儿童青春期发育提前的社会心理因素分析

Analysis on psychosocial factors for early puberty in children

儿童青春期发育提前的社会心理因素分析

Authors: Li Ying, Wang Shanshan, Yu Yue, Zuo Min, Li Jing, Ling Xuebing, Tao Fangbiao, Liu Deyun, Sun Ying

Source: Zhonghua Liu Xing Bing Xue Za Zhi

DOI：10.3760/cma.j.cn112338-20240714-00424

Abstract

Objective: To investigate the effects of psychosocial factors on early puberty and its sex specific differences.

Methods: Bengbu Yuhui Longitudinal Study of Children Development Cohort, consisting of 1 162 students in grades 1-3 (524 girls) and their parents, was established in April 2021 in Bengbu, Anhui Province. The parents were surveyed by questionnaire to collect the information about their children's 56 items of psychosocial factor exposures, including 5 dimensions: major life events, early life adversity, interpersonal/relational conflict, family economic status and daily life troubles. Pubertal growth and physical examinations were conducted by trained professionals at baseline, the 1^st (May 2022), 2^nd (October 2022), 3^rd (May 2023), and 4^th (October 2023) follow-up surveys. In this study, the pubertal development status data were from the 4^th follow-up examination. Fianally, the valid data on pubertal development of 1,105 children were obtained, including the data from 510 girls (46.15%). Multinomial logistic regression model was used to analyze the association between psychosocial factors and early puberty, and the final predictors of early puberty were explored by using four models [least absolute shrinkage and selection operator (LASSO), multiple logistic regression, ridge regression, and Bayesian].

Results: The detection rates of early puberty in boys and girls were 13.60% and 16.30%, respectively. The median of intra-group absolute correlation of psychosocial factor exposure (0.042-0.066) was generally higher than that of inter-group among girls (0.031-0.059), while no similar diference was found among boys. LASSO model showed that moving house, being raised by someone other than parents, sexual abuse, peer conflict, high monthly household income, and high exposure to electronics on school days were predictors of early puberty in girls, while moving house and high monthly household income were the predictors of early puberty in girls in all four models (LASSO, multiple logistic regression, ridge regression, and Bayesian). Among boys, only a transient loss from family was a predictor of early puberty.

Conclusion: Early puberty in children can be predicted by psychosocial factors, and there are gender-specific differences.

Keywords: Psychosocial exposome;Early puberty;Environment-wide association study

摘要

目的：探讨儿童青春期发育提前的社会心理因素及性别差异。

方法：于2021年10月在安徽省蚌埠市建立蚌埠禹会儿童发育队列，招募1,162名（女童524名）1-3年级学生及其父母参与调查。采用父母问卷评估儿童社会心理暴露因素56个（包含重大生活事件、早期成长逆境、人际关系冲突、家庭经济状况和日常生活困扰5个维度）。在基线、第一次随访（2022年5月）、第二次随访（2022年10月）、第三次随访（2023年5月）和第四次随访（2023年10月）过程中开展青春期发育与体格检查，本研究的青春期发育状况为第4期随访检查数据，由经过培训的专业人员评估儿童身高、体重、青春期发育状况等。最终纳入青春期发育数据有效的儿童1,105名，其中女童510名（46.15%）。采用多元logistic回归分析社会心理暴露因素与青春期发育提前的关联，使用最小绝对收缩与选择算子（LASSO）、多元logistic回归、岭回归和贝叶斯4种模型探讨青春期发育提前的最终预测因素。

结果:男、女童青春期发育提前的检出率分别为13.60%和16.30%。女童中社会心理暴露组内绝对相关中位数（0.042-0.066）一般要高于社会心理暴露组间绝对相关中位数（0.031~0.059），男童中则没有类似结果。LASSO模型显示，搬家、由父母以外的人抚养、性虐待、同学冲突、家庭经济收入高和上学日电子产品接触多是女童青春发育提前的预测因素，其中搬家和家庭经济收入高在LASSO、多元logistic回归、岭回归和贝叶斯4种模型中均是女童青春期发育提前的预测因素。男童中仅短暂走失是青春期发育提前的预测因素。

结论:社会心理因素能够预测儿童青春期发育提前，且存在性别差异。

关键词：社会心理暴露组; 青春期发育提前; 全环境关联研究