清晨皮质醇与体脂水平在同伴欺凌与乳房早发育关联间的中介效应

李晶; 方姣; 周艺; 孙莹

doi:10.16835/j.cnki.1000-9817.2022.07.005

清晨皮质醇与体脂水平在同伴欺凌与乳房早发育关联间的中介效应

doi: 10.16835/j.cnki.1000-9817.2022.07.005

李晶¹,
方姣¹,
周艺¹,
孙莹^{1, 2, ,}

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系, 合肥 230032
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室

基金项目:

国家自然科学基金项目 82173537

国家自然科学基金项目 81872638

安徽省自然科学基金杰青项目 1908085J26

详细信息

作者简介:
李晶(2000-)，女，湖南岳阳人，在读硕士，主要研究方向为儿童青少年卫生

通讯作者:
孙莹，E-mail：yingsun@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R 444 R 173 G 627.8
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- 被引次数: 0
出版历程
- 收稿日期: 2021-11-02
- 修回日期: 2021-12-22
- 网络出版日期: 2022-07-27
- 刊出日期: 2022-07-25

Peer victimization on early onset of breast development: mediation effects of morning cortisol and body fat

LI Jing¹,
FANG Jiao¹,
ZHOU Yi¹,
SUN Ying^{1, 2
, ,}

1.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei (230032), China

摘要

摘要: 目的探讨同伴欺凌与女童乳房早发育间的关联及潜在机制，为预防女童性早熟提供新策略。方法选取来自马鞍山市市区3所小学950名女童[平均年龄为(9.0±1.2)岁]进行研究，使用修订版《欺凌/受害者调查问卷》(BVQ)评估同伴欺凌，由1名儿童内分泌女医生评估受试女童乳房Tanner分期。使用Salivette^®唾液采集器采集所有女童清晨起床唾液样本，体脂率使用生物电阻抗分析法测量。通过逐步Logistic回归分析同伴欺凌与乳房早发育之间的关联，用Logistic回归估算中介系数。结果受试女童中，23.2%(220/950)报告自今年年初以来在学校经历过同伴欺凌。同伴欺凌组的乳房早发育女童占比(24.1%，53名)高于未经历过同伴欺凌组(13.7%，100名)。Logistic回归分析表明，调整体脂率和清晨皮质醇水平后，同伴欺凌与乳房早发育相关(OR=1.74，95%CI=1.16~2.59)。中介分析表明，高皮质醇水平和高体脂率在同伴欺凌和乳房早发育之间都有间接影响，中介效应值分别为0.37，0.45。结论在女童中，同伴欺凌与乳房早发育显著相关，可能与HPA轴异常活动和高体脂水平有关。
- 氢化可的松 /
- 脂肪组织 /
- 暴力 /
- 乳房 /
- 回归分析 /
- 儿童 /
- 女(雌)性
Abstract: Objective To explore the relationship and potential mechanism between peer victimization and early onset of breast development in girls, and to provide new strategies for precocious puberty prevention. Methods A total of 950 girls aged (9.0±1.2) years participated in this survey in Ma'anshan City in China. Revised Bully/Victim Questionnaire (BVQ) was used. Each girl was assessed on breast Tanner stage by one female pediatric endocrinologist. All the girls collected morning awakening saliva sample with Salivette^® at home. Body fat percentage (%BF) was derived from Bioelectrical Impedance Analyzer (BIA) measurements.The association between peer bullying and early breast development was analyzed by stepwise Logistic regression.The mediation coefficient was estimated using the Logistic regression. Results Totally 23.2% (220/950) of all the girls reported being victimized at school. More girls reported peer victimization had early breast onset (24.1%, 53) compared with girls with no victimization experience (13.7%, 100). Logistic regression analyses indicated that peer victimization was associated with early onset of breast development (OR=1.74, 95%CI=1.16-2.59) after body fat and awakening cortisol adjusted. Mediation analysis showed that high cortisol and high fat both had indirect effects in the association between peer victimization and early onset of breast development.Mediating analysis showed that both high cortisol level and high body fat rate had indirect effects between peer bullying and early breast development, and the mediating effect values were 0.37 and 0.45, respectively. Conclusion Peer victimization significantly correlated with early onset of breast development among girls, which might be mediated through HPA axis hyperactivity and high adiposity.
- Hydrocortisone /
- Adipose tissue /
- Violence /
- Breast /
- Regression analysis /
- Child /
- Female
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 有无同伴欺凌经历女童感知家庭社会经济地位、乳房发育提前、皮质醇浓度和体脂率水平构成情况

Table 1. Component ratios of perceived SES, early breast development, cortisol concentration, and %BF in girls with and without peer bullying

同伴欺凌	人数	感知家庭社会经济地位			乳房发育提前		清晨唾液皮质醇			体脂率
同伴欺凌	人数	低	中	高	否	是	低	中	高	正常	高
有	220	21(9.6)	107(48.6)	92(41.8)	167(75.9)	53(24.1)	27(12.3)	115(52.3)	78(35.5)	170(77.3)	50(22.7)
无	730	30(4.1)	343(47.0)	357(48.9)	630(86.3)	100(13.7)	193(26.4)	438(60.0)	99(13.6)	620(84.9)	110(15.1)
χ²值		11.20			13.51		59.87			7.08
P值		＜0.01			＜0.01		＜0.01			0.01
注：()内数字为构成比/%。

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表 2 同伴欺凌、皮质醇水平和体脂率与女童青春期发动时相提前Logistic回归分析情况[OR值(OR值95%CI)]

Table 2. Logistic regression analysis of peer bullying, cortisol levels and BF percentage with earlier onset of puberty in girls [OR(OR 95%CI)]

自变量	选项	人数	发育提前		模型1	模型2
自变量	选项	人数	检出人数	检出率/%	模型1	模型2
同伴欺凌	无	730	100	13.70	1.00	1.00
	有	220	53	24.10	2.00(1.38~2.91)^**	1.74(1.16~2.59)^*
皮质醇	低	220	41	18.64	1.58(1.04~2.41)^*	1.50(0.97~2.33)
	中	553	70	12.66	1.00	1.00
	高	177	42	23.73	2.15(1.40~3.29)^**	1.83(1.17~2.86)^*
体脂率	正常	790	104	13.17	1.00	1.00
	高	160	49	30.63	2.91(1.96~4.32)^**	2.67(1.78~4.00)^**
注：在模型1中，将同伴欺凌、皮质醇水平和体脂率作为乳房早发育的预测变量分别列入方程；在模型2中，同伴欺凌、皮质醇水平和体脂率作为预测变量同时列入方程；两个模型均控制年龄和感知SES。P＜0.05，*P＜0.01。

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