| Objective:To understand the characteristics and current situation of peri-pubertal physique growth among middle school students in Jining City,analyze the correlation between peri-pubertal physique growth characteristics and puberty development phase,and explore the early life influencing factors of peri-pubertal physique growth level.Methods:Jining Fengtai Middle School was selected as the investigation school,and the 6th and 7th grade students were clustered by class as a unit,and those with congenital malformations,hereditary or metabolic diseases and chronic diseases of the endocrine system were excluded,and 714 adolescents were finally included.students,tracked through to 9th grade graduation.In June 2015,physical examinations were performed on the respondents,and questionnaires were conducted on their parents.Follow-up surveys were conducted in June 2016,June 2017,and June 2018,respectively.The four surveys measured the sexual development level and physical development evaluation indicators of the respondents through physical examination,and calculated the height standard deviation score（Height standard deviation score,HtSDS）,body mass index（Body mass index,BMI）,body mass index standard deviation score（Body mass index standard deviation score,BMI SDS）,waist-to-height ratio（Waist-To-Height Ratio,Whtr）,waist-to-hip ratio（Waist-to-Hip Ratio,WHR）;a questionnaire survey was conducted on their parents,and the questionnaire content included the general demographic and family socioeconomic characteristics of the respondents,and the situation before and after birth.Results:1.The basic situation of peri-pubertal growth and development of children and adolescents in urban areas of Jining CityAt the baseline of this study,a total of 714 children and adolescents in Jining City were investigated.The age range of the initial survey was 11-15 years old.There were 364 boys with an average age of 12.7 years and 350 girls with an average age of 12.6 years.77 people（21.27%）were obese,75（20.72%）were obese,46（13.18%）were overweight girls,49（14.04%）were obese,and 49（14.04%）were overweight and obese.were significantly larger than those of girls（P<0.05）;at baseline,the detection rate of short stature（-2SD～-1SD）was 6.08%in boys,0.83%in short stature（<-2SD）,and 6.32 in girls.%,and the detection rate of short stature was 0.29%.2.The correlation between the level of peri-pubertal physical development and puberty in urban middle school students in Jining City①The BMI of boys and girls increased gradually with the increase of sexual development stage.②Age at menarche was significantly associated with BMI SDS and waist height ratio in girls.When BMI SDS<-0.53,BMI SDS increased by 1,the age of menarche was 0.92 years earlier（β-0.92,95%CI-1.32,-0.53;P=0.0001）,BMI SDS>-0.53,BMI SDS increased by 1,Menarche was 0.19 years earlier（β-0.19,95%CI-0.28,-0.09;P<0.0001）.When Whtr<0.41,the waist height ratio increased by 0.1,the age of menarche was 1.31 years earlier（β-13.1,95%CI-20.73,-5.45;P=0.0009）,Whtr>0.41,Whtr was not significantly correlated with the age of menarche in girls（β-1.5,95%CI-20.73,-5.45;P=0.2875）.3.The growth rate of height before and after the first nocturnal emission of boys and girls before and after menarche among middle school students in Jining CityThe average age of boys with their first nocturnal emission was 13.7±1.0 years old;the height growth rate was 7.5 ± 2.8cm/year in the year before the first nocturnal emission,and the height growth rate in the first year after the first nocturnal emission was 5.7 ± 4.4cm/year,and the height growth rate in the second year.4.5±2.9cm/year.The average age of girls at menarche was 11.8±1.0 years.The height growth rate in the year before menarche was 5.7±2.1cm/year,the height growth rate in the first year after menarche was 3.4±2.1 cm/year,and the growth rate in the second year after menarche was 2.2±2.3cm/year.The growth rate of height in the third year after menarche was 2.0±1.9cm/year.4.Analysis of early life influencing factors of peri-adolescent physical growth level in children and adolescents①The mode of delivery at birth was significantly associated with being overweight or obese during puberty.Compared with vaginal delivery,caesarean section delivery increased the risk of pubertal overweight or obesity in offspring by 1.43 times（OR 2.43,95%CI 1.65,3.58;P<0.001）.②Birth weight and adolescent HtSDS were positively correlated.When birth weight was>2.8kg,the HtSDS increased by 0.54 for every 1kg increase in birth weight（β0.03,95%CI 0.002,0.005;P<0.0001）,and when birth weight was<2.8kg,the correlation was not statistically significant（P>0.05）.Conclusion:1.The peri-pubertal growth and development of middle school students aged 11-15 in Jining City conformed to the general law of adolescent growth and development.The level of physical growth was closely related to puberty development.Girls with high BMI and high waist-to-height ratio had relatively early menarche.2.Early life factors such as cesarean section at birth and birth weight may influence the level of peri-pubertal physical growth.Therefore,the intervention window for body shape in children and adolescents should be advanced to the early stage of life. |
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