for girls;children at Tanner stage 2&3 initially were taller and heavier than those of the same age group;and later grew shorter and lighter than those of the same age group,the two sets of curves cross over;boys aged 16 and under and girl aged under 14 who are at Tanner stage 4 were taller and heavier than those of the same age group(all P<0.01),the d

关 键 词：青春期 性发育 身高 体重 

分 类 号：R179[医药卫生—妇幼卫生保健]