Comparison Self-assessment Method And Examer-assessment Of Early Pubertal Timing And The Analysis Of Influence Factors In Chongqing Adolescents

Objective:1.To investigate the current status of pubertal timing and prevalence of sexual precocity among Chongqing urban school-aged boys.2.To compare the self-assessment with the examer-assessment for chongqing urben children, provide a reference for better evaluation method.3.To explore the influence factors of pubertal timing for scientific and reasonable adolescent health care reference.Methods : 1. 2969 subjects were selected in Chongqing urben school-aged children through the multi-stage samping.The questionnaire survey,secondary sexual development and physical examination were used to evaluate the two methods` incidence of early pubertal timing.The value of Kappa, sensitivity and specificity were calculated to estimate the two methods’ coefficient of concordance.2.Using the unconditional Logistic regression analysis to explore the influence factors of early pubertal timing.Results:1.This study surveyed 2969 subjects,and the range of age was 8~20 years,the average age was(13.70 ± 2.87)years.There were 1528 males and 1441 females;1534 urban children and 1435 rural children;906 primary school-students, 985 junior school-students and 1078 senior school-students.2.The median average age of the first spermatorrhea,testicular volume reached 4 ml,12 ml and 20 ml,pubic hair development stage to MP2,MP3 and MP4 of boys was 14.65 years,9.98,13.14 and 18.47,12.85,14.45 and 15.75 years,respectively.The median average age of the menarche,pubic hair growth stage to FP2,FP3 and FP4,breast development stage to B2,B3 and B4 of girls was 11.92 years,12.54,12.54 and 18.51,9.70,12.36 and 15.53, respectively.3.According to the examer-assessment method,the incidence of early pubertal timing in girls(8.8%)is higher than boys(3.3%);the incidence in urban children(8.3%)is higher than rural children(3.5%);the above differences are statistically significant(P<0.05).According to the self-assessment method,the incidence in urban children(19.4%)is higher than rural children(13.7%)and there is statistically significant(P<0.05).4.The overall incidence of early pubertal timing of the two methods is 6.0% and 16.7% respectively,and there is statistically significant(P<0.05).The value of Kappa of the two methods is 0.126.And the examer-assessment method is considered as the gold standard, the value of sensitivity and specificity of the self-assessment method is 0.384 and 0.833,respectively.5.Our study shows that girls comparing with boys,urban comparing with rural,juniors comparing with primary students and obesity and over-weight comparing with normal weight are the risk factors of early pubertal timing through the unconditional Logistic regression analysis, and the difference are statistically significant(P<0.05).Conclusion:1.The self-assessment method is not perfect and needed more studys because of there is difference between the examer-assessment method with the self-assessment method.2.Comparison with boys,the rural children and the normal weight children,girls,the urban children and obesity and over-weight are more likely to early pubertal timing.And juniors comparing with primary students is another risk factor of early pubertal timing.Thus,our health-care of puberty should be more targeted.