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Liang X, Huang K, Dong G, Chen R, Chen S, Zheng R, Wang C, Wei H, Cao B, Liang Y, Yao H, Su Z, Maimaiti M, Luo F, Li P, Zhu M, Du H, Yang Y, Cui L, Si S, Bai G, Yu Y, Wang EG, Hofman PL, Fu J. Current Pubertal Development in Chinese Children and the Impact of Overnutrition, Lifestyle, and Perinatal Factors. J Clin Endocrinol Metab 2023; 108:2282-2289. [PMID: 36881937 DOI: 10.1210/clinem/dgad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Abstract
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.
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Affiliation(s)
- Xinyi Liang
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310057, China
| | - Ke Huang
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310057, China
| | - Guangping Dong
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310057, China
| | - Ruimin Chen
- Department of Endocrinology, Children's Hospital of Fuzhou, Fuzhou, Fujian Province 350001, China
| | - Shaoke Chen
- Department of Pediatric, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530002, China
| | - Rongxiu Zheng
- Department of Pediatrics, Tianjin Medical University Central Hospital, Tianjin 300204, China
| | - Chunlin Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Haiyan Wei
- Department of Endocrinology, Zhengzhou Children's Hospital, Zhengzhou 450012, China
| | - Bingyan Cao
- Department of Endocrinology, Beijing Children's Hospital, Capital Medical University, National Medical Center for Children's health, Beijing 100045, China
| | - Yan Liang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hui Yao
- Department of Pediatric, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430019, China
| | - Zhe Su
- Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen 518034, China
| | - Mireguli Maimaiti
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 839911, China
| | - Feihong Luo
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, Shanghai 200433, China
| | - Pin Li
- Department of Endocrinology, Children's Hospital of Shanghai Jiaotong University, Shanghai 200240, China
| | - Min Zhu
- Department of Endocrinology, Children's Hospital of Chongqing Medical University, Chongqing 400015, China
| | - Hongwei Du
- Department of Pediatric Endocrinology, The First Bethune Hospital of Jilin University, Changchun 130021, China
| | - Yu Yang
- Department of Endocrinology, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - Lanwei Cui
- Department of Pediatrics, The First Affiliated Hospital of Harbin Medical University, Harbin 150010, China
| | - Shuting Si
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310030, China
| | - Guannan Bai
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310057, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310030, China
| | - Er-Gang Wang
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Junfen Fu
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310057, China
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Puwanant M, Mo-Suwan L, Jaruratanasirikul S, Jessadapakorn W. Body-Fat-Percentile Curves for Thai Children and Adolescents. Nutrients 2023; 15:nu15020448. [PMID: 36678319 PMCID: PMC9865357 DOI: 10.3390/nu15020448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
This study aimed to generate sex-specific percentile curves for the percentage of body fat (PBF) in Thai children using a bioelectrical impedance analysis (BIA). The secondary objective of this study was to determine the association between body fat and other anthropometric measurements. A cross-sectional study was conducted on 3455 Thai school children aged 6-18 years. The body-fat contents were measured using BIA. Smoothed percentile curves of PBF were derived using a scatter plot with a smooth curve fitted by the Loess method. The correlations between the body fat and the anthropometric measurements were assessed using the Spearman's rank correlation. The 50th and lower body-fat-percentile curves of the boys slowly increased until age 12, after which they slightly decreased until age 15 and then slightly increased until age 18. In the higher boys' percentiles, the body fat sharply increased until age 11 and then decreased until age 18. In the girls, the PBF percentiles increased steadily from 6 to 18 years. The body-mass index was strongly correlated with PBF and fat mass in both sexes. The waist-to-height ratios showed strong correlations with PBF and fat mass in the boys but were moderate in the girls. The use of PBF percentile curves can be an additional metric for the evaluation of obesity in Thai children.
