摘要
目的探讨性早熟女童中早期成长逆境(ELA)与胰岛素抵抗指标甘油三酯-葡萄糖指数(TyG)的关联,为后续开展有效预防和干预措施提供科学依据。方法于2020年7月至2021年9月,在安徽省儿童医院儿童保健门诊招募性早熟女童,纳入有完整血液指标和问卷信息的性早熟女童150名。采用父母评估和儿童自我报告结合共同评估儿童早期成长逆境暴露情况,采集空腹血样评估TyG。根据ELA得分分类为0,1,≥2共3组,采用多元线性回归模型探索累积早期成长逆境与性早熟女童TyG指数的关联。结果性早熟女童主观报告的早期成长逆境暴露率高,ELA平均得分为(1.07±1.17)分,TyG平均水平为(7.99±0.49)。单一逆境关联发现,性早熟女童暴露于缺乏温暖抚育与TyG指数呈正相关(β=0.26,95%CI=0.03~0.50,P<0.05)。累积逆境关联发现,在未调整混杂因素前,与未经历早期成长逆境的女童相比,ELA≥2组的女童TyG水平增加(β=0.24,95%CI=0.04~0.43);控制儿童年龄、母亲年龄、父亲年龄、体力活动、视屏时间、出生体重、出生方式(包括顺产和剖宫产)、自感压力,BMI标准化Z分和父母评估SDQ得分等协变量后,该关联仍有统计学意义(β=0.25,95%CI=0.04~0.46)(P值均<0.05),且独立于BMI。结论性早熟女童的累积早期成长逆境与胰岛素抵抗指标TyG指数呈正相关。应尽早识别暴露于高ELA的性早熟女童,及时干预以改善其糖代谢功能。
Objective To investigate the association between early life adversity(ELA)and the triglyceride-glucose(TyG)index for an indicator of insulin resistance among girls with precocious puberty,so as to provide scientific basis for effective prevention and intervention measures.Methods From July 2020 to September 2021,girls with precocious puberty were recruited from the children's health clinic of Anhui Provincial Children's Hospital.Among them,150 girls with complete blood indicators and questionnaire information were included.Both parental reports and child self-reports were combined to assess ELA exposure.Fasting blood samples were collected to evaluate thetyg index.According to the ELA score classification,girls were classified into 3 groups for 0,1 and>2,multiple linear regression analysis were conducted to examine the association between ELA exposure and TyG index in girls with precocious puberty.Results Precocious pubertal girls subjectively reported high rates of ELA exposure,with an average ELA score of(1.07±1.17)and an average TyG level of(7.99±0.49).A single adverse association was found that the exposure of girls with precocious puberty to a lack of warm nurturing was significantly positively correlated with the TyG index(β=0.26,95%CI=0.03-0.50,P<0.05).Multiple linear regression analysis showed that girls in the ELA≥2 group had a 0.24 increase in TyG levels compared to girls who did not experience ELA(β=0.24,95%CI=0.04-0.43).After controlling for covariates such as child age,mother's age,father's age,physical activity,screen time,birth weight,birth method(including natural and cesarean sections),perceived stress,BMI standardized Z-score,and parental assessment SDQ score,The association remained significant after controlling for covariates and was independent of BMI(β=0.25,95%CI=0.04-0.46)(P<0.05).Conclusions Cumulative early life adversity in girls with precocious puberty is significantly positively correlated with the TyG index.It should early identify the girls exposed to high ELA for precocious p
作者
王亚
李晶
李婷
周妍
朱若平
孙莹
WANG Ya;LI Jing;LI Ting;ZHOU Yan;ZHU Ruoping;SUN Ying(Department of Child health,Anhui Provinal Children's Hospital,Hefei(230032),Anhui Province,China;不详)
出处
《中国学校卫生》
CAS
北大核心
2024年第5期714-718,共5页
Chinese Journal of School Health
基金
国家自然科学基金项目(82173537)
安徽省卫生健康委科研项目(AHWJ2021b101)。
