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Indian Pediatrics May 2024To evaluate the role of basal and follicle-stimulating hormone (FSH)-stimulated inhibin B to differentiate premature thelarche from gonadotropin-dependent precocious...
OBJECTIVE
To evaluate the role of basal and follicle-stimulating hormone (FSH)-stimulated inhibin B to differentiate premature thelarche from gonadotropin-dependent precocious puberty (GDPP).
METHOD
This was a prospective interventional study. Basal and FSH-stimulated inhibin B levels were estimated in girls presenting with thelarche < 8 years age (n = 10), healthy girls with normal pubertal development (pubertal control) (n = 8) and healthy prepubertal girls (prepubertal control) (n = 7). Girls with early puberty were classified as premature thelarche or GDPP based on GnRH agonist stimulation test.
RESULTS
Median (IQR) basal inhibin B in premature thelarche was 5.42 (2.91, 30.58) pg/mL and FSH-stimulated inhibin B was 236.72 (111.53, 4431.73) pg/mL (P = 0.043). Median (IQR) basal inhibin B in GDPP was 64.11 (24.96, 792.45) pg/mL and FSH-stimulated inhibin B was 833.66 (500.11-1266.18) pg/mL (P = 0.043). Basal inhibin B was discriminatory between GDPP and premature thelarche (P = 0.032). Median (IQR) basal inhibin B in prepubertal and prepubertal controls was 20.36 (9.61, 29.12) and 75.48 (58.55, 165.55) pg/mL, respectively.
CONCLUSIONS
Basal inhibin B is useful in differentiation of premature thelarche from GDPP while the role of FSH-stimulated inhibin B needs to be further explored in large sample size.
PubMed: 38803096
DOI: No ID Found -
Endocrinology and Metabolism Clinics of... Jun 2024The age of thelarche has declined in the past few decades but not the age of menarche. This is important when assessing girls who present with breast development between... (Review)
Review
The age of thelarche has declined in the past few decades but not the age of menarche. This is important when assessing girls who present with breast development between 6 and 8 years because not all of them will need treatment. The decision for treatment depends on age, bone age (BA), rate of pubertal progression, height velocity, psychosocial factors, and predicted adult height (PAH), with the caveat that height predictions are not precise and BA interpretation is variable.
Topics: Humans; Puberty, Precocious; Female; Child; Body Height
PubMed: 38677866
DOI: 10.1016/j.ecl.2024.01.004 -
Genes Aug 2023Disorders/Differences of sex development (DSD) are often due to disruptions of the genetic programs that regulate gonad development. The gene, located on chromosome... (Review)
Review
BACKGROUND
Disorders/Differences of sex development (DSD) are often due to disruptions of the genetic programs that regulate gonad development. The gene, located on chromosome 8p23.1, encodes GATA-binding protein 4 (GATA-4), a transcription factor that is essential for cardiac and gonadal development and sexual differentiation.
CASE DESCRIPTION
A child with a history of micropenis and cryptorchidism. At 8 years of age, he came under our observation for an increase in sexual pubic hair (pubarche). The laboratory parameters and the GnRH test suggested a central precocious puberty (CPP). Treatment with GnRH analogs was started, and we decided to perform genetic tests for DSD. The NGS genetic investigation showed a novel and heterozygous variant in the gene.
DISCUSSION
In the literature, 26 cases with 46,XY DSD due to the gene were reported.
CONCLUSION
The novel variant in the gene of our patient was not previously associated with DSD. This is the first case of a DSD due to a mutation that develops precocious puberty. Precocious puberty could be associated with DSD and considered a prelude to hypogonadism in some cases.
Topics: Male; Child; Humans; Puberty, Precocious; Sexual Development; Mutation; Disorders of Sex Development; Gonadotropin-Releasing Hormone
PubMed: 37628683
DOI: 10.3390/genes14081631 -
The Journal of Clinical Endocrinology... Aug 2023Age of pubertal onset has been decreasing in many countries but there have been no data on pubertal development in Chinese children over the last decade.
CONTEXT
Age of pubertal onset has been decreasing in many countries but there have been no data on pubertal development in Chinese children over the last decade.
OBJECTIVE
The primary objective of the study was to evaluate the current status of sexual maturation in Chinese children and adolescents. Secondary objectives were to examine socioeconomic, lifestyle, and auxological associations with pubertal onset.
METHODS
In this national, cross-sectional, community-based health survey, a multistage, stratified cluster random sampling method was used to select a nationally representative sample, consisting of 231 575 children and adolescents (123 232 boys and 108 343 girls) between 2017 and 2019. Growth parameters and pubertal staging were assessed by physical examination.
