Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The timing of sexual maturation and secular trends of menarchial age in Korean adolescents

한국 청소년의 성성숙 시기 및 장기간의 초경연령 추세분석

  • Park, Mi Jung (Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Lee, In-Sook (College of Nursing, Seoul National University) ;
  • Shin, Eun-Kyung (School of Public Health, Seoul National University) ;
  • Joung, Hyojee (School of Public Health, Seoul National University) ;
  • Cho, Sung-Il (School of Public Health, Seoul National University)
  • 박미정 (인제대학교 의과대학 상계백병원 소아과) ;
  • 이인숙 (서울대학교 간호대학) ;
  • 신은경 (서울대학교 보건대학원) ;
  • 정효지 (서울대학교 보건대학원) ;
  • 조성일 (서울대학교 보건대학원)
  • Received : 2006.02.21
  • Accepted : 2006.03.31
  • Published : 2006.06.15
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Abstract

Purpose : The purpose of this study was to evaluate the timing of sexual maturation and secular trends of menarchial age in Korean adolescents. Methods : Nine hundred eighty two school students and 119 university female students were included. Tanner's pubertal assessment method was applied using a self-assessment sheet with pictures for their developmental stages. A medical checkup database from 1,156,022 women was also used to analyze the age of menarche from the year 1900 to 1980. Results : Onset of puberty was at $11.3{\pm}1.3$ years(y) in girls and $12.1{\pm}1.5$ y in boys and total pubertal duration was 3.6 y in girls and 3.3 y in boys. Height at the onset of puberty was $146.1{\pm}7.9cm$ in girls and $152.7{\pm}9.8cm$ in boys. Weight at the onset of puberty was $39.3{\pm}6.9kg$ in girls and $47.7{\pm}14.4kg$ in boys. The mean age of menarche was $12.0{\pm}1.0y$ and mean age at nocturnal emission was $12.3{\pm}1.8y$. By age ten, 3.0 percent of girls experienced menarche, which increased to 41.1 percent by age 12, and 98.0 percent by age over 15. By SMR 2 breast stage, 18.2 percent of girls experienced menarche, which increased to 66.1 percent and 91.7 percent by SMR stages 3 and 4, respectively. By SMR 2 pubic hair stage, 52.0 percent and by SMR 3, 93.8 percent of girls experienced menarche. While the menarchial age of women born around 1980 was $12.4{\pm}1.1y$, the menarchial age of women born around 1990 was $12.0{\pm}1.1y$. Age at menarche has been advanced approximately by 2 years between 1900 and 1980 birth cohorts. Conclusion : There was a downward secular trend in pubertal timing. Age at menarche has been advanced by 2 years during the last 80 years. Further large scale, prospective studies, including inspection by specialists, are needed to provide reference data for pubertal timing in Korean adolescents.

목 적 : 우리나라 청소년의 성성숙 시기를 알아보고, 특히 성성숙의 객관적 지표인 초경연령의 장기간의 변화추세를 알아보고자 하였다. 방 법 : 초등학교 4학년부터 고등학교 1학년 남녀 총 982명 및 여대생 119명을 대상으로 Tanner의 사춘기 단계를 확인하며 초경연령을 알아보았고, 중, 장년 여성 115만 6천 22명의 건강검진 설문지를 통하여 1900년에서 1980년까지 초경 연령을 확인하여 초경연령의 장기간의 변화를 분석하였다. 결 과 : 사춘기가 시작되는 연령은 여자는 $11.3{\pm}1.3$세, 남자는 $12.1{\pm}1.5$세였으며 성성숙의 총 변화기간은 여자는 평균 3.6년, 남자는 3.3년이었다. 사춘기가 시작될 당시 평균키는 여자는 $146.1{\pm}7.9cm$, 남자는 $152.7{\pm}9.8cm$였고 체중은 여자는 $39.3{\pm}6.9cm$ 남자는 $47.7{\pm}14.4kg$였다. 여자의 평균 초경연령은 $12.0{\pm}1.0$세였고 남자에서 몽정을 처음 경험한 연령은 $12.3{\pm}1.8$세였다. 연령별 초경률은 10세에는 3%, 12세에는 41.1%, 15세 이상의 여학생에서는 98%에서 초경을 경험하였다. 성성숙도별 초경률은 유방발달 2단계에서 18.2%, 3단계에서 66.1%, 4단계에서 91.7%에서 초경을 경험하였으며, 음모발달 2단계에서 초경률은 52.0%이며 음모발달 3단계에서는 93.8% 초경을 경험하였다. 1900년대 출생자의 경우 15-16세까지 약 50%가 초경을 경험한 것에 비해 1980년대 출생자의 경우 13-14세까지 약 50%가 초경을 경험하게 됨으로써 1900-1980년 기간동안 초경연령은 약 2년 정도 빨라진 것으로 나타났다. 1980년대 출생인 대학생의 경우 평균 초경연령은 $12.4{\pm}1.1$세인데 반하여 1990년대 이후 출생인 초, 중, 고등학생의 경우 평균 초경연령은 $12.0{\pm}1.0$세로 나타나 초경의 조기화 경향이 있었다. 결 론 : 남녀 모두에서 성성숙 단계는 점차 빨라지며 특히 초경연령은 지난 80여년간 약 2세 가량 빨라졌으며, 현재의 여학생들에서는 더욱 앞당겨지는 경향이 있어 12세까지 41%가 초경을 경험하였다. 한국 청소년의 사춘기 시기에 관한 참고치를 설정하기 위해서는 전문가의 시진이 포함된 대규모 전향연구가 추후 필요하리라 사료된다.

Keywords

Acknowledgement

Grant : 한국 청소년의 성성숙 시기 및 관련인자 연구

Supported by : 국립독성연구원

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