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Affiliation(s)
- Maneerat Puwanant
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai District, Songkhla 90110, Thailand
- Correspondence: ; Tel.: +66-89-659-4779
| | - Ladda Mo-Suwan
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai District, Songkhla 90110, Thailand
| | - Somchit Jaruratanasirikul
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai District, Songkhla 90110, Thailand
| | - Wipa Jessadapakorn
- Vachira Phuket Hospital, 353 Yaowarat Road, Talat Yai Subdistrict, Mueang Phuket District, Phuket 83000, Thailand
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Xu D, Zhou X, Wang J, Cao X, Liu T. The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis. BMC Pediatr 2022; 22:453. [PMID: 35902824 PMCID: PMC9331156 DOI: 10.1186/s12887-022-03481-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The gonadotropin-releasing hormone (GnRH) stimulation test is time-consuming, invasive, and costly. However, it is the diagnostic gold standard for central precocious puberty (CPP), which in girls is defined as the onset of secondary sexual characteristics before the age of 8 years accompanied by breast buds, accelerated growth, and advanced bone age. This meta-analysis was performed to compare the diagnostic value of urinary gonadotropins and the GnRH stimulation test for CPP. METHODS We searched six databases for relevant literature. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we estimated the sensitivity, specificity, area under the summary receiver operating characteristic curve (AUC), and publication bias. RESULTS Six eligible trials fulfilled the inclusion criteria. In the meta-analysis of urinary luteinizing hormone (ULH), after excluding the data of one study, we obtained an AUC of 0.90 (sensitivity = 0.81, specificity = 0.85). The meta-analysis of the ULH to urinary follicle-stimulating hormone (UFSH) ratio revealed an AUC of 0.8116 (sensitivity = 0.79, specificity = 0.84). CONCLUSION Both the ULH level and ULH:UFSH ratio are effective and available approaches for CPP diagnosis. TRIAL REGISTRATION INPLASY 2021120076 .
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Affiliation(s)
- Dan Xu
- Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China.,Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat- sen University, New Xiangzhou, Zhuhai, Guangdong Province, 519000, China
| | - Xueying Zhou
- Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China
| | - Junfei Wang
- Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China
| | - Xi Cao
- Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China
| | - Tao Liu
- Department of Pediatrics, the First Affiliated Hospital of Nanchang University, Jiangxi, 330006, Nanchang, China.
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Liu M, Cao B, Luo Q, Wang Q, Liu M, Liang X, Wu D, Li W, Su C, Chen J, Gong C. The critical BMI hypothesis for puberty initiation and the gender prevalence difference: Evidence from an epidemiological survey in Beijing, China. Front Endocrinol (Lausanne) 2022; 13:1009133. [PMID: 36387887 PMCID: PMC9641365 DOI: 10.3389/fendo.2022.1009133] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although previous studies suggested that there is a certain level of body fat mass before puberty can be initiated, most studies have focused on girls. OBJECTIVE To investigate the relationship between precocious puberty and physical growth in school-aged children in Beijing, China. METHODS 7590 Chinese children (3591 girls and 3999 boys) aged 6-11 years were recruited in Beijing, China. Body mass index (BMI) categories were defined by WHO Child Growth Standards and central obesity were defined by sex-specific waist-to-height ratio cut-offs (≥0.46 for girls, ≥0.48 for boys). Sexual development was assessed using Tanner criteria. RESULTS The prevalence of general obesity and central obesity among boys was higher than that in girls. Girls had a significantly higher precocious puberty rate than boys (5.93% vs. 0.87%), particularly in those aged 7 years old (9.20%). Children in the general obesity and central obesity groups have a higher prevalence of precocious puberty and earlier median ages for the attainment of Tanner B2/T2. For girls with Tanner stages≥II at 6-year-old and 7-year-old, the mean BMI was equivalent to the 50th centile of a normal 9.9-year-old and 11.9-year-old girl, respectively. The mean BMI of boys with Tanner stages≥II at 7-year-old and 8-year-old was correspondent to the 50th centile of a normal 14-year-old and 15.3-year-old boy, respectively. For girls, general obesity appears to contribute to the risk of the development of precocious puberty to a greater extent than central obesity does. For boys, central obesity, but not general obesity, was an independent risk factor for precocious puberty. CONCLUSIONS The prevalence of childhood obesity and precocious puberty was high in China. Precocious puberty was correlated with a large BMI. Boys had a higher threshold of BMI for puberty development than girls. Children with precocious puberty, particularly those with central obesity, should be aware of adverse cardiovascular events.