RESULTS
Compared to 10 years previously, the median age of Tanner 2 breast development and menarche were similar at 9.65 years and 12.39 years respectively. However, male puberty occurred earlier with a median age of testicular volume ≥4 mL of 10.65 years. Pubertal onset did occur earlier at the extremes, with 3.3% of the girls with breast development at 6.5-6.99 years old, increasing to 5.8% by 7.5-7.99 years old. Early pubertal onset was also noted in boys, with a testicular volume ≥ 4 mL noted in 1.5% at 7.5-7.99 years, increasing to 3.5% at 8.5-8.99 years old. Obesity and overweight increased risk of developing earlier puberty relative to normal weight in both boys and girls.
CONCLUSION
Over the past decade, pubertal development is occurring earlier in Chinese children. While the cause is multifactorial, overweight and obesity are associated with earlier puberty onset. The currently used normative pubertal data of precocious puberty may not be applicable to diagnose precocious puberty.
Topics: Child; Female; Humans; Male; Cross-Sectional Studies; East Asian People; Menarche; Obesity; Overweight; Puberty; Puberty, Precocious; Sexual Maturation
PubMed: 36881937
DOI: 10.1210/clinem/dgad102 -
Journal of Pediatric Endocrinology &... Jun 2024This study is aimed to explore the correlation between bisphenol A (BPA) and phthalates, including diethylhexylphthalate (DEHP) and dibutylphthalate (DBP), and...
OBJECTIVES
This study is aimed to explore the correlation between bisphenol A (BPA) and phthalates, including diethylhexylphthalate (DEHP) and dibutylphthalate (DBP), and precocious puberty (PP).
METHODS
A case-control study was conducted in Ho Chi Minh City, Vietnam, from November 2021 to April 2022, involving 250 children, with 124 of them diagnosed with PP and 126 serving as controls. We assessed the levels of urinary BPA, DEHP, and DBP in all participants and examined their association with the risk of PP.
RESULTS
BPA was detected in 11.3 % of PP cases but was not found in any individuals in the control group (p<0.001). Diethylhexylphthalate metabolite (MEHP) was not detected in any of the samples. Positive urinary results for dibutylphthalate metabolite (MBP) were observed in 8.1 % of PP cases and 2.4 % in the control group, with an odds ratio of 3.6 (95 % confidence interval: 0.97-13.4, p=0.03).
CONCLUSIONS
The PP group exhibited a higher prevalence of positive urinary BPA and DBP levels compared to the control group.
PubMed: 38829694
DOI: 10.1515/jpem-2024-0144 -
The Journal of Clinical Endocrinology... Feb 2024There are only a few nationwide studies on boys with central precocious puberty (CPP) and the last Italian study is a case series of 45 boys that dates back to 2000.
CONTEXT
There are only a few nationwide studies on boys with central precocious puberty (CPP) and the last Italian study is a case series of 45 boys that dates back to 2000.
OBJECTIVE
We aimed to evaluate the causes of CPP in boys diagnosed during the last 2 decades in Italy and the relative frequency of forms with associated central nervous system (CNS) abnormalities on magnetic resonance imaging (MRI) compared to idiopathic ones.
METHODS
We performed a national multicenter retrospective study collecting data from 193 otherwise normal healthy boys with a diagnosis of CPP. Based on MRI findings, the patients were divided into: Group 1, no CNS abnormalities; Group 2, mild abnormalities (incidental findings) unrelated to CPP; and Group 3, causal pathological CNS abnormalities.
RESULTS
The MRI findings show normal findings in 86%, mild abnormalities (incidental findings) in 8.3%, and causal pathological CNS abnormalities in 5.7% of the cases. In Group 3, we found a higher proportion of patients with chronological age at diagnosis < 7 years (P = .00001) and body mass index greater than +2 SDS (P < .01). Gonadotropin-releasing hormone analogue therapy was started in 183/193 subjects. The final height appeared in the range of the target height in all groups and in 9 patients in whom the therapy was not started.
CONCLUSION
In our study on a large nationwide cohort of boys referred for precocious puberty signs, the percentage of forms associated with CNS abnormalities was one of the lowest reported in the literature.
PubMed: 38308814
DOI: 10.1210/clinem/dgae035 -
Clinics (Sao Paulo, Brazil) 2023Prior studies have found inconsistent results regarding the relationship between vitamin D status and Idiopathic Central Precocious Puberty (ICPP).
INTRODUCTION
Prior studies have found inconsistent results regarding the relationship between vitamin D status and Idiopathic Central Precocious Puberty (ICPP).
OBJECTIVE
To assess the role of serum 25-hydroxyvitamin D (25 [OH]D) levels in ICPP development.
