中国女童初潮年龄与碳水化合物及膳食纤维摄入的关系

陈玥; 段若男; 高婉珂; 刘雪婷; 段若彤; 成果

doi:10.16835/j.cnki.1000-9817.2021.02.011

中国女童初潮年龄与碳水化合物及膳食纤维摄入的关系

doi: 10.16835/j.cnki.1000-9817.2021.02.011

1.
四川大学华西公共卫生学院营养食品卫生与毒理学系/四川大学华西第四医院，成都 610041
2.
长冶医学院第一临床学院
3.
四川大学第二医院西部妇幼医学研究中心

基金项目:

四川省杰出青年基金项目 2014JQ0005

详细信息

作者简介:
陈玥(1995-)，女，重庆大足人，在读硕士，主要研究方向为营养流行病学

通讯作者:
成果, E-mail：gcheng@scu.edu.cn

中图分类号: R 151.3 R 173
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- 被引次数: 0
出版历程
- 收稿日期: 2020-06-02
- 修回日期: 2020-07-31
- 网络出版日期: 2021-04-06
- 刊出日期: 2021-02-25

Influence of carbohydrate and fiber intakes on age at menarche in Chinese girls

1.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu(610041), China

摘要

摘要: 目的探索中国女童初潮前碳水化合物及膳食纤维摄入与初潮年龄的关系，为预防儿童性早熟提供有效干预措施。方法由中国健康与营养调查数据库获取750名中国女童初潮前膳食信息及初潮年龄，建立多元线性回归及逻辑回归模型，分析女童初潮前膳食碳水化合物及膳食纤维摄入量对初潮年龄的影响，以碳水化合物供能比替代碳水化合物摄入量进行敏感性分析。结果调整居住地、家庭人均年收入、体质量指数标准差评分、膳食总能量摄入后，初潮前较高碳水化合物摄入量和碳水化合物供能比推迟初潮发生(P值均 < 0.01)；碳水化合物摄入量在最高三分位数组的女童初潮年龄较最低三分位组推迟0.35岁(2.8%)。碳水化合物供能比在最高三分位数女童初潮早发风险较最低三分位组降低55%[OR值(OR值95%CI)=0.45(0.30~0.69)]。在所有模型中，膳食纤维摄入量与初潮年龄间相关无统计学意义(P>0.2)。结论初潮前较高膳食碳水化合物摄入可能推迟中国女童初潮发生，而膳食纤维摄入与初潮年龄无关。
- 月经初潮 /
- 年龄因素 /
- 碳水化合物 /
- 膳食纤维 /
- 摄食行为 /
- 儿童 /
- 女(雌)性
Abstract: Objective To explore the relationship between premenarchal dietary carbohydrate and dietary fiber intakes and age at menarche in Chinese girls. Methods Based on dietary and menarcheal information on 750 girls from the Chinese Health and Nutrition Survey, multivariate linear regression models and logistic models were used to analyze the influence of dietary carbohydrate and dietary fiber intakes before menarche onset and age at menarche. Carbohydrate intake was replaced by engergg ratio carbohydrate for a sensitivity analysis. Results Adjusting for residence, per capita household income, body mass index standard deviation score, and energy intake, higher intake and higher energy ratio of carbohydrate were associated with later age at menarche(P < 0.01). Compared to girls at the lowest tertile of carbohydrate intake level, those at the highest tertile had a 0.35 years(2.8%) delay in age at menarche, while 55% decreased[OR(95%CI)=0.45(0.30-0.69)]. Dietary fiber intake was not associated with age at menarche in any model(P>0.2). Conclusion Girls with higher premenarcheal carbohydrate intake experienced menarche later, while dietary fiber intake was not associated with age at menarche.
- Menarche /
- Age factors /
- Carbohydrates /
- Dietary fiber /
- Feeding behavior /
- Child /
- Female

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表 1 初潮早发与未早发组女童基本情况与膳食摄入情况比较[M(P₂₅~P₇₅)]

Table 1. General characteristics and dietary intakes in girls with or without early menarche [M(P₂₅~P₇₅)]

组别	人数	基线年龄/岁	初潮年龄/岁	BMI SDS	膳食能量摄入/(kcal·d^-1)		碳水化合物摄入量/(g·d^-1)
初潮早发组	253	9(8~11)	12(11~12)	0.3(-0.4~1.1)	1 852.9(1 419.0~2 202.2)		262.6(205.1~339.7)
未初潮早发组	497	11(9~12)	13(13~14)	0.3(-0.4~0.9)	1 538.2(1 234.5~1 934.9)		313.3(235.5~392.3)
Z值		-6.60	-23.24	1.15	-2.73		-5.31
P值		< 0.01	< 0.01	0.25	0.01		< 0.01

