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Chen X, Fu S, Chen C, Yuan Y, Dai Z, Chen A, Zhang B, Liu S, Lin C. Association of Traditional dietary pattern with early and precocious puberty: a population-based cross-sectional study. Pediatr Res 2024; 96:245-252. [PMID: 38431666 DOI: 10.1038/s41390-024-03110-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/02/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Precocious puberty is an endocrine disease that is diagnosed by sex, age, and Tanner stage of puberty. This study aimed to investigate the association between various dietary patterns and early or precocious puberty, especially Traditional dietary patterns, which have been rarely investigated. METHODS A total of 4085 primary school students in grades 1-3 (6-9 years) completed individual characteristic surveys, health examinations, and food frequency questionnaires (FFQs). Physical examinations were also conducted to assess obesity and pubertal onset. Traditional, Westernized, and Protein dietary patterns were determined by factor analysis, and their associations with pubertal onset were analyzed by multiple logistic regression analysis. RESULTS Compared to the other two patterns, children who predominant the Traditional dietary pattern were protectively associated with precocious puberty (OR = 0.72, 95% CI = 0.55, 0.94), even after adjusting the confounders (OR = 0.66, 95% CI = 0.48, 0.89). Neither the Westernized nor Protein dietary pattern demonstrated an association with pubertal onset. The Traditional dietary pattern was negatively associated with children's weight status, classified by body mass index (BMI), and was positively associated with parental education. The maternal education and the Protein dietary pattern were negatively related. CONCLUSIONS Traditional dietary patterns were protective associated with early and precocious puberty among Chinese children. IMPACT The Traditional dietary pattern was protective associated with early puberty or precocious puberty in children, as found in large-scale population-based public health research. Current research primarily focuses on Westernized dietary patterns, and we studied Traditional dietary patterns to further explore the influence of food on children's puberty development. We discovered that children's preference for Traditional dietary patterns is protective of pubertal development, which implies that society and parents can benefit from diet guidance to protect children's natural development during adolescence.
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Affiliation(s)
- Xinlin Chen
- The Second School of Clinical Medical, Southern Medical University, Guangzhou, China
| | - Simao Fu
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Chaojun Chen
- Health Care Centre for Primary and Secondary Schools, Zhongshan, China
| | - Yawen Yuan
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Zhibin Dai
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Ang Chen
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Bihong Zhang
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China
| | - Shijian Liu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Cuilan Lin
- BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China.
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Wang J, Tang Y, Chen G, Yang M, Gao Q, Wang Y, Zhou W. Irisin combined index to diagnose central precocious puberty in girls: a cross-sectional study. BMC Pediatr 2024; 24:275. [PMID: 38671415 PMCID: PMC11046821 DOI: 10.1186/s12887-024-04743-w] [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: 10/03/2023] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND To investigate serum irisin levels in girls at different developmental status and explore the significance of irisin for the diagnosis of central precocious puberty (CPP) in girls. METHODS In this cross-sectional study 111 girls were enrolled, including 43 cases of CPP, 44 cases of peripheral precocious puberty (PPP) and 24 cases of girls with normal sexual development as controls. The data on age, weight and height, measured blood levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and irisin were collected. Pelvic Doppler ultrasound was performed to evaluate uterine length, transverse diameter, anteroposterior diameter. The girls were divided into non-CPP group and CPP group according to gonadotropin-releasing hormone (GnRH) stimulation test. RESULTS Serum irisin levels were significantly higher in CPP group than in PPP group and normal control group. Serum irisin level was positively correlated with basal LH level, basal FSH level, peak LH level, peak LH /FSH ratio, uterine volume, bone age, and bone age index. The area under the curve, cut-off value, sensitivity and specificity of serum irisin were 0.958, 219.255 pg/ml, 100% and 80.6%. The combined diagnosis of CPP in girls by serum irisin and serum basal LH combined with uterine volume had an AUC, sensitivity, and specificity of 0.994, 97.6%, and 100%, superior to that of the single index. CONCLUSIONS Serum irisin level in girls with CPP is significantly increased. An irisin combined index could help the diagnosis of CPP in girls.
