Secular trend and urban–rural disparity for age at spermarche among Chinese Han boys from 1995 to 2019

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Abstract

Aim

To examine the secular trend and the urban–rural disparity of spermarche among Chinese Han boys from 1995 to 2019.

Methods

A total of 392 775 boys of Han ethnicity aged 11–18 years were extracted from the 1995, 2000, 2005, 2010, 2014 and 2019 Chinese National Surveys on Students' Constitution and Health. The median age at spermarche was estimated using the status quo data and probit analysis. The chi‐square, ANOVA and LSD tests were used to compare the differences between the year‐subgroups. U‐test was used to compare the difference between urban and rural areas at each year.

Results

The median age at spermarche in Chinese Han boys decreased from 14.6 years in 1995 to 13.9 years in 2019 ( p < 0.001). The rural boys showed a faster decreasing pace with a 1‐year advance of age at spermarche while the urban boys had only a 0.5‐year decrement, and there was still a statistically significant difference between urban–rural areas in 2019 ( p < 0.001). Similar to urban–rural disparity, the age gap at spermarche between areas with different urbanisation rates became smaller over time.

Conclusions

In general, spermarche in Chinese Han boys showed a decreasing trend, but the pace was slowing down. The urban–rural disparity in puberty development still existed but was gradually narrowing.

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Most cited references 27

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Importance of investing in adolescence from a developmental science perspective

Ronald E. Dahl, Linda Wilbrecht, Nicholas Allen … (2018)

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Public health implications of altered puberty timing.

Ewa Rajpert-De Meyts, Richard Sharpe, Jorma Toppari … (2008)

Changes in puberty timing have implications for the treatment of individual children, for the risk of later adult disease, and for chemical testing and risk assessment for the population. Children with early puberty are at a risk for accelerated skeletal maturation and short adult height, early sexual debut, potential sexual abuse, and psychosocial difficulties. Altered puberty timing is also of concern for the development of reproductive tract cancers later in life. For example, an early age of menarche is a risk factor for breast cancer. A low age at male puberty is associated with an increased risk for testicular cancer according to several, but not all, epidemiologic studies. Girls and, possibly, boys who exhibit premature adrenarche are at a higher risk for developing features of metabolic syndrome, including obesity, type 2 diabetes, and cardiovascular disease later in adulthood. Altered timing of puberty also has implications for behavioral disorders. For example, an early maturation is associated with a greater incidence of conduct and behavior disorders during adolescence. Finally, altered puberty timing is considered an adverse effect in reproductive toxicity risk assessment for chemicals. Recent US legislation has mandated improved chemical testing approaches for protecting children's health and screening for endocrine-disrupting agents, which has led to changes in the US Environmental Protection Agency's risk assessment and toxicity testing guidelines to include puberty-related assessments and to the validation of pubertal male and female rat assays for endocrine screening.

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Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis

Camilla Eckert-Lind, Alexander S. Busch, Jørgen H. Petersen … (2020)

Has the age at onset of thelarche in girls changed within the past 4 decades? This systematic review and meta-analysis found that age at pubertal onset, with thelarche assessed by physical or clinical examination of the breast, decreased by a mean of almost 3 months per decade from 1977 to 2013. In most textbooks, thelarche among girls younger than 8 years is considered pathologic and warrants further investigations; therefore, a younger age at thelarche in girls in the general population will change current diagnostic decision-making in girls suspected to have puberty disorders. The initial clinical sign of pubertal onset in girls is breast gland development (thelarche). Although numerous studies have used recalled age at menarche (first menstruation) to assess secular trends of pubertal timing, no systematic review has been conducted of secular trends of thelarche. To systematically evaluate published data on pubertal timing based on age at thelarche and evaluate the change in pubertal onset in healthy girls around the world. A systematic literature search was performed in PubMed and Embase of all original peer-reviewed articles published in English before June 20, 2019. Included studies used clinical assessment of breast development in healthy girls and used adequate statistical methods, including the reporting of SEs or CIs. The quality of the articles was evaluated by assessing study design, potential sources of bias, main characteristics of the study population, and methods of statistical analysis. In accordance with PRISMA guidelines, all articles were assessed for eligibility independently by 2 authors. Weighted regression analysis was performed using a random-effects model. Studies examining age at thelarche (development of Tanner breast stage 2) in healthy girls. The literature search resulted in a total of 3602 studies, of which 30 studies fulfilled the eligibility criteria. There was a secular trend in ages at thelarche according to race/ethnicity and geography. Overall, the age at thelarche decreased 0.24 years (95% CI, −0.44 to −0.04) (almost 3 months) per decade from 1977 to 2013 ( P = .02). The age at thelarche has decreased a mean of almost 3 months per decade from 1977 to 2013. A younger age at pubertal onset may change current diagnostic decision-making. The medical community needs current and relevant data to redefine “precocious puberty,” because the traditional definition may be outdated, at least in some regions of the world. This systematic review and meta-analysis evaluates published data on pubertal timing based on age at thelarche and evaluates the change in pubertal onset in healthy girls around the world.

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Author and article information

Contributors

Di Shi: (View ORCID Profile)

Yi Song: (View ORCID Profile)

Journal

Title: Acta Paediatrica

Abbreviated Title: Acta Paediatrica

Publisher: Wiley

ISSN (Print): 0803-5253

ISSN (Electronic): 1651-2227

Publication date Created: March 2023

Publication date (Electronic): December 30 2022

Publication date (Print): March 2023

Volume: 112

Issue: 3

Pages: 529-536

Affiliations

[1 ] Institute of Child and Adolescent Health, School of Public Health Peking University Beijing China

[2 ] National Health Commission Key Laboratory of Reproductive Health Peking University Beijing China

[3 ] Department of Sport, Physical Education and Health Hong Kong Baptist University Hong Kong China

[4 ] Laboratory of Exercise Science and Health BNU‐HKBU United International College Zhuhai China

Article

DOI: 10.1111/apa.16636

PubMed ID: 36541131

SO-VID: 87574506-96c9-4a56-82e2-963cec79923e

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http://onlinelibrary.wiley.com/termsAndConditions#vor

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Secular trend and urban–rural disparity for age at spermarche among Chinese Han boys from 1995 to 2019

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Abstract

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Most cited references 27

Importance of investing in adolescence from a developmental science perspective

Public health implications of altered puberty timing.

Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis

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Cited by 4

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