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Affiliation(s)
- Meijuan Liu
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Bingyan Cao
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Qipeng Luo
- Department of Pain Medicine, Peking University Third Hospital, Beijing, China
| | - Qiao Wang
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Min Liu
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Xuejun Liang
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Wenjing Li
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Chang Su
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Jiajia Chen
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chunxiu Gong,
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5
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Sex differences in the relationship between body composition and biomarkers of bone and fat metabolism in obese boys and girls. Bone Rep 2021; 14:101087. [PMID: 34026951 DOI: 10.1016/j.bonr.2021.101087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
Whether a body mass derived from extremes of body weight is beneficial to bone remains controversial. When fat accumulation reaches excessive levels and induces changes in hormonal factors and adipokines, it may affect bone accrual during growth. This study evaluated the relationships between body composition and key biomarkers in relation to bone and fat metabolism in obese Thai boys and girls. Subjects aged 12-14 years were grouped by body mass index (BMI) and percentage of body fat (%Fat). Body composition and heel bone Z-score and speed of sound (SOS) were assessed by bioelectrical impedance analysis and calcaneus bone densitometry, respectively. Serum osteocalcin (OC), adiponectin, leptin, insulin, and 25 hydroxyvitamin D (25(OH)D) were measured by ELISA. Their correlations were analyzed and compared between sexes. The results showed that the obese groups had no differences in mean BMIs and body composition, except that boys had more muscle mass than girls. Boys had lower serum OC and leptin levels than girls. Positive correlations of leptin with %Fat and FM were found in both sexes, while positive associations of %Fat with OC and insulin were found only in boys. Bone Z-score and SOS positively correlated with OC in boys but negatively correlated with 25(OH)D in girls. When classifying the obese group using %Fat ≥25, the positive correlations between %Fat and insulin and the negative associations between %Fat and adiponectin in girls were more pronounced. These results suggest that the associations of body fat and bone parameters with OC, adiponectin, 25(OH)D, and insulin were sex-specific, with greater clarity when %Fat was used instead of BMI to classify obesity.
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Key Words
- %Fat, percentage of body fat
- 25(OH)D
- 25(OH)D, 25-hydroxyvitamin D
- Adiponectin
- Adolescents
- BMC, bone mineral content
- BMD, bone mineral density
- BMI, body mass index
- BW, body weight
- Body fat percentage
- ELISA, enzyme-linked immunosorbent assay
- FFM, free fat mass
- FFMI, free fat mass index
- FM, fat mass
- FMI, fat mass index
- IR, insulin resistance
- Leptin
- MM, muscle mass
- OC, osteocalcin
- Osteocalcin
- SOS, speed of sound
- aBMD, areal bone mineral density
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Jaruratanasirikul S, Satitpatanapan P, Sriplung H. Longitudinal 15-year follow-up of women with former early puberty: abnormal metabolic profiles not associated with earlier age at onset of puberty, but associated with obesity. J Pediatr Endocrinol Metab 2021; 34:71-77. [PMID: 33180041 DOI: 10.1515/jpem-2020-0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/03/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND In 2011, we described 104 girls who were diagnosed as early puberty (EP) during 2003-2005. In 2019-2020, the former EP women had been followed up 14 years after attaining their final height. OBJECTIVE To determine the reproductive function and metabolic profiles of former EP women. STUDY DESIGN Fifty-seven former EP women were evaluated for reproductive function and examined for health status. Blood samples were obtained for metabolic profiles of glucose, lipids and insulin, and testosterone levels. RESULTS In 2020, the average age of the study women was 22.9 ± 1.7 years. The average height was 156.7 ± 5.6 cm. The average weight had increased from 52.5 ± 7.8 kg in 2011 to 58.5 ± 11.1 kg in 2020 and average body mass index (BMI) from 21.4 ± 2.9 to 23.8 ± 4.0 kg/m2. Obesity (BMI>25 kg/m2) was found in 8.8% (five participants) in 2011 and had increased to 22.8% (13 participants) in 2020. Most participants (79%) had regular menstrual cycle. Of the 17 married women, 4 (23.5%) had 1-2 children. Dividing the participants into obese and nonobese groups, the average fasting plasma glucose, lipid profiles, and testosterone levels were similar in both groups. However, the average systolic blood pressure and the serum insulin levels and HOMA-IR assessments were significantly higher in the obese group than in the nonobese group. CONCLUSION The former EP women had normal menstruation and reproductive function. The former EP women with average BMI at the follow-up had normal metabolic profiles while those who later became obese had significantly higher systolic blood pressure, serum insulin, and HOMA-IR assessments.
