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Biomedicine & Pharmacotherapy =... Dec 2022Precocious puberty in children is one of the common endocrine diseases in paediatrics. Epidemiological surveys have shown that the number of children with precocious... (Review)
Review
Precocious puberty in children is one of the common endocrine diseases in paediatrics. Epidemiological surveys have shown that the number of children with precocious puberty has significantly increased globally. Precocious puberty negatively affects the physical and mental health of children and may increase the risk of hypertension, diabetes, obesity and infertility in adulthood. Therefore, the initiating factors of adolescence have become core issues in the study of sexual development in children. Owing to developments in molecular genetics, many studies have been able to show that precocious puberty is mostly resulted in autosomal inheritance. For instance, makorin ring finger protein 3 gene (MKRN3) may be implicated in familial CPP. Gonadotropin-releasing hormone agonist (GnRHa) is the gold standard for treatment, but its safety still requires long-term evaluation and management. Traditional medicinal plants have been used in clinical treatments and in exploring novel treatment methods. From the collected datas, in Asia, traditional Chinese medicine treatment is based on the principles of nourishing Yin, lowering fire and draining fire from the liver to help precocious children and alleviate or delay the onset of precocious puberty by medicinal plants such as Anemarrhena asphodeloides Bge., Phellodendron amurense Rupr., Rehmannia glutinosa and Poria cocos Wolf. They play an important role in exploring the pharmacological mechanisms of precocious puberty treatment effects and drug development. Therefore, by elucidating the occurrence and development of precocious puberty, this review provides novel and valuable insights of paediatric endocrine therapy accessing the published researches on the effectiveness of traditional herbal medicine in the treatment of precocious puberty and its therapeutic mechanisms.
Topics: Child; Humans; Puberty, Precocious; Plants, Medicinal; Gonadotropin-Releasing Hormone; Medicine, Traditional; Ubiquitin-Protein Ligases
PubMed: 36411607
DOI: 10.1016/j.biopha.2022.113907 -
International Journal of Public Health 2023To investigate the associations of obesity with growth and puberty in children. From November 2017 to December 2019, height, weight, and Tanner stages of 26,879...
To investigate the associations of obesity with growth and puberty in children. From November 2017 to December 2019, height, weight, and Tanner stages of 26,879 children aged 3-18 years in Fuzhou, China were assessed. The obese group was significantly taller than the non-obese group after age 4 years for both genders, yet there was no significant difference in height between obese and non-obese group after 15.5 years old for boys and 12.5 years old for girls. The inflection points of significant growth deceleration in obese and non-obese groups were 14.4 and 14.6 years old for boys, and 11.8 and 12.8 years old for girls, respectively. The proportions of testicular development in boys with obesity and non-obesity were 7.96% and 5.08% at 8.5-8.9 years old, respectively, while the proportions of breast development in girls were 17.19% and 3.22% at age 7.5-7.9 years old, respectively. Children with obesity were taller in early childhood, earlier onset of puberty and earlier cessation of growth than children with non-obesity of the same age. However, there was sex dimorphism on the effect of obesity on the incidence of precocious puberty.
Topics: Humans; Child; Child, Preschool; Female; Male; Adolescent; Cross-Sectional Studies; Obesity; Puberty; Puberty, Precocious; China
PubMed: 37255545
DOI: 10.3389/ijph.2023.1605433 -
Journal of Pediatric and Adolescent... Oct 2022This is the first of two installments examining early puberty in girls. The first paper will discuss secular trends in onset of puberty and the possible mechanisms to... (Review)
Review
This is the first of two installments examining early puberty in girls. The first paper will discuss secular trends in onset of puberty and the possible mechanisms to explain these developments. The potential etiologies examined will include the role of endocrine-disrupting chemicals and obesogens, the impact of body mass index and obesity, genetic and biologic pathways, and the influence of lifestyle behaviors. The second paper of the two-part series will examine the potential health impacts of early puberty on young and adult women and offer suggestions for clinical management and public health prevention.
Topics: Adult; Biological Products; Body Mass Index; Female; Humans; Obesity; Puberty; Puberty, Precocious
PubMed: 35537618
DOI: 10.1016/j.jpag.2022.04.009 -
Advances in Pediatrics Aug 2020
Review
Topics: Body Height; Child; Disease Management; Gonadotropin-Releasing Hormone; Humans; Puberty, Precocious
PubMed: 32591066
DOI: 10.1016/j.yapd.2020.04.003 -
Endocrinology and Metabolism Clinics of... Jun 2024Central precocious puberty (CPP) among males is less frequent than among females but more likely to have an underlying pathologic cause. Diagnosis of CPP is often... (Review)
Review
Central precocious puberty (CPP) among males is less frequent than among females but more likely to have an underlying pathologic cause. Diagnosis of CPP is often straightforward among males because increased testicular volume, the first sign of puberty, can be verified although careful central nervous system (CNS) assessment is generally necessary. Treatment with gonadotropin-releasing hormone agonist (GnRHa) is indicated, given in conjunction with any therapy needed for CNS lesions. Monitoring of treatment usually can consist of evaluating growth and physical puberty and with testosterone levels as the only lab data. Short-term and long-term outcome data indicate efficacy and safety, although data are limited. Such data need to be reported.