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Affiliation(s)
- Jie Wang
- Department of Pediatrics, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, 223300, China
| | - Yongquan Tang
- Department of Pediatrics, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, 223300, China
| | - Guanyu Chen
- Department of Pediatrics, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, 223300, China
| | - Mingming Yang
- Department of Pediatrics, Huai'an Clinical College of Xuzhou Medical University, Huai'an, 223300, China
| | - Qian Gao
- Department of Pediatrics, Huai'an Clinical College of Xuzhou Medical University, Huai'an, 223300, China
| | - Yingdan Wang
- Department of Pediatrics, Huai'an Clinical College of Xuzhou Medical University, Huai'an, 223300, China
| | - Wendi Zhou
- Department of Pediatrics, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, 223300, China.
- Department of Pediatrics, Huai'an Clinical College of Xuzhou Medical University, Huai'an, 223300, China.
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Lorenzon B, Burlo F, Barbi L, Tamaro G, Tornese G. Fifteen-minute consultation: The approach to the child with precocious puberty. Arch Dis Child Educ Pract Ed 2024:edpract-2023-326217. [PMID: 38514136 DOI: 10.1136/archdischild-2023-326217] [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: 10/07/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
Precocious puberty has traditionally been defined as the onset of secondary sexual characteristics occurring before age 8 years in girls and 9 years in boys. This earlier onset of puberty may have significant physical and psychological consequences if left untreated. Moreover, it should be excluded that pubertal signs are not secondary to malignancies, other organic aetiologies or associated syndromic phenotypes. Initial assessment involves a thorough medical history and physical examination; a hand and wrist X-ray to determine bone age, and hormonal tests might be indicated to confirm the diagnosis and to determine the origin of hormonal production. Treatment options depend on the underlying cause. Given the complexity of the differential diagnosis, this article aims to familiarise clinicians with the different steps that can be taken when precocious puberty is suspected.
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Affiliation(s)
- Beatrice Lorenzon
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesca Burlo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Ludovica Barbi
- FHML, Maastricht University, Maastricht, The Netherlands
| | | | - Gianluca Tornese
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
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Sun H, Qian Y, Wan N, Liu L. Differential diagnosis of precocious puberty in girls during the COVID-19 pandemic: a pilot study. BMC Pediatr 2023; 23:185. [PMID: 37081435 PMCID: PMC10116441 DOI: 10.1186/s12887-023-04009-x] [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: 11/27/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND To investigate the differential diagnosis of girls aged 6 to 8 years with idiopathic premature thelarche (IPT) and central precocious puberty (CPP) during the COVID-19 pandemic. We explored predicted adult height (PAH) discrepancy to guide appropriate diagnosis and treatment. METHODS From January 2020 to December 2021, Chinese girls aged 6 to 8 years with precocious puberty were recruited. They were divided into IPT and CPP groups. Clinical characteristics, including height, weight, body mass index (BMI), basal luteinizing hormone (LH), oestradiol, uterine length and volume, follicle numbers (d > 4 mm) and bone age (BA) were recorded. We analysed differential diagnosis and PAH discrepancy in both groups. Binary logistic regression analysis was used to explore risk factors for CPP, and receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic value of related indexes. RESULTS Sixty patients, including 40 girls with IPT and 20 girls with CPP, were recruited. The prevalence of overweight and obesity in the entire cohort was 25% (15/60) and was significantly higher in IPT than CPP, 32.5% (13/40) vs. 10% (2/20), respectively (P=0.045). There were significant differences in LH, uterine volume, follicle numbers and BA (P<0.05). The impaired PAH of IPT and CPP was 0.01 ± 1.19 SD and 0.62 ± 0.94 SD with significant differences (P=0.047). Logistic regression analysis showed that LH and follicle numbers were independent risk factors for CPP. The ROC curve showed that the area under the curve (AUC) of LH and follicle numbers were 0.823 and 0.697. The sensitivity and specificity of LH with a cut off of 0.285 IU/L were 78.9% and 77.8%. The sensitivity and specificity of follicle numbers with a cut off of 3.5 were 89.5% and 52.8%. CONCLUSION The prevalence of overweight and obesity in 6- to 8-year-old girls with precocious puberty was high. Auxological data should not be used in the differential diagnosis of IPT and CPP. Basal LH above 0.285 IU/L and follicle numbers greater than 4 were important features suggestive of CPP. PAH was impaired in individuals with CPP, but it was not impaired in individuals with IPT.
