青春期发育时相和发育速度与儿童睡眠时长的关联研究

Association between pubertal timing and tempo with sleep duration in children

青春期发育时相和发育速度与儿童睡眠时长的关联研究

Authors: Zhang Chao; Xu Yuxiang; Fang Jiao; Tao Fangbiao; Sun Ying

Source: Zhonghua LiuXingBingXue ZaZhi

DOI： 10.3760/cma.j.cn112338-20241021-00643

Abstract

Objective:To evaluate the association between pubertal timing and tempo with sleep duration in children.

Methods: A total of 2 288 students from grade 1 to 3 were recruited from 3 primary schools in Bengbu, Anhui Province in 2013 by convenient sampling method, and a child health and development cohort was established and a baseline survey was conducted, followed by 4 follow-up surveys in 2015, 2017, 2018 and 2019. Each survey included a questionnaire survey, a physical examination and an assessment of pubertal development. Tanner stage of testicular volume in boys and breast development in girls were evaluated objectively by visual examination combined with palpation. The nonlinear growth model was used to evaluate the timing and tempo of puberty. After controlling confounding factors, generalized estimation equations were used to evaluate the association between pubertal timing and tempo and the 6-year sleep duration in children.

Results: A total of 1 903 children with age of (8.10±0.87) years were enrolled, including 1056 boys (55.50%). After adjusting for confounds, compared with children in normal timing group, children in early timing group had a decrease of 0.19 hours ( β=-0.19,95% CI:-0.30--0.07, P=0.001) in sleep duration in 6 years, while children in late timing group had an increase of 0.14 hours (β=0.14, 95% CI: 0.01-0.28, P=0.041) in sleep duration in 6 years. Compared with children in normal tempo group, children in slow tempo group had a decrease of 0.16 hours (β=-0.16, 95% CI: -0.30- -0.02, P=0.021) in sleep duration in 6 years.

Conclusions:Compared with children in normal timing group, the sleep duration of children in early timing group decreased, while the sleep duration of children in late timing group increased. Compared with normal tempo group, the sleep duration of the children in slow tempo group decreased.

Keywords：Puberty; Children; Sleep duration; Cohort study

摘要

目的: 分析儿童青春期发育时相及发育速度与儿童睡眠时长的关联。

方法: 采用方便抽样的方法于2013年在安徽省蚌埠市3所小学共招募2288名1～3年级学生，建立儿童健康与发育队列并进行基线调查，随后在2015、2017、2018、2019年进行4轮随访调查。每次调查包括问卷、体格检查及青春期发育评估。采用视诊结合触诊的方法评估男童睾丸容积和女童乳房发育Tanner分期。通过非线性生长模型评估儿童青春期发育时相与发育速度。调整混杂因素后，通过广义估计方程评估青春期发育时相及速度与儿童6年睡眠时长的关联。

结果: 最终纳入1903名儿童，基线年龄为（8.10±0.87）岁，其中男童1056名（55.50%）。在调整协变量后，相较于青春期发育适时组儿童，发育提前组儿童6年睡眠时长缩短0.19 h（β=-0.19，95% CI：-0.30～-0.07， P=0.001），发育延迟组儿童6年睡眠时长增加0.14 h（β=0.14，95% CI：0.01～0.28， P=0.041）；相较于青春期发育速度正常组儿童，发育缓慢组儿童6年睡眠时长缩短0.16 h（β=-0.16，95% CI：-0.30～-0.02， P=0.021）。

结论: 相较于青春期发育适时组儿童，青春期发育提前组儿童睡眠时长缩短，而发育延迟组儿童睡眠时长增加；相较于青春期发育速度正常组儿童，发育缓慢组儿童睡眠时长缩短。

关键词：青春期; 儿童; 睡眠时长; 队列研究