Fang Jiao, Gong Chun, Su Puyu, Wan Yuhui, Zhang Zhihua, Tao Fangbiao, Sun Ying
Department of Maternal, Child & Adolescent Health, School of Public Health, Hefei, Anhui Province, China.
Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China.
Pediatr Res. 2021 Mar;89(4):1026-1031. doi: 10.1038/s41390-020-1001-8. Epub 2020 Jun 8.
The earliest onset of puberty had shifted downward, which may be due to the role of early growth and development factors in childhood.
All of 1575 Kindergarten Two (K2) children from Anhui province, China were followed up to elementary school. Girls (n = 342) with available data on AR and breast development were included for this analysis. Polygenic risk score (PRS) was computed based on 17 single nucleotide polymorphisms for early puberty. Accelerate failure time (AFT) model was used to describe thelarche timing by early AR among girls with different polygenic susceptibility.
After adjustment for perinatal anthropometric, household income, parental education and prepuberty BMI-Z score, puberty started 4.12-month earlier in early AR girls compared with normal AR girls (TR: 0.96; 95% CI: 0.95, 0.98, p < 0.001). Furthermore, this puberty-accelerating effect was observed among girls with high (6.06-month earlier, TR: 0.94; 95% CI: 0.90, 0.99) and moderate PRS (4.20-month earlier, TR: 0.96; 95% CI: 0.93, 0.98). No similar results were observed in the low PRS groups (TR: 1.00; 95% CI: 0.96, 1.04).
Girls with early AR displayed younger age at thelarche; however, this accelerating effect was only observed among those with genetic susceptibility to early puberty.
Early AR plays a more important role in predicting earlier thelarche among girls with high and moderate PRS. This study combined with the hot topics of pubertal-related polygenic risk score (PRS) for pubertal timing to examine the longitudinal association between early AR with accelerated pubertal onset. Our results mean that accelerating growth in the early childhood years after birth might forecast early puberty only among girls with genetic predisposition to early puberty. Prevention strategies and management options should be emphasized to target early childhood to address secular trend for early puberty observed in the past decades in China.
青春期的最早开始时间已经提前,这可能归因于儿童期早期生长发育因素的作用。
对来自中国安徽省的1575名幼儿园大班儿童进行随访直至小学。本分析纳入了有雄激素受体(AR)和乳房发育相关数据的女孩(n = 342)。基于17个与青春期提前相关的单核苷酸多态性计算多基因风险评分(PRS)。采用加速失效时间(AFT)模型描述不同多基因易感性女孩中早期AR对乳房初发育时间的影响。
在校正围产期人体测量指标、家庭收入、父母教育程度和青春期前BMI-Z评分后,早期AR女孩的青春期开始时间比正常AR女孩提前4.12个月(风险比:0.96;95%置信区间:0.95,0.98,p < 0.001)。此外,在高PRS组女孩(提前6.06个月,风险比:0.94;95%置信区间:0.90,0.99)和中PRS组女孩(提前4.20个月,风险比:0.96;95%置信区间:0.93,0.98)中也观察到这种青春期加速效应。在低PRS组未观察到类似结果(风险比:1.00;95%置信区间:0.96,1.04)。
早期AR女孩的乳房初发育年龄更小;然而,这种加速效应仅在那些对青春期提前有遗传易感性的女孩中观察到。
早期AR在预测高PRS和中PRS女孩更早的乳房初发育方面发挥更重要作用。本研究结合青春期相关多基因风险评分(PRS)这一热点话题来研究青春期时间,以检验早期AR与青春期提前之间的纵向关联。我们的结果意味着出生后幼儿期的加速生长可能仅在有青春期提前遗传易感性的女孩中预测青春期提前。应强调针对幼儿期的预防策略和管理方案,以应对中国过去几十年观察到的青春期提前的长期趋势。