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Affiliation(s)
- Huihui Sun
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Yi Qian
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Naijun Wan
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Lili Liu
- Acupuncture Department, Beijing Jishuitan Hospital, Beijing, China.
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Shope C, Ritter A, Matlock K, Wine Lee L. Pathologic acne in pre-pubertal children: A case series and review on when to refer to pediatric endocrinology. Pediatr Dermatol 2023; 40:5-10. [PMID: 36394116 DOI: 10.1111/pde.15166] [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: 04/08/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022]
Abstract
Acne vulgaris is an extremely common chronic disease of the pilosebaceous unit. Despite its ubiquity, acne in the childhood years of approximately ages 1-6 years is exceedingly rare. Physicians should be suspicious of underlying systemic disease processes in patients of this age who present with onset of acne lesions, as pre-pubertal acne in childhood has a distinctly different pathology than that of other age groups. Through a case series, we highlight the importance of a thorough work-up and provide a review on when to refer to pediatric endocrinology to rule out precocious puberty and tumors as the cause of pre-pubertal acne.
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Affiliation(s)
- Chelsea Shope
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Alexandra Ritter
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kristal Matlock
- Department of Pediatric Endocrinology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Xiao Y, Li Y, Cai Z, Xie J. Investigation on the Correlation of Anxiety Degree with Family Atmosphere in Children with Precocious Puberty. Emerg Med Int 2022; 2022:3269807. [PMID: 36193542 PMCID: PMC9525782 DOI: 10.1155/2022/3269807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This research sets out to explore the correlation of anxiety degree with family atmosphere in children with precocious puberty (PP), so as to provide a reference for future treatment of PP. Methods Eighty-one cases of PP were visited between January 2021 and March 2021, and their direct relatives were selected as the research population for retrospective analysis. After admission, children and their direct relatives completed a questionnaire survey on the quality of life and social anxiety of children with PP. Children were assigned to the research group and the control group based on their anxiety scores. The intergroup differences in daily activities, diet, and family status, as well as children's and parents' psychological status, were identified, and the relationship between anxiety degree in PP children and family atmosphere was discussed. Results The children's anxiety score was (6.17 ± 4.26), and they were divided into groups according to the median, with 30 cases in the research group and 51 cases in the control group. The two cohorts were similar in dietary status and children's physiological status (P > 0.05); however, the research group exhibited a greater number of cases who used electronic products for 2-3 h daily and watched romantic TV series (movies). The daily exercise time of the research group is lower than that of the control group (P < 0.05). In the research group, the monthly family income and the number of family companions and very harmonious families were significantly lower, while the number of divorces or remarriages increased (P < 0.05). The survey results on parents' psychological status also showed better psychological states in patients in the control group (P < 0.05). Conclusion The anxiety level of PP children is closely related to the family atmosphere. In future clinical treatment of children with PP, it will also be necessary to pay attention to and adjust the family relationship of the children, which is of great significance for relieving PP-associated anxiety.
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Affiliation(s)
- Yongbei Xiao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Zhengrong Cai
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Jiao Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
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Hornor G. Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners. J Pediatr Health Care 2022; 36:489-499. [PMID: 35987556 DOI: 10.1016/j.pedhc.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Gail Hornor
- Gail Hornor, Forensic Nurse Specialist, International Association of Forensic Nurses, Hilliard, OH.