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Affiliation(s)
- Somchit Jaruratanasirikul
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Pitchaya Satitpatanapan
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Chen T, Chen C, Wu H, Chen X, Xie R, Wang F, Sun H, Chen L. Overexpression of p53 accelerates puberty in high-fat diet-fed mice through Lin28/let-7 system. Exp Biol Med (Maywood) 2021; 246:66-71. [PMID: 32996351 PMCID: PMC7797992 DOI: 10.1177/1535370220961320] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/02/2020] [Indexed: 01/22/2023] Open
Abstract
IMPACT STATEMENT High-fat intake and subsequent obesity are associated with premature onset of puberty, but the exact neuroendocrine mechanisms are still unclear. The transcriptional factor p53 has been predicted to be a central hub of the gene networks controlling the pubertal onset. Besides, p53 also plays crucial roles in metabolism. Here, we explored p53 in the hypothalami of mice fed a high-fat diet (HFD), which showed an up-regulated expression. Besides, we also revealed that overexpressed p53 may accelerate hypothalamo-pituitary-gonadal (HPG) axis activation partially through the c-Myc/Lin28/let-7 system. These results can deepen our understanding of the interaction between metabolic regulation and puberty onset control, and may shed light on the neuroendocrine mechanisms of obesity-related central precocious puberty.
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Affiliation(s)
- Ting Chen
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Cailong Chen
- Office of Human Resource, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Haiying Wu
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Xiuli Chen
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Rongrong Xie
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Fengyun Wang
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Hui Sun
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
| | - Linqi Chen
- Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Soochow University, Jiangsu 215000, China
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Xie L, Tang Q, Yao D, Gu Q, Zheng H, Wang X, Yu Z, Shen X. Effect of Decaffeinated Green Tea Polyphenols on Body Fat and Precocious Puberty in Obese Girls: A Randomized Controlled Trial. Front Endocrinol (Lausanne) 2021; 12:736724. [PMID: 34712203 PMCID: PMC8546255 DOI: 10.3389/fendo.2021.736724] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obesity has been reported to be an important contributing factor for precocious puberty, especially in girls. The effect of green tea polyphenols on weight reduction in adult population has been shown, but few related studies have been conducted in children. This study was performed to examine the effectiveness and safety of decaffeinated green tea polyphenols (DGTP) on ameliorating obesity and early sexual development in girls with obesity. DESIGN This is a double-blinded randomized controlled trial. Girls with obesity aged 6-10 years old were randomly assigned to receive 400 mg/day DGTP or isodose placebo orally for 12 weeks. During this period, all participants received the same instruction on diet and exercise from trained dietitians. Anthropometric measurements, secondary sexual characteristics, B-scan ultrasonography of uterus, ovaries and breast tissues, and related biochemical parameters were examined and assessed pre- and post-treatment. RESULTS Between August 2018 and January 2020, 62 girls with obesity (DGTP group n = 31, control group n = 31) completed the intervention and were included in analysis. After the intervention, body mass index, waist circumference, and waist-to-hip ratio significantly decreased in both groups, but the percentage of body fat (PBF), serum uric acid (UA), and the volumes of ovaries decreased significantly only within the DGTP group. After controlling confounders, DGTP showed a significantly decreased effect on the change of PBF (β = 2.932, 95% CI: 0.214 to 5.650), serum UA (β = 52.601, 95% CI: 2.520 to 102.681), and ovarian volumes (right: β = 1.881, 95% CI: 0.062 to 3.699, left: β = 0.971, 95% CI: 0.019 to 1.923) in girls with obesity. No side effect was reported in both groups during the whole period. CONCLUSION DGTP have shown beneficial effects of ameliorated obesity and postponed early sexual development in girls with obesity without any adverse effects. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT03628937], identifier [NCT03628937].