Topics: Humans; Puberty, Precocious; Male; Gonadotropin-Releasing Hormone; Child; Treatment Outcome
PubMed: 38677867
DOI: 10.1016/j.ecl.2024.01.005 -
Journal of Neuroendocrinology Feb 2022Puberty is a crucial biological process normally occurring at a specific time during the lifespan, during which sexual and somatic maturation are completed, and... (Review)
Review
Puberty is a crucial biological process normally occurring at a specific time during the lifespan, during which sexual and somatic maturation are completed, and reproductive capacity is reached. Pubertal timing is not only determined by genetics, but also by endogenous and environmental cues, including nutritional and metabolic signals. During the last decade, we have learned much regarding the essential roles of kisspeptins and the neuropeptide pathways that converge on these neurones to modulate kisspeptin signalling, as well as neurokinin B and dynorphin, the co-transmitters of Kiss1 neurones in the arcuate nucleus, and the effects of melanocortins on puberty. Indeed, melanocortins are involved in transmitting the regulatory actions of metabolic cues on pubertal maturation. Intracellular metabolic sensors, such as the AMP-activated protein kinase and the fuel-sensing deacetylase SIRT1, have been shown to contribute to puberty. Further understanding of these signals and regulatory circuits will help uncover the intimacies of the central control of puberty, as well as how alterations in metabolic status, ranging from undernutrition to obesity, affect the pubertal process. Precocious puberty is rare and has a clear female predominance. Central precocious puberty (CPP) is diagnosed when premature activation of the hypothalamic-pituitary axis occurs. Its causes are heterogeneous, with alterations of the central nervous system being of special interest, and with environmental factors also playing a role in some cases. During the last decade, several mutations in different genes (including KISS1, KISS1R, MKRN3 and DLK1) that cause CPP have been discovered. Loss-of-function mutations in MKRN3 are the most common monogenic cause of CPP known to date. Here, we review and update what is known regarding the genotype-phenotype relationship in patients with CPP.
Topics: Female; Humans; Kisspeptins; Male; Melanocortins; Puberty, Precocious; Receptors, Kisspeptin-1; Sexual Maturation; Ubiquitin-Protein Ligases
PubMed: 33904190
DOI: 10.1111/jne.12979 -
Environmental Science & Technology Jun 2023Concerns about the endocrine-disrupting effects of per- and polyfluoroalkyl substances (PFASs) have raised questions about their potential influence on precocious...
Concerns about the endocrine-disrupting effects of per- and polyfluoroalkyl substances (PFASs) have raised questions about their potential influence on precocious puberty in girls, which is an emerging concern in some populations. However, epidemiological evidence is lacking. In this study, 882 serum samples were collected from girls with central precocious puberty (CPP, = 226), peripheral precocious puberty (PPP, = 316), and healthy controls ( = 340) in 2021 in Shanghai, China. The serum levels of 25 legacy and emerging PFASs and 17 steroids were measured. Results showed that PFAS exposure was positively associated with estradiol levels. Eleven PFASs were significantly or marginally associated with the higher odds of the overall precocious puberty. Across subtypes, PFASs were more clearly associated with PPP, while the associations with CPP were consistent in direction but did not reach statistical significance. These findings were consistent with the assessment of PFAS mixtures using quantile-based g-computation (qgcomp) and Bayesian kernel machine regression, with perfluorobutane sulfonate and 6:2 polyfluorinated ether sulfonate showing the highest contribution to joint effects. Although changes in serum estradiol could arise from various factors, our results suggest that the PFAS exposure may contribute to the increase in estradiol secretion, thereby increasing the risk of precocious puberty, especially PPP. The potential effects of PFASs on precocious puberty warrant further investigation, given the associated complications of public health concern, including psychological distress and increased risk of multiple diseases.
Topics: Female; Humans; Puberty, Precocious; Bayes Theorem; China; Estradiol; Fluorocarbons
PubMed: 37308320
DOI: 10.1021/acs.est.3c01271 -
Frontiers in Endocrinology 2022To compared the incidence rates and clinical features of precocious girls before and during the COVID-19 pandemic among Shanghai school-aged girls, and explored the...
OBJECTIVE
To compared the incidence rates and clinical features of precocious girls before and during the COVID-19 pandemic among Shanghai school-aged girls, and explored the potential mechanisms.
