臺灣博碩士論文加值系統

目的：青春期是一個重要的發展時期，而且在許多精神疾患扮演重要的角色。在過去研究中，針對單一的測量指標，發現有遺傳的貢獻。然而，青春期發展有越來越早啟動的現象，而且不同的國家之間的差異。本研究目的主要針對台灣青少年雙胞胎，探討遺傳因子與環境因子對青春期各項指標的相對貢獻。
方法：研究個案來自於兩個不同的研究計畫，分別進行於1996-1998年以及2001-2004年，共有160對男性雙胞胎、254女性雙胞胎以及54對異性的配對納入本研究的分析。使用中文版的青春期發展量表測量青春期的各項指標，雙胞胎的胎性判定結合身體相似性問卷以及基因定型檢驗兩種方法。利用結構方程式模型建構來估計線性遺傳、非線性遺傳、共享環境與非共享環境因子佔所有變異的百分比。
結果：女性每項青春期指標的線性遺傳佔40%到67%，而男性佔38%到75%。在一些項目有些微的共享環境因子的影響，女性約佔11%到36%，男性約佔12%到21%。女性初經有88%可被共享環境因子所解釋，而女性初經年齡則有73%的變異受到線性遺傳因子的影響。就女生而言，若將青春期分期當做連續變項進行分析，發現沒有線性遺傳因子的效應，若當做類別變項則有63%的變異是來自於現性遺傳因子；就男生而言，利用連續型方法估計到的線性遺傳百分比為49%，利用類別型方法則為75%。
結論：由於青春期發展有趨早啟動的現象，因此環境影響因素不能被忽視，但是本研究發現在台灣青少年中，一些青春期發展主要的特徵，其遺傳的因子都有相當的貢獻。

Objective: Puberty is a critical developmental period and may play an important role on several psychiatric disorders. Despite that contribution from genes to single measures of puberty was indicated in previous twin studies, prominent differential secular trends in pubertal timing were also noted in different countries. The purpose of this study is to examine the relative contributions of genetic and environmental factors to pubertal development assessed comprehensively among adolescent twins in Taiwan, where a steady decline in pubertal timing has been noted in the past decades.
Methods: Participants were adolescent twins recruited from two sources. One was recruited in Taipei City during 1996-1998, and the other was in Taipei City or Taipei County during 2001-2004. A total of 160 pairs of male twins, 254 pairs of female twins, and 54 opposite-sex pairs were included. A Chinese-version of Puberty Developmental Scale was used to measure various aspects of pubertal development. Zygosity was determined using a combination of physical similarity questionnaire and DNA typing. We used structural equation modeling to estimate parameters of additive genetic (A), shared environmental (C), dominant genetic (D), and non-shared environmental (E) factors in accounting for the variation of both individual pubertal development items and composite pubertal scores in either dichotomized or continuous form of variable.
Results: For each pubertal development item common to both genders, including height growth spurt, body hair, and skin change, the proportion of the variance attributed to additive genetic factors ranged from 0.40 to 0.67 for girls and from 0.39 to 0.58 for boys. Moderate contributions from shared environmental factors were also found to breast development (29%), height growth (11%), body hair (36%), and pubertal stage (28%) in girls and skin change (19%), body hair (21%), and facial hair (12%) in boys. For girls, the majority of the variance for the presence of menarche (88%) was explained by shared environmental factors, while that for age of menarche (73%) was by genetic factors. In terms of pubertal stage, the contribution from genes was estimated to be zero using continuous approach and 63% of the variance using categorical approach for girls; meanwhile, for boys, the corresponding figures were 49% and 75%, respectively.
Conclusions: There is substantial genetic contribution to pubertal development for adolescents in Taiwan despite non-negligible influences from shared environmental factors that might have resulted in a prominent secular decline in pubertal timing.