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Affiliation(s)
- Luyao Xie
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Die Yao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuyun Gu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Zheng
- Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, United States
| | - Xiuhua Shen
- Department of Nutrition, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Xiuhua Shen,
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DeWitte SN, Lewis M. Medieval menarche: Changes in pubertal timing before and after the Black Death. Am J Hum Biol 2020; 33:e23439. [PMID: 32567154 DOI: 10.1002/ajhb.23439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/07/2020] [Accepted: 05/08/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Bioarcheological evidence suggests stature increased in males but decreased in females after the Black Death (1348-1350 CE). Because tradeoffs between growth and reproduction can result in earlier ages at menarche and lower limb length, we assess menarcheal age between 1120 and 1540 CE to better understand the health of medieval adolescent females before and after the plague. MATERIALS AND METHODS Our sample comprises 74 adolescent females from St. Mary Spital, London (1120-1540 CE) within the age range during which menarche occurs (10-25 years). They were assessed as being pre- or post-menarcheal and divided into three groups: Early Pre-Black Death (n = 13), Late Pre-Black Death (n = 38), and Post-Black Death (n = 23). Changes in the ages of pre- and post-menarcheal females were assessed using Mann-Whitney tests. RESULTS The average age of post-menarcheal females increased from the Early- to Late Pre-Black Death periods and declined after the Black Death. CONCLUSIONS Short stature can reflect unfavorable growth environments, while younger menarcheal age indicates improved living conditions. The paradoxical pattern of female, but not male, stature reduction after the Black Death might reflect the association of early menarche with lower limb length and signal that adolescent females experienced improved health conditions after the epidemic. Our focus on pre- and post-menarche within a limited age span provides a novel approach for inferring average ages of menarche over time. Pathways to skeletal development and reproductive investment are part of an integrated system, providing a bridge between life history research in bioarchaeology and human biology.
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Affiliation(s)
- Sharon N DeWitte
- Department of Anthropology, University of South Carolina, Columbia, South Carolina, USA
| | - Mary Lewis
- Department of Archaeology, University of Reading, Reading, England, UK
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Eckert-Lind C, Busch AS, Petersen JH, Biro FM, Butler G, Bräuner EV, Juul A. Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:e195881. [PMID: 32040143 PMCID: PMC7042934 DOI: 10.1001/jamapediatrics.2019.5881] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPORTANCE 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. OBJECTIVES 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. DATA SOURCES A systematic literature search was performed in PubMed and Embase of all original peer-reviewed articles published in English before June 20, 2019. STUDY SELECTION 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. DATA EXTRACTION AND SYNTHESIS 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. MAIN OUTCOMES AND MEASURES Studies examining age at thelarche (development of Tanner breast stage 2) in healthy girls. RESULTS 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). CONCLUSIONS AND RELEVANCE 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.
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Affiliation(s)
- Camilla Eckert-Lind
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Alexander S. Busch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen H. Petersen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Frank M. Biro
- Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Gary Butler
- Institute of Child Health, University College London Hospital, London, United Kingdom
| | - Elvira V. Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Srilanchakon K, Thadsri T, Jantarat C, Thengyai S, Nosoognoen W, Supornsilchai V. Higher phthalate concentrations are associated with precocious puberty in normal weight Thai girls. J Pediatr Endocrinol Metab 2017; 30:1293-1298. [PMID: 29176028 DOI: 10.1515/jpem-2017-0281] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/04/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The cause of precocious puberty may be associated with genetics and other conditions such as central nervous system (CNS) insults, or the exposure to endocrine disrupting chemicals (EDCs). Phthalates is known to be one of the EDCs and have estrogenic and antiandrogenic activities, and may be associated with advanced puberty. The objective of the study was to determine the association between urinary phthalate metabolites and advanced puberty. METHODS A cross-sectional study was conducted in patients with precocious puberty (breast onset <8 years, n=42) and early puberty (breast onset 8-9 years, n=17), compared to age-matched controls (n=77). Anthropometric measurements, estradiol, basal and gonadotropin releasing hormone (GnRH)-stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, uterine sizes, ovarian diameters and bone ages (BA) were obtained. Urine samples were collected and mono-methyl phthalate (MMP) and mono-ethyl phthalate (MEP) were analyzed by high performance liquid chromatography (HPLC) and adjusted with urine creatinine. RESULTS The median adjusted-MEP concentration in girls with precocious puberty, was greater than in normal girls (6105.09 vs. 4633.98 μg/g Cr: p<0.05), and had the same trend among early puberty and normal puberty (5141.41 vs. 4633.98 μg/g Cr: p=0.4), but was not statistically significant. CONCLUSIONS Precocious puberty girls had an association with increased MEP concentration. This is the first report of the association between urinary phthalate levels and precocious puberty in Thai girls.