METHODS
This cross-sectional study collected medical data about precocious girls between 2016 and 2020 from Shanghai Children's Medical Center. Data of inpatient precocious girls from March to August in 2016-2019 (n=246) and 2020 (n=237) were collected. Subjects with abnormal brain and pituitary gland MRI reports, other endocrine diseases or chronic diseases were excluded. Finally, 209 precocious girls were included in the 2016-2019 group and 191 precocious girls were include in the 2020 group. Monthly incidence rates and clinical features were compared between before and during the COVID-19 pandemic. Linear regression models were used to examine the associations between biomarkers to explore the potential mechanisms.
RESULTS
Monthly incidence rates of precocious puberty in outpatient girls from March to December 2020 (0.44-1.36%) and in inpatient girls from March to August 2020 (27.04-47.83%) were higher than those in 2016-2019 (0.30-0.52% and 10.53-18.42%, respectively). Serum concentrations of GnRH were higher in the 2020 group than in the 2016-2019 group (2.81 vs 1.99 mg/L). Serum concentrations of MKRN3 (1.02 vs 1.93 ng/ml) and ghrelin (0.38 vs 0.88 ng/ml) were lower in the 2020 group than in the 2016-2019 group. Moreover, the serum concentration of ghrelin was positively associated with the serum concentration of MKRN3 [0.891 (, 0.612, 1.171); 0.001].
CONCLUSIONS
These findings suggest an increased incidence of precocious puberty during the COVID-19 pandemic among Shanghai school-aged girls, which may be associated with decreased serum concentrations of MKRN3 and ghrelin, and indicated ghrelin as a potential regulatory mechanism of puberty.
Topics: COVID-19; Child; China; Cross-Sectional Studies; Female; Ghrelin; Humans; Pandemics; Puberty, Precocious; Ubiquitin-Protein Ligases
PubMed: 35392135
DOI: 10.3389/fendo.2022.839895 -
Journal of Clinical Research in... Aug 2022Early puberty is development of secondary sex characteristics earlier than the expected normal age range. We subjectively observed an increased frequency of early...
OBJECTIVE
Early puberty is development of secondary sex characteristics earlier than the expected normal age range. We subjectively observed an increased frequency of early puberty during the Coronavirus disease-2019 (COVID-19) lockdown and aimed to show the clinical, demographic characteristics of the cases and the change in its incidence.
METHODS
Female patients with central precocious puberty (CPP, n=28) and rapidly progressive early puberty (RPEP, n=61), presenting to our clinic before (January 2019-March 2020) and during the COVID-19 pandemic (April 2020-June 2021) were included.
RESULTS
Among 28 CPP cases, six (21%) presented before the pandemic lockdown, whereas 22 (79%) were diagnosed during the COVID-19 pandemic lockdown. While RPEP was seen in 16 (26%) patients before the pandemic, 45 (74%) patients were diagnosed during the lockdown period. Presentation with menarche was seen in 15 RPEP patients; two (13%) were in the prepandemic period and 13 (87%) were in the lockdown period. Chronological age, bone age, bone age to chronological age ratio, height, weight, and body mass index standard deviation scores of patients with RPEP and CPP were similar between the prepandemic and pandemic period.
CONCLUSION
In this cohort, the frequency of CPP and RPP cases were significantly (p<0.001) increased during the COVID-19 pandemic, possibly due to environmental changes.
Topics: COVID-19; Communicable Disease Control; Female; Gonadotropin-Releasing Hormone; Humans; Menarche; Pandemics; Puberty, Precocious
PubMed: 35633642
DOI: 10.4274/jcrpe.galenos.2022.2022-12-11 -
Frontiers in Endocrinology 2022As the worldwide secular trends are toward earlier puberty, identification of contributing factors for precocious puberty is critical. We aimed to identify and optimize...
BACKGROUND AND OBJECTIVES
As the worldwide secular trends are toward earlier puberty, identification of contributing factors for precocious puberty is critical. We aimed to identify and optimize contributing factors responsible for onset of precocious puberty machine learning/deep learning algorithms in girls.
METHODS
A cross-sectional study was performed among girls aged 6-16 years from 26 schools in Beijing based on a cluster sampling method. Information was gleaned online questionnaires. Machine/deep learning algorithms were performed using Python language (v3.7.6) on PyCharm platform.
RESULTS
Of 11308 students enrolled, there are 5527 girls, and 408 of them had experienced precocious puberty. Training 13 machine learning algorithms revealed that gradient boosting machine (GBM) performed best in predicting precocious puberty. By comparison, six top factors including maternal age at menarche, paternal body mass index (BMI), waist-to-height ratio, maternal BMI, screen time, and physical activity were sufficient in prediction performance, with accuracy of 0.9530, precision of 0.9818, and area under the receiver operating characteristic curve (AUROC) of 0.7861. The performance of the top six factors was further validated by deep learning sequential model, with accuracy reaching 92.9%.
CONCLUSIONS
We identified six important factors from both parents and girls that can help predict the onset of precocious puberty among Chinese girls.
Topics: China; Cross-Sectional Studies; Deep Learning; Female; Humans; Language; Puberty, Precocious
PubMed: 35846287
DOI: 10.3389/fendo.2022.892005