母亲月经初潮年龄与矮小症儿童身高标准差积分相关性研究

Association between Maternal Age of Menarche and Height Standard Deviation Scores of Children with Short Stature

摘要: 目的：本研究旨在探讨母亲月经初潮年龄(Maternal age of menarche, MAM)与矮小症儿童身高标准差积分(Height standard deviation scores, Ht SDS)的关系，以及分析儿童骨龄(Bone age, BA)与年龄(Chronological age, CA)差值即Δ(BA-CA)在不同MAM组间是否有差异，为全面评估矮小症儿童生长发育情况提供一定的临床依据。方法：研究对象为2013年3月至2019年2月于济宁医学院附属医院内分泌科住院的矮小症儿童，共纳入529例。收集研究对象的一般资料如性别、年龄、生长发育史、其父母亲身高、MAM等，人体测量学指标如身高、体重、血压等，并计算其体重指数(Body mass index, BMI)与Ht SDS，其他实验室测量学指标如肝肾功、血脂谱、空腹血糖、电解质、血红蛋白、甲状腺功能、生长激素峰值(Growth hormone peak, GH peak)、胰岛素生长因子-1 (Insulin-like growth factor-1, IGF-1)并计算胰岛素生长因子-1标准差积分(Insulin-like growth factor-1 standard deviation score, IGF-1 SDS)。分析Ht SDS与MAM以及其他变量的相关性。根据MAM将研究对象分为5组，依次为≥13岁、14岁、15岁、16岁和17岁，比较不同组间Δ(BA-CA)有无差异性。结果：Ht SDS和MAM的平均水平分别为−2.63 ± 0.59和14.8 ± 1.7岁。Pearson相关性分析显示MAM与Ht SDS呈负相关关系(r = −0.128，p = 0.003)。在调整其他混杂因素后，多元线性回归显示MAM与Ht SDS呈独立负相关关系(β = −0.115, p = 0.007)。并且方差分析显示不同MAM组间Δ(BA-CA)差异无统计学意义(F = 1.625, p = 0.167)。结论：MAM与矮小症儿童Ht SDS呈显著负相关关系。而且研究显示，在各组MAM组间Δ(BA-CA)没有明显差异即在最晚MAM组间儿童没有明显BA落后，提示应重视MAM晚的儿童身高评估。

Abstract: Aim: This study aimed to explore the association between maternal age of menarche (MAM) and height standard deviation scores (Ht SDS) of children with short stature, and to analyze the differ-ences between the Bone age (BA) and age (CA) of children, as Δ(BA-CA), in different MAM groups, so as to provide a clinical basis for the comprehensive assessment of the growth and development of children with short stature. Method: A total of 529 children with short stature hospitalized in the Department of Endocrinology, Affiliated Hospital of Jining Medical University from March 2013 to February 2019 were included in this study. General information such as gender, age, growth history, height of parents, MAM, etc., anthropometric indicators such as height, weight, blood pressure, etc., were collected, and Body mass index (BMI) and Ht SDS were calculated. Other laboratory measure-ments such as liver and kidney function, lipid profile, fasting blood glucose, electrolytes, hemoglo-bin, thyroid function, Growth hormone peak (GH peak), Insulin-like growth factor-1 (insulin-like growth factor-1, IGF-1) and the Insulin-like growth factor-1 standard deviation score (IGF-1 SDS) were calculated. The correlation between Ht SDS and MAM and other variables was analyzed. Ac-cording to MAM, the subjects were divided into 5 groups (≥13 years old, 14 years old, 15 years old, 16 years old, and 17 years old). The differences of Δ(BA-CA) between different groups were com-pared. Results: The mean levels of Ht SDS and MAM were −2.63 ± 0.59 and 14.8 ± 1.7 years, respec-tively. Pearson correlation analysis showed that MAM was negatively correlated with Ht SDS (r = −0.128, p = 0.003). After adjusting for other confounding factors, multiple linear regression showed an independent negative correlation between MAM and Ht SDS (β = −0.115, p = 0.007). Anova anal-ysis showed no significant difference in Δ(BA-CA) between different MAM groups (F = 1.625, p = 0.167). Conclusion: MAM was negatively correlated with Ht SDS in children with short stature. In addition, the study showed that there was no significant difference in Δ(BA-CA) between MAM groups, that is, children in the latest MAM group did not lag significantly in BA, suggesting that at-tention should be paid to the height assessment of children with late MAM.