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Chen C, Zhang Y, Sun W, Chen Y, Jiang Y, Song Y, Lin Q, Zhu L, Zhu Q, Wang X, Liu S, Jiang F. Investigating the relationship between precocious puberty and obesity: a cross-sectional study in Shanghai, China. BMJ Open 2017; 7:e014004. [PMID: 28400459 PMCID: PMC5566589 DOI: 10.1136/bmjopen-2016-014004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Obesity is reported to be closely relevant to early sexual development but the relationship between sexual precocity and obesity or central obesity is still inconsistent, especially in boys. We aimed to investigate the relationship between precocious puberty and obesity as well as central obesity. DESIGN A large population-based cross-sectional study using multistage, stratified cluster random sampling. SETTING Data from the Shanghai Children's Health, Education and Lifestyle Evaluation (SCHEDULE) study in June 2014. PARTICIPANTS 17 620 Chinese children aged 6-12 years. PRIMARY AND SECONDARY OUTCOME MEASURES Obesity was defined by WHO Child Growth Standards. Central obesity was defined by sex-specific waist-to-height ratio (WHtR) cut-offs (WHtR ≥0.48 for boys, WHtR ≥0.46 for girls). Precocious puberty was identified by Tanner stage of breast, pubic hair and testicle development. A χ2 test was performed to compare rates. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the association between precocious puberty and general obesity and central obesity. Probit analysis was used for estimating the median age at entry into Tanner stage 2 or greater for breast, pubic hair and testicle development. Linear regression was utilised to compare the effects of WHtR and body mass index (BMI) on sex development indicators. RESULTS 25.98% and 38.58% of boys with precocious puberty were respectively accompanied by obesity (OR=2.15, 95% CI=1.31 to 3.50) or central obesity (OR=2.10, 95% CI=1.46 to 3.03); meanwhile, 13.86% and 29.42% of girls with precocious puberty were respectively accompanied by obesity (OR=9.00, 95% CI=5.60 to 14.46) or central obesity (OR=5.40, 95% CI=4.10 to 7.12). The median ages of breast, pubic hair and testicle development decreased with BMI increase and median ages of thelarche and testicular development rather than pubarche were earlier in children with central obesity. CONCLUSIONS Earlier pubertal development was positively associated with obesity and central obesity in Chinese children.
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Affiliation(s)
- Chang Chen
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yao Chen
- Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
- Department of Endocrine and Genetic Metabolic Diseases, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuanjin Song
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qinmin Lin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lixia Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiumin Wang
- Department of Endocrine and Genetic Metabolic Diseases, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shijian Liu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Supornsilchai V, Jantarat C, Nosoognoen W, Pornkunwilai S, Wacharasindhu S, Soder O. Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty. J Pediatr Endocrinol Metab 2016; 29:1233-1239. [PMID: 26812862 DOI: 10.1515/jpem-2015-0326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/19/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Reports on the secular trend of pubertal onset indicate a recent earlier start especially in girls. Bisphenol A (BPA), which posses estrogenic activity, might be a cause of advanced puberty. The objective of the study was to determine the association between BPA and advanced puberty. METHODS A cross-sectional study was conducted in patients with advanced puberty (n=41) compared to age-matched controls (n=47). Anthropometric measurements, estradiol, basal and gonadotropin releasing hormone (GnRH)-stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, uterine sizes, ovarian diameters and bone ages were obtained. Urinary BPA concentrations were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC/MSMS) with the lower limit of quantification (LLOQ) of 0.05 ng/mL. RESULTS The median adjust-BPA concentration in advanced puberty group was higher than in control groups [1.44 vs. 0.59 μg/g creatinine (Cr): p<0.05]. We also found that the median adjust-BPA concentration in girls with advanced puberty who were overweight/obese, was greater than in the normal pubertal overweight/obese girls (1.74 vs. 0.59 μg/g Cr: p<0.05), and was in the same trend among normal weight girls with advanced and normal puberty (0.83 vs. 0.49 μg/g Cr: p=0.09), but not statistically significant. CONCLUSIONS The present findings suggest that BPA exposure appears to be related to an earlier age at onset of puberty especially in obese girls.
