PAEs暴露和体脂交互作用对青春发动时相影响的性别差异

The effects of phthalates (PAEs) on pubertal development have been reported. The obesity epidemic is thought to affect pubertal timing, but the association between obesity and male/female puberty is far from clear. The interaction between PAEs, known as "obesogens", and body fat may induce the sex differences of pubertal timing, which should be an important topic in pubertal development. Students in the 2nd to 10th grades who have early and delayed pubertal development are selected. Then their body fat mass and urinary PAEs concentrations are measured. The effects of risk factors of body fat and PAEs on pubertal development are analyzed. Meanwhile, we select children in 2nd, 4th, 6th and 8th grades to follow up for 4 times in 2 years, which means at intervals of 6 months after last visit. At each visit, BMI、WHtR and body composition are measured to evaluate body fat mass, and urinary PAEs and gonadotrophins concentrations are measured. The timing of puberty is assessed by the Pubertal Development Scale (PDS) and Tanner stage. Statistical interaction between PAEs and percentage body fat on sex differences of pubertal timing are evaluated. In this study, a new variable of risk factor of pubertal development will be introduced, which will expand a new area for effect of environmental factors on pubertal development and children physical/mental health.

邻苯二甲酸酯（PAEs）影响青春期发育已有研究报道，而肥胖引起儿童青春发动时相改变在女童和男童中表现不同，机制不清。PAEs作为新近发现"致肥原"（obesogens）和体脂交互作用与青春发动时相的关联，应是青春期发育的重要课题。本研究首先以2～10年级学生为对象，筛选青春发动提前和延迟者，测定体脂和尿PAEs代谢物水平，分析体脂、PAEs与青春发动提前和推迟的关联强度及其两者共同暴露病因意义。同时以2、4、6、8年级男女生为队列，随访2年，每6个月测量BMI、腰高比和体成分，测定尿PAEs和促性腺激素，并进行青春发育评估，评价不同年龄PAEs暴露及体脂百分比与儿童青春发动时相提前和推迟的关系，阐明PAEs和体脂交互作用对青春发动时相影响的性别差异。本研究为青春发育影响因素拓宽新变量，为进而探讨环境因素作用青春发动的生物学机制及身心健康效应提供新平台。

本研究主要目的为探讨PAEs与体脂交互作用对青春期发育的影响。. 课题组建立了环境与儿童青少年发育和健康研究队列，收集学生人口统计学基本信息、青春发育自评、体力活动情况、心理行为发育特征等信息，建立尿液标本库，并随访2年。可供研究各种环境因素对青春期发育影响所用。课题组建立了尿液中7种PAEs代谢产物的高效液相色谱串联质谱测定法，优化了尿样的前处理过程，为PAEs暴露水平评估提供了适宜、有效的测定方法。. 在大样本队列人群的基础上，观察青春发动时相的影响因素及身心健康效应。结果显示，超重肥胖是女生青春发育提前的危险因素。但是，这种关联在男生中没有发现；与家庭经济状况较好组相比，较差组男女生阶段标化青春发动提前检出率均增加。采用《长处与困难问卷》（SDQ）评价青少年心理行为问题。与阶段标化的青春发动时相适时组相比，女生阶段标化的青春发动时相提前是情绪、多动、同伴交往、客观困难异常的危险因素，男生阶段标化的青春发动时相提前和延迟均与心理行为问题不存在统计学关联。与同伴标化的青春发动时相适时组相比，女生同伴标化的青春发动提前是情绪、同伴交往、客观困难异常的危险因素，同伴标化的青春发动时相延迟是情绪、品行、多动、客观困难异常的危险因素；而男生同伴标化的青春发动时相提前是情绪、客观困难异常的危险因素，同伴标化的青春发动时相延迟可增加情绪、多动、客观困难异常的危险因素。. DEP暴露是男生阴毛发育提前的危险因素，DBP暴露是女生乳房发育提前的危险因素，低分子量的PAEs对青春发动时相更具影响。对于男生来说，超重肥胖和低PAEs暴露水平的交互作用男生阴毛发育提前的危险因素；对于女生来说，超重肥胖和低PAEs暴露水平的交互作用是女生乳房发育提前的危险因素。两者的交互作用对青春期发育具有一定的影响，且这种影响具有性别差异性。在对青春发动时相异常的男女生进行干预时需考虑性别差异。.