METHOD
The authors retrospectively collected data from 221 girls with ICPP and 144 healthy girls between January 2017 and December 2019. The participants' serum 25(OH)D levels were measured using an automatic chemiluminescence method, and the association between serum 25(OH)D levels and the risk of ICPP was assessed using multivariate logistic regression analysis. Odds Ratios (OR) with 95% Confidence Intervals (95% CI) were calculated as effect estimates.
RESULTS
Serum 25(OH)D levels in the ICPP group were significantly lower than those in healthy controls (p < 0.001). Multivariate analysis indicated that girls with insufficient vitamin D levels (OR = 0.201; 95% CI 0.094-0.428; p < 0.001) and sufficient vitamin D levels (OR = 0.141; 95% CI 0.053-0.375; p < 0.001) both had a lower risk of ICPP than girls with vitamin D deficiency. Moreover, the authors found that the height (p = 0.014), weight (p = 0.014), breast stage (p = 0.010), mother's height (p < 0.001), and luteinizing hormone/follicle-stimulating hormone ratio (p = 0.010) in girls with ICPP could be associated with levels of vitamin D.
CONCLUSION
This study found that a low serum 25(OH)D level is an independent risk factor for ICPP, and several characteristics of girls with ICPP could be affected by their vitamin D status.
Topics: Female; Humans; Puberty, Precocious; Retrospective Studies; Vitamin D; Luteinizing Hormone; Vitamins; Gonadotropin-Releasing Hormone
PubMed: 37418796
DOI: 10.1016/j.clinsp.2023.100244 -
Cancer Management and Research 2023Optic pathway glioma (OPG) occurs in as many as one-fifth of individuals with the neurofibromatosis type 1 (NF1) cancer predisposition syndrome. Generally considered... (Review)
Review
Optic pathway glioma (OPG) occurs in as many as one-fifth of individuals with the neurofibromatosis type 1 (NF1) cancer predisposition syndrome. Generally considered low-grade and slow growing, many children with NF1-OPGs remain asymptomatic. However, due to their location within the optic pathway, ~20-30% of those harboring NF1-OPGs will experience symptoms, including progressive vision loss, proptosis, diplopia, and precocious puberty. While treatment with conventional chemotherapy is largely effective at attenuating tumor growth, it is not clear whether there is much long-term recovery of visual function. Additionally, because these tumors predominantly affect young children, there are unique challenges to NF1-OPG diagnosis, monitoring, and longitudinal management. Over the past two decades, the employment of authenticated genetically engineered -OPG mouse models have provided key insights into the function of the protein, neurofibromin, as well as the molecular and cellular pathways that contribute to optic gliomagenesis. Findings from these studies have resulted in the identification of new molecular targets whose inhibition blocks murine -OPG growth in preclinical studies. Some of these promising compounds have now entered into early clinical trials. Future research focused on defining the determinants that underlie optic glioma initiation, expansion, and tumor-induced optic nerve injury will pave the way to personalized risk assessment strategies, improved tumor monitoring, and optimized treatment plans for children with NF1-OPG.
PubMed: 37465080
DOI: 10.2147/CMAR.S362678 -
BMC Pediatrics Jul 2023This study aimed to examine the mediating effects of parenting style on the relationship between parental stress and behavioral problems of girls with precocious puberty.
The mediating effects of parenting style on the relationship between parental stress and behavioral problems in girls with precocious puberty in Korea: a cross-sectional study.
BACKGROUND
This study aimed to examine the mediating effects of parenting style on the relationship between parental stress and behavioral problems of girls with precocious puberty.
METHODS
This cross-sectional study analyzed a convenience sample of 200 mothers of girls with precocious puberty at a university hospital located in a metropolitan area. The Parental Stress measurement, Parents as Social Context Questionnaire, and Korean version Child Behavior Checklist (K-CBCL) 6-18 were measured via self-report questionnaires. Descriptive, t-test, Pearson correlation, and bootstrapping analyses were used to analyze the data.
RESULTS
Negative parenting styles had a full mediating effect on the relationship between parental stress and internalizing and externalizing behavioral problems.
CONCLUSIONS
Care plans for parents of girls with precocious puberty should be designed and applied in health care settings to reduce internalizing and externalizing behavioral problems by decreasing negative parenting styles.
Topics: Child; Female; Humans; Parenting; Cross-Sectional Studies; Puberty, Precocious; Problem Behavior; Parents; Republic of Korea
PubMed: 37438739
DOI: 10.1186/s12887-023-04172-1 -
Frontiers in Pediatrics 2023[This corrects the article DOI: 10.3389/fped.2023.1226933.].
[This corrects the article DOI: 10.3389/fped.2023.1226933.].
PubMed: 37822321
DOI: 10.3389/fped.2023.1283833