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Susanto T, Saito R, Kimura R, Tsuda A, Tabuchi N, Sugama J. Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0051/ijamh-2016-0051.xml. [PMID: 27740920 DOI: 10.1515/ijamh-2016-0051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/14/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Complex factors influence adolescents' attitudes. Secondary sexual development and emotional changes are markers of puberty and affect attitudes toward reproductive health (RH). This is especially evident in the society and culture of Indonesia. This study examined the presence of immaturity at puberty and factors associated with negative attitudes toward RH among Indonesian adolescents. METHODS We conducted a cross-sectional study with 1040 students (aged 11-16 years) selected using multistage random cluster sampling. Data were collected using a self-administered questionnaire that included the illustrative questionnaire for interview surveys with young people and the pubertal development scale (PDS), modified in accordance with the Indonesian context. Data analysis used descriptive and comparative statistics and logistic regression analyses. RESULTS Immature pubertal development was higher in boys [22.7%, 95% confidence interval (CI): 14.7%-30.7%] than girls (18.4%, 95% CI: 11%-25.7%). However, negative attitudes were higher in girls (40.6%, 95% CI: 34.3%-46.8%) than boys (37.1%, 95% CI: 29.9%-44.7%). Factors associated with negative attitudes toward RH in both boys and girls were age, RH communication with parents, and pubertal development. Smoking was an additional factor in boys, whereas living in an urban area was an additional factor in girls. High knowledge about RH was associated with less negative attitudes toward RH in both boys and girls. CONCLUSION Immaturity and factors that influence negative attitudes toward RH should be explored during puberty. Improving knowledge about RH may help to prevent negative attitudes toward RH, especially for girls in urban areas and boys with smoking habits.
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Affiliation(s)
- Tantut Susanto
- Doctoral Course of Health Development Nursing, Division of Health Sciences, Graduate School of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan.,Family and Community Health Nursing Department, School of Nursing, University of Jember, Jl. Kalimantan 37 Jember, Jawa Timur, Indonesia68121, Phone/Fax +62331323450
| | - Ruka Saito
- Doctoral Course of Health Development Nursing, Division of Health Sciences, Graduate School of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan
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- Doctoral Course of Health Development Nursing, Division of Health Sciences, Graduate School of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan
| | - Rumiko Kimura
- Department of Health Development Nursing, Division of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan
| | - Akiko Tsuda
- Department of Health Development Nursing, Division of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan
| | - Noriko Tabuchi
- Department of Health Development Nursing, Division of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan
| | - Junko Sugama
- Department of Clinical Nursing, Division of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kodatsuno,Kanazawa, Japan.,Wellness Promotion Sciences Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, 920-0942,Japan.,Division of Health Sciences, Graduate School of Kanazawa University, Kodatsuno,Kanazawa, Japan, Phone/Fax: +81-76-265-2555
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Glandular breast tissue volume by magnetic resonance imaging in 100 healthy peripubertal girls: evaluation of clinical Tanner staging. Pediatr Res 2016; 80:526-30. [PMID: 27384405 DOI: 10.1038/pr.2016.125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/21/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Appearance of glandular breast tissue may be difficult to distinguish from fat tissue by palpation, especially in obese girls. To our knowledge, validation of the clinical assessment of pubertal breast stages by magnetic resonance imaging (MRI) has never been performed. Our objective was to report normative data of glandular breast tissue volume and validate the clinical evaluation of pubertal breast staging by MRI of breast tissue and to evaluate circulating reproductive hormone levels and estrogen-dependent transabdominal ultrasound (TAUS) parameters as markers of glandular breast tissue. METHODS Glandular breast tissue volume quantified by MRI and breast stage evaluation was performed in 100 healthy peripubertal girls. Circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, and estradiol were measured by immunoassays. Ovarian volume, uterine volume, and endometrial thickness were assessed by TAUS. RESULTS Glandular breast tissue volume was positively associated with Tanner stages (r = 0.858, P < 0.001). The sensitivity and specificity of breast palpation to detect presence of glandular breast tissue using MRI as gold standard were 96 and 95%, respectively. The best parameters to distinguish prepubertal girls from girls with breast development were: LH (area under the curve (AUC) by receiver operating characteristic analysis = 0.871), inhibin B (AUC = 0.847) and estradiol (AUC = 0.830). CONCLUSION Clinical palpation reliably detects the presence of glandular breast tissue.
