| ObjectiveTo understand the developing process, age and gender characteristic of the events during puberty development of children and adolescents in urban or rural areas of Zhengzhou.To study the healthy effects while the advanced puberty development, probe into the relationship between preceding events during puberty and youth’s health (both physical and mental), and lay the foundation of related research about the puberty.MethodsAt least2elementary schools and middle schools were selected in Zhengzhou which represent city and in Xingyang which represent rural area as samples, measuring them by class as group samples in the selected schools, Sampled at least100boys and100girls in each grade (from Gradel in Elementary School to Grade3in senior school) both areas. Those investigates included medical examination such as stature, weight, waistline, hipline and the skinfold thickness, the significant events during puberty:genital development, testis development, beard development of boys and breast development of girls and also pubic hair and axillary hair development both boys and girls. Using the anonymous questionnaires among the students (above10years old) from Grade4in elementary school to Grade3in senior school, included the investigation of events during puberty, psychological depression and physical activity.Results1. Boys’general states during puberty:The P50age of Genital Development Stage Tanner Ⅱ was attained at11.27years, Stage III at14.02years, Stage Ⅳ at15.80years and Stage Ⅴ at16.45years. The earliest age was at7years.The P50age of Pubic hair Stage Tanner Ⅱ to Ⅴ respectively was attained at13.22years,14.37years,16.10years and16.67years.The earliest age was at10years. The P50age of axillary hair development stage Ⅱand stage Ⅲrespectively was attained at15.54years and16.80years.The earliest age was at Ⅱ years.The P50age of beard development stage Ⅱand stage Ⅲ respectively was attained at16.02years and16.88years.The earliest age was at11years.The age at attainment of testicular volume above4ml was9.98years, and above12ml was12.41years. The P50age of the first spermatorrhea was at13.75years in urban boys while14.50years in rural boys. Urban boys were earlier than rural boys. The minimum age of the first spermatorrhea was at11years.2. Girls’general states during puberty:The P50age of Breast Development Stage Ⅱ was attained at10.64years, Stage Ⅲ at13.63years, Stage Ⅳat15.07years and Stage V at15.58years.The earliest age was at7years. The P50age of Pubic hair Stage Ⅱ to Ⅴ respectively was attained at13.44years,14.80years,15.42years and15.95years.The earliest age was at9years. The P50age of axillary hair stage Ⅱand stage Ⅲ development respectively was attained at14.58years and15.92years.The earliest age was at9years.The P50age of menarche was at12.09years in urban girls,12.23years in rural girls.Urban girls were earlier than rural girls.The minimum of menarche age was at10years.3. States of pubertal self-assessment:The P50age of Genital Development Stage Tanner Ⅱ was attained at11.96years, Stage Ⅲ at14.21years, Stage Ⅳat15.22years and Stage Ⅴ at16.41years. The P50age of Pubic hair Stage Tanner Ⅱ to Ⅴ respectively was attained at11.46years,13.88years,15.17years and16.01years. The P50age of the first spermatorrhea was at13.87years.The P50age of Breast Development Stage Ⅱ was attained at11.20years, Stage Ⅲ at13.50years, Stage IVat14.90years and Stage V at16.37years.T The P50age of Pubic hair Stage II to V respectively was attained at12.24years,14.31years,15.31years and15.79years. The P50age of menarche was at11.40years.4. Relationship between puberty sexual development level and physique development:With the development of puberty, the physical development index such as status, weight, waistline, hipline and skinfold thickness raised up.The developing speed was also different in varied developing stages, the early puberty increased obviously, the growth peak mainly centralized Tanner Ⅱ and Ⅲ, even though in the same age, the physical development index still increased as the puberty development level increased.As for boy’s mean skinfold thickness of triceps, inferior angle of scapula, abdominal, advanced puberty develop group were thicker than normal group(P<0.05), while girls’were thinner than normal puberty development group(P<0.05). The mean waist hip ratio and body fat percentage were higher than normal group no matter boys or girls(P<0.05). The difference of mean BMI index was not significant in those groups.5. Relationship between advanced puberty development and body fat:Using unconditional Logistic Regression analysis showed that BMI was the risk factor (OR=1.334, P<0.05)for boys to increase advanced puberty development, while waist hip ratio was a risk factor, BMI and body fat percentage were protective factors (OR respectively was1.751,0.455,0.687,P<0.05)for girls.The overweight rate (includes obesity) of both girls and boys in advanced puberty development groups were higher than normal groups(P<0.01), the obesity rate was higher obviously(P<0.01).The status of advanced puberty timing were different among different nutritional groups. The obese group was the highest,then overweight group,normal group lower(P<0.01).6. Psychological and physical activity between puberty advanced development group and normal group:Depress symptom detection rate in boys advanced development group(22.0%)was significantly higher than normal boys development group(15.6%).The difference was statistically significant(P<0.05);The same existed in girls group while advanced group(15.9%)and normal group (10.8%). But for the physical activity, that was meaningless in statistics level(P>0.05).Conclusions1. The general order of events during puberty for boys, testicle development was the beginning, next was Genital Development, and then pubic hair was generated, first spermatorrhea appeared at one year later, axillary hair development and beard development were the final steps. For girls, breast development was the first signal, one year later, menarche appeared at one and a half years later, and then pubic air and axillary hair developed. As for the development level, there existed difference in urban and rural children.2. There was closely relationship between puberty sexual development level and physique development. Physique developed with the development level of puberty sexual, and also could increase fast while the level was higher in the same age. The physique developing speed was different obviously in the early puberty, the growth peak mainly centralized Tanner Ⅱ and Ⅲ.There were related between the early pubertal timing and obesity.3. There were some extent effects on psychology during the puberty development, which can be showed by higher detection rates of psychological blahs in the advanced puberty development children and adolescents.The detection and effective interference happened in advance will lead to significant effects on healthy physical and psychological development of children and adolescents.4. Self-assessment of Tanner stage as a reasonable substitute for Tanner stage determined by physical examination, for the purpose of large-scale, epidemiologic research studies when physical examination may not be feasible. |
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