CONTENTS
ACKNOWLEDGMENT I
ABSTRACT II
ABSTRACT (in Chinese) IV
CONTENTS V
LIST OF TABLES VI

INTRODUCTION 1
METHODS 4
Participants 4
Measures 5
Zygosity Determination 6
Statistical Analyses 7
RESULTS 9
DISCUSSION 11
REFERENCES 14

References

Anderson SE, Dallal GE, Must A (2003): Relative weight and race influence average age at menarche: results from two nationally representative surveys of US girls studied 25 years apart. Pediatrics 111:844-50.
Angold A, Coctello EJ, Worthman CM (1998): Puberty and depression: the role of age, pubertal status and pubertal timing. Psychological Medicine 28:51-61.
Angold A, Rutter M (1992): Effects of age and pubertal status on depression in a large clinical sample. Development and Psychopathology 4:5-28.
Angold A, Worthman CW (1993): Puberty onset of gender differences in rates of depression: a developmental, epidemiologic and neuroendocrine perspective. Journal of Affective Disorders 29:145-158.
Bourguignon JP (1988): Linear growth as a function of age at onset of puberty and sex steroid dosage: therapeutic implications. Endocrine Reviews 9:467-88.
Bourguignon JP (1991): Growth and timing of puberty: reciprocal effects. Hormone Research 36:131-5.
Carskadon MA, Acebo C (1993): A self-administered rating scale for pubertal development. Journal of Adolescent Health 14:190-5.
Carter CO, Marshall MA (1978): The genetics of adult stature. In Tanner JM (ed), Human growth, Vol 1. Principles and Prenatal Growth. London, Bailliere Tindall, pp 299-305.
Chang SH, Tzeng SJ, Cheng JY, Chie WC (2000): Height and weight change across menarche of schoolgirls with early menarche. Archives of Pediatrics & Adolescent Medicine 154:880-4.
Chen CJ, Lin TM, Chang C, Cheng YJ (1987): Epidemiological characteristics of twinning rates in Taiwan. Acta Genetic Medical Gemellology 36:335-342.
Chen WJ, Chang HW, Wu MZ, Lin CCH, Chang C, Chiu YN, et al (1999): Diagnosis of zygosity by questionnaire and polymarker polymerase chain reaction in young twins. Behavior Genetics 29:115-123.
Chie WC, Li CY, Huang CS, Chang KJ, Yen ML, Lin RS (1998): Oral contraceptives and breast cancer risk in Taiwan, a country of low incidence of breast cancer and low use of oral contraceptives. International Journal of Cancer 77:219-23.
Chou W-H (2003): Effects of Pubertal Status, Timing, and Progress on Depression and Eating Problems in Adolescents: A longitudinal Study in Taiwan, Institute of Epidemiology. Taipei: National Taiwan University.
Chumlea WC, Schubert CM, Roche AF, Kulin HE, Lee PA, Himes JH, et al (2003): Age at menarche and racial comparisons in US girls. Pediatrics 111:110-3.
Cohen P, Cohen J, Kasen S, Velez C, Hartmark C, Johnson J, et al (1993): An epidemiological study of disorders in late childhood and adolescence--I. Age- and gender-specific prevalence. Journal of Child Psychology & Psychiatry & Allied Disciplines 34.
Cole TJ (2000): Secular trends in growth. Proceedings of the Nutrition Society 59:317-24.
de Muinich Keizer SM, Mul D (2001): Trends in pubertal development in Europe. Human Reproduction Update. 7:287-91.
Delemarre-van de Waal HA, van Coeverden SC, Engelbregt MT (2002): Factors affecting onset of puberty. Hormone Research Suppl 2:15-8.
Eaves L, Silberg J, Foley D, Bulik C, Maes H, Erkanli A, et al (2004): Genetic and environmental influences on the relative timing of pubertal change. Twin Research 7:471-81.
Gau S-F, Soong W-T, Tsai W-Y, Chiu Y-N (1997): A Chinese version of a self-administered rating scale for pubertal development. Taiwanese Journal of Psychiatry 11:128-140.