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8
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Bakhtiani P, Geffner M. Early Puberty. Pediatr Rev 2022; 43:483-492. [PMID: 36045159 DOI: 10.1542/pir.2021-005059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Priyanka Bakhtiani
- Keck School of Medicine of the University of Southern California, Los Angeles, CA.,Children's Hospital Los Angeles, Los Angeles, CA
| | - Mitchell Geffner
- Keck School of Medicine of the University of Southern California, Los Angeles, CA.,Children's Hospital Los Angeles, Los Angeles, CA.,The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA
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Yesiltepe Mutlu G, Eviz E, Haliloglu B, Kirmizibekmez H, Dursun F, Ozalkak S, Cayir A, Sacli BY, Ozbek MN, Demirbilek H, Hatun S. The effects of the covid-19 pandemic on puberty: a cross-sectional, multicenter study from Turkey. Ital J Pediatr 2022; 48:144. [PMID: 35964090 PMCID: PMC9375063 DOI: 10.1186/s13052-022-01337-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS During the Coronavirus-19 disease (Covid-19) pandemic it was observed that the number of girls presenting with early puberty had increased. The aim of this study was to carry out a retrospective evaluation of the characteristics of girls who had been referred for evaluation of precocious puberty in five different pediatric endocrinology units, before and during the pandemic. METHODS The study participants comprised 359 girls who were assigned into 2 groups a pre-pandemic group (n:214) and a pandemic group (n:145). Those participants (n:99) who had medical records in the follow-up period were classified into 3 subgroups according to the time of presentation and follow-up visits (group-1: first admission and follow-up visit before the pandemic, group-2: first admission before the pandemic, the follow-up visit during the pandemic, group-3: first admission and follow-up visit during the pandemic). RESULTS The age at presentation and age at pubertal onset were both significantly lower in the pandemic group than those in the pre-pandemic group(8.1 vs 8.6, p: < 0.001,7.7 vs 7.9,p:0.013, respectively). There was no significant difference between the body mass index standard deviation scores (BMI-SDS) values of the groups (0.57 vs 0.51, p:0.430). The initiation rate of pubertal suppression therapy at the time of presentation was significantly higher in the pandemic group compared to that of the pre-pandemic group (7.7%vs 27.5%), and in groups-2 & 3 compared to group-1, during follow-up (20%&44%vs 8%). CONCLUSION Our research showed that the onset of puberty occurred earlier in the pandemic period compared to the previous year, and the need for pubertal suppression therapy increased during the pandemic.
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Affiliation(s)
- Gul Yesiltepe Mutlu
- Department of Pediatric Endocrinology and Diabetes, Koç University School of Medicine, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No:4, Topkapı, 34010, Turkey
| | - Elif Eviz
- Department of Pediatric Endocrinology and Diabetes, Koç University School of Medicine, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No:4, Topkapı, 34010, Turkey.
| | - Belma Haliloglu
- Department of Pediatric Endocrinology and Diabetes, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Heves Kirmizibekmez
- Department of Pediatric Endocrinology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatma Dursun
- Department of Pediatric Endocrinology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Servan Ozalkak
- Clinic of Pediatric Endocrinology, University of Health Sciences Turkey, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Atilla Cayir
- Department of Pediatric Endocrinology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Beste Yuksel Sacli
- Department of Pediatric Endocrinology and Diabetes, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Mehmet Nuri Ozbek
- Clinic of Pediatric Endocrinology, University of Health Sciences Turkey, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Huseyin Demirbilek
- Faculty of Medicine, Department of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Sukru Hatun
- Department of Pediatric Endocrinology and Diabetes, Koç University School of Medicine, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No:4, Topkapı, 34010, Turkey
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Zhan S, Huang K, Wu W, Zhang D, Liu A, Dorazio RM, Shi J, Ullah R, Zhang L, Wang J, Dong G, Ni Y, Fu J. The Use of Morning Urinary Gonadotropins and Sex Hormones in the Management of Early Puberty in Chinese Girls. J Clin Endocrinol Metab 2021; 106:e4520-e4530. [PMID: 34160619 PMCID: PMC8530706 DOI: 10.1210/clinem/dgab448] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Indexed: 11/29/2022]
Abstract
CONTEXT Although gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels. OBJECTIVE We evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure. METHODS We performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples. RESULTS Their urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio > 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly. CONCLUSION uLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment.
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Affiliation(s)
- Shumin Zhan
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Ke Huang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Wei Wu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Danni Zhang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Ana Liu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Robert M Dorazio
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Jianrong Shi
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Rahim Ullah
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Li Zhang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Jinling Wang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Guanping Dong
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Yan Ni
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Junfen Fu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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11
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Chiarelli F. Physiology and abnormalities of growth and puberty. Minerva Pediatr 2020; 72:449-451. [PMID: 32731737 DOI: 10.23736/s0026-4946.20.06018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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