组别	人数	碳水化合物供能比/%	脂肪摄入量/(g·d^-1)	脂肪供能比/%	蛋白质摄入量/(g·d^-1)	蛋白质供能比/%	膳食纤维摄入量/(g·d^-1)
初潮早发组	253	59.9(51.5~67.6)	49.6(34.8~74.7)	27.9(20.0~35.9)	55.7(44.1~71.2)	12.4(11.0~14.4)	8.6(6.6~11.7)
未初潮早发组	497	65.2(56.9~73.3)	45.3(30.3~64.4)	22.7(14.2~30.2)	55.0(44.6~69.7)	11.6(10.1~13.1)	9.0(6.7~11.8)
Z值		-5.78	2.98	5.40	0.19	4.80	-0.75
P值		< 0.01	< 0.01	< 0.01	0.85	< 0.01	0.45
注：164名女童膳食纤维摄入量信息缺失，1 kcal=4.18 kJ。

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表 2 中国女童营养素摄入供能比与初潮年龄关系多重线性回归分析(n=750)

Table 2. Multivariate regression analyses between nutrients supply ratio and age at menarche among Chinese girls (n=750)

因素	模型	< P₃₃	P₃₃~P₆₆	>P₆₆	P值
碳水化合物摄入量/(g·d^-1)	未调整	12.60(12.46~12.74)	12.95(12.81~13.09)	13.14(13.00~13.28)	< 0.01
	1	12.65(12.51~12.79)	12.95(12.81~13.09)	13.10(12.95~13.24)	< 0.01
	2	12.63(12.49~12.77)	12.95(12.81~13.09)	13.11(12.97~13.26)	< 0.01
	3	12.69(12.52~12.88)	12.95(12.81~13.03)	13.04(12.86~13.23)	< 0.01
碳水化合物供能比/%	未调整	12.60(12.46~12.74)	12.90(12.76~13.04)	13.20(13.05~13.34)	< 0.01
	1	12.64(12.50~12.79)	12.90(12.76~13.04)	13.15(13.00~13.30)	< 0.01
	2	12.64(12.49~12.78)	12.89(12.75~13.03)	13.16(13.02~13.32)	< 0.01
	3	12.65(12.50~12.79)	12.90(12.76~13.04)	13.15(13.00~13.30)	< 0.01
膳食纤维摄入量/(g·d^-1)	未调整	12.67(12.51~12.83)	12.91(12.75~13.08)	12.92(12.76~13.09)	0.06
	1	12.67(12.51~12.84)	12.91(12.75~13.07)	12.93(12.76~13.07)	0.08
	2	12.67(12.51~12.84)	12.90(12.73~13.06)	12.94(12.78~13.10)	0.07
	3	12.71(12.55~12.87)	12.89(12.73~13.06)	12.91(12.74~13.07)	0.25
注：模型1为调整居住地、家庭人均年收入，模型2为进一步调整BMI SDS，模型3为进一步调整膳食能量摄入量。表中数据为不同营养摄入组的初潮年龄最小二乘法均数。

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表 3 中国女童营养素摄入量供能比与初潮早发关系逻辑回归分析[n=750，OR值(OR值95%CI)]

Table 3. Logistic regression analyses between nutrients supply ratio and age at menarche among Chinese girls [n=750, OR(OR95%CI)]

因素	模型	P₃₃~P₆₆	>P₆₆	P_趋势值
碳水化合物摄入	未调整	0.69(0.48~0.99)	0.43(0.29~0.63)	< 0.01
量/(g·d^-1)	1	0.78(0.54~1.13)	0.54(0.36~0.80)	< 0.01
	2	0.76(0.52~1.10)	0.51(0.34~0.77)	< 0.01
	3	0.81(0.53~1.25)	0.59(0.32~1.08)	< 0.01
碳水化合物供	未调整	0.57(0.40~0.82)	0.36(0.24~0.53)	< 0.01
能比/%	1	0.64(0.44~0.93)	0.45(0.30~0.68)	< 0.01
	2	0.64(0.44~0.94)	0.44(0.29~0.67)	< 0.01
	3	0.44(0.44~0.93)	0.45(0.30~0.69)	< 0.01
膳食纤维摄入	未调整	0.78(0.51~1.17)	0.90(0.59~1.35)	0.60
量/(g·d^-1)	1	0.78(0.51~1.18)	0.88(0.58~1.34)	0.55
	2	0.79(0.52~1.21)	0.87(0.57~1.32)	0.50
	3	0.83(0.54~1.26)	0.94(0.61~1.44)	0.75
注：模型1为调整居住地、家庭人均年收入，模型2为进一步调整BMI SDS，模型3为进一步调整膳食能量摄入量。营养摄入量/供能比分组均以较低为参照。

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