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Jansen EC, Marín C, Mora-Plazas M, Villamor E. Higher Childhood Red Meat Intake Frequency Is Associated with Earlier Age at Menarche. J Nutr 2015; 146:792-798. [PMID: 26962195 DOI: 10.3945/jn.115.226456] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/23/2015] [Accepted: 02/09/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early age at menarche is associated with increased breast cancer risk. Red meat consumption in adolescence predicts breast cancer risk, but it is unknown whether it is also related to earlier menarche. OBJECTIVE We studied the association between intake of red meat at ages 5-12 y and age at menarche in a prospective study. METHODS We assessed usual diets with a food-frequency questionnaire in a group of 456 girls aged 8.4 ± 1.7 y and followed them for a median 5.6 y in Bogotá, Colombia. Girls were asked periodically about the occurrence and date of menarche. Median age at menarche was estimated with use of Kaplan-Meier survival probabilities by categories of red meat intake frequency. Cox proportional hazards models were used to compare the incidence of menarche by red meat intake frequency, adjusting for potential sociodemographic and dietary confounders including total energy intake and intake frequency of other animal food groups (dairy, poultry, freshwater fish, tuna/sardines, eggs, and innards). RESULTS Median age at menarche was 12.4 y. After adjustment for total energy intake, maternal parity, and socioeconomic status, red meat intake frequency was inversely associated with age at menarche. When compared with girls with red meat intake <4 times/wk, those consuming it ≥2 times/d had a significantly earlier age at menarche (HR: 1.64; 95% CI: 1.11, 2.41; P-trend = 0.0009). Incidentally, we found that girls with tuna/sardine intake >1 time/wk had a significantly later age at menarche (HR: 0.62; 95% CI: 0.42, 0.90; P = 0.01) than those with intake <1 time/mo. Intake frequency of other animal food groups was not significantly associated with age at menarche. CONCLUSION Higher red meat intake frequency during childhood is associated with an earlier age at menarche, whereas greater fatty fish intake frequency is associated with a later menarcheal age.
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Affiliation(s)
- Erica C Jansen
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Constanza Marín
- Foundation for Research in Nutrition and Health, Bogotá, Colombia
| | | | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
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Abstract
Hidradenitis Suppurativa (HS) is an uncommon disease, which is particularly rare in young and prepubescent children. HS pathology centers on the follicular unit and involves aberrant cutaneous cellular immunity. HS tends to first manifest in puberty, but a handful of prepubescent cases of HS have been reported and are linked to hormonal disorders, in particular elevated testosterone. The most common manifestations of HS are abscesses, scarring, acne inversa, and keloids, especially in the intertriginous areas of the groin and the axilla. Treatments including topical anti-infectives including chlorhexidine wash, topical clindamycin, tretinoin cream, and azelaic acid cream, which may be of limited use because bacteria involved in HS likely create biofilms. Oral agents include clindamycin with or without rifampin for short-term usage. Cases resistant to conservative therapy have been reported to respond to finasteride, onabotulinumtoxin, or microfractionated 10,600-nm CO2 laser.
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Affiliation(s)
- Noah Scheinfeld
- Department of Dermatology Weill Cornell Medical College, 150 West 55th Street, NYC, NY 10019.
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