Sex differences in the growth and physical development of Beijing school-aged children and adolescents
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摘要:
目的 探索学龄儿童青少年体格发育指标增长速度的性别差异，为明确中国儿童青少年的生长发育规律提供科学依据。 方法 基于北京市顺义区2009—2018年6~18岁学龄儿童及青少年健康体检资料，经匹配个人信息后共纳入94 122名学生，计算年龄别身高、体重、体质量指数(BMI)增长速度，以及以身高增速高峰年龄(PHA)为基点的体重和BMI增长速度，采用混合效应线性模型分析增长速度的性别差异。 结果 男、女生平均身高、体重和BMI随年龄增长而增长，除10~11岁男生平均身高低于女生外，其他年龄段男生平均身高均高于女生，各年龄段男生的平均体重和BMI均高于女生(P值均 < 0.01)；混合效应线性模型结果显示身高、体重和BMI的增长速度存在性别年龄交互作用(t值分别为-67.56，-47.46，3.22，P值均 < 0.01)，即每个年龄段身高、体重和BMI的增长速度具有性别差异；男生PHA为12岁，女生PHA为10岁，男生出现身高增速高峰较女生晚2年，但峰高高于女生。男生体重增长速度高峰年龄为12岁，女生为11岁。男生BMI增长速度曲线呈“双峰”状且最大增长速度年龄为10岁，女生为11岁，男生较女生早1年；调整PHA后的体重增长速度曲线均显示，男生和女生青春期体重增长与身高增长相一致，即体重增长速度在PHA前随年龄增加而升高，在PHA达到高峰，之后又下降；7~9岁男生可能出现青春期启动前脂肪堆积。 结论 青春期各年龄段男、女生身高、体重和BMI的增长速度存在性别差异，且体重的变化与身高增长密切相关。 Abstract:Objective The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents. Methods Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individual-level information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA). Results Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11-year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P < 0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56, -47.46, 3.22, P < 0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty. Conclusion Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height. -
Key words:
- Growth and development /
- Body mass index /
- Physical examination /
- Chid /
- Adolescent
1) 赵瑞兰与李子昂为共同第一作者。 -
表 1 北京市顺义区2009—2018年6~18岁儿童青少年年龄别身高体重和BMI的性别比较
Table 1. Comparison of sex differences in age-specific height, weight and BMI among children and adolescents aged 6-18 years in Shunyi District, Beijing from 2009 to 2018
年龄/岁 男生 女生 t身高值 Z体重值 tBMI值 人数 身高/cm 体重/kg BMI/
(kg·m-2)人数 身高/cm 体重/kg BMI/
(kg·m-2)6 17 864 122.2±5.1 23.6(21.3, 27.1) 16.5±2.5 16 309 120.8±5.0 22.3(20.2, 25.1) 15.7±2.1 25.0 -32.3 30.2 7 24 839 127.6±5.6 26.3(23.5, 30.9) 17.0±2.8 21 859 126.2±5.5 24.7(22.2, 28.4) 16.1±2.4 26.6 -36.9 36.4 8 25 754 133.3±6.0 29.9(26.2, 36.2) 17.8±3.3 22 553 131.9±6.0 27.8(24.7, 32.6) 16.7±2.8 25.1 -38.4 40.5 9 24 051 138.6±6.3 33.9(29.1, 42.0) 18.7±3.7 21 007 137.9±6.6 31.6(27.6, 37.9) 17.4±3.1 11.5 -31.8 39.4 10 23 299 144.0±6.8 38.6(32.5, 48.1) 19.6±4.1 20 209 144.4±7.2 36.6(31.3, 44.3) 18.3±3.5 -6.9 -22.0 36.0 11 21 138 150.0±7.7 44.1(36.4, 54.7) 20.5±4.3 18 620 150.9±7.2 42.4(36.1, 50.5) 19.2±3.7 -12.7 -15.0 20.5 12 19 649 157.4±8.6 50.7(42.1, 62.0) 21.2±4.5 17 724 156.3±6.3 47.7(41.6, 55.6) 20.1±3.7 13.7 -21.6 25.6 13 18 430 164.4±8.1 56.1(48.0, 68.0) 21.6±4.5 16 222 159.2±5.7 50.8(45.3, 58.3) 20.7±3.7 69.5 -38.9 20.7 14 15 389 169.4±6.9 60.5(52.8, 73.0) 22.2±4.6 13 620 160.6±5.5 52.8(47.6, 59.7) 21.1±3.5 120.3 -56.2 21.8 15 12 925 172.5±6.2 63.7(56.3, 75.4) 22.5±4.4 12 830 161.5±5.5 54.4(49.4, 61.0) 21.5±3.4 149.5 -66.3 20.7 16 10 248 174.1±5.9 66.3(58.9, 77.8) 23.0±4.5 9 843 161.9±5.6 55.2(50.1, 61.7) 21.6±3.3 149.6 -68.3 23.5 17 8 592 174.8±6.0 68.4(60.9, 79.5) 23.3±4.4 8 323 162.2±5.5 55.7(50.6, 62.0) 21.7±3.3 144.2 -69.6 26.9 18 2 462 174.9±6.0 68.5(61.2, 78.1) 23.4±4.2 1 887 162.5±5.7 55.8(50.3, 61.1) 21.8±3.2 75.4 -36.5 12.7 注：体重为M(P25, P75)，身高与BMI为(x±s)；P值均 < 0.01。 
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表 2 北京市顺义区2009—2018年6~18岁儿童青少年身高、体重和BMI的增长速度混合效应线性模型(n=94 122)
Table 2. Linear mixed-effects models of the growth velocity of height, weight and BMI among children and adolescents aged 6-18 years in Shunyi District, Beijing from 2009 to 2018(n=94 122)
变量 身高 体重 BMI β值 标准误 t值 P值 β值 标准误 t值 P值 β值 标准误 t值 P值 常数项 9.98 0.04 259.75 < 0.01 4.16 0.04 100.07 < 0.01 -0.76 0.01 54.72 < 0.01 年龄 -0.39 < 0.01 -116.85 < 0.01 0.08 < 0.01 19.57 < 0.01 0.01 < 0.01 2.95 < 0.01 女a 2.81 0.06 50.37 < 0.01 1.74 0.06 27.70 < 0.01 -0.19 0.02 -8.18 < 0.01 年龄×女b -0.32 < 0.01 -67.56 < 0.01 0.24 0.01 -47.46 < 0.01 0.01 < 0.01 3.22 < 0.01 注： a表示以男为参照组；b表示以年龄×男为参照组。
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