Hauspie RC, Vercauteren M, Susanne C (1996): Secular changes in growth. Hormone Research 2:8-17.
Hayward C, Killen J, Hammer L, Litt IF, Wilson D, Simmonds B, et al (1992): Pubertal stage and panic attack history in sixth- and seventh-grade girls. American Journal of Psychiatry 149:1239-1243.
Kaprio J, Rimpela A, Winter T, Viken RJ, Rimpela M, Rose RJ (1995): Common genetic influences on BMI and age at menarche. Human Biology 67:739-53.
Koff E, Rierdan J (1993): Advanced pubertal development and eating disturbance in early adolescent girls. Journal of Adolescent Health 14:433-439.
Kuo PH, Lin CC, Yang HJ, Soong WT, Chen WJ (2004): A twin study of competence and behavioral/emotional problems among adolescents in taiwan. Behavior Genetics 34:63-74.
Laitinen-Krispijn S, Van der Ende J, Hazebroek-Kampschreur A, Verhulst F (1999): Pubertal maturation and the development of behavioural and emotional problems in early adolescence. Acta Psychiatrica Scandinavica 99:16-25.
Lin CC, Hsiao CK, Chen WJ (1999): Development of sustained attention assessed using the continuous performance test among children 6-15 years of age. Journal of Abnormal Child Psychology 27:403-12.
Loesch DZ, Huggins R, Rogucka E, Hoang NH, Hopper JL (1995): Genetic correlates of menarcheal age: a multivariate twin study. Annals of Human Biology 22:470-90.
Meyer JM, Eaves LJ, Heath AC, Martin NG (1991): Estimating genetic influences on the age-at-menarche: a survival analysis approach. American Journal of Medical Genetics 39:148-54.
Mustanski BS, Viken RJ, Kaprio J, Pulkkinen L, Rose RJ (2004): Genetic and environmental influences on pubertal development: longitudinal data from Finnish twins at ages 11 and 14. Developmental Psychology 40:1188-98.
Neale MC, Cardon LR (1992): Methodology for genetic studies of twins and families. New York: Kluwer Academic.
Neale MC, Cardon LR (1997): Mx: statistical modeling, 3rd ed. Box 98012, Medical College of Virginia, Richmond, Va.: Genetics and Human Development Technical Report.
Palmert MR, Boepple PA (2001): Variation in the timing of puberty: clinical spectrum and genetic investigation. Journal of Clinical Endocrinology & Metabolism 86:2364-8.
Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP (2003): The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocrine Reviews 24:668-93.
Perkonigg A, Lieb R, Wittchen H (1998): Prevalence of use, abuse and dependence of illicit drugs among adolescents and young adults in a community sample. European Addiction Research 110:473-480.
Peterson AC, Crockett L, Richards M, Boxer A (1988): A self-report measure of pubertal status: Relibility, validity, and initial norms. Journal of Youth and Adolescence 17:117-133.
Remschmidt H (1994): Psychosocial milestones in normal puberty and adolescence. Hormone Research 41 (Suppl. 2):19-29.
SAS (2002): SAS/STAT User''s Guide, 9 ed. Cary, NC: SAS Institute Inc.
Sharma JC (1983): The genetic contribution to pubertal growth and development studied by longitudinal growth data on twins. Annals of Human Biology 10:163-71.
Steiner M, Dunn E, Born L (2003): Hormones and mood: from menarche to menopause and beyond. Journal of Affective Disorders 74:67-83.
Steinhausen HC (1994): Anorexia and bulimia nervosa. In Hersov L (ed), Child and adolescent psychiatry, 3rd ed: Oxford: Blackwell, pp 425-440.
Treloar SA, Martin NG (1990): Age at menarche as a fitness trait: nonadditive genetic variance detected in a large twin sample.[see comment]. American Journal of Human Genetics 47:137-48.