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Timme K, González-Alvarez ME, Keating AF. Pre-pubertal obesity compromises ovarian oxidative stress, DNA repair and chemical biotransformation. Toxicol Appl Pharmacol 2024; 489:116981. [PMID: 38838792 DOI: 10.1016/j.taap.2024.116981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/07/2024]
Abstract
Obesity in adult females impairs fertility by altering oxidative stress, DNA repair and chemical biotransformation. Whether prepubertal obesity results in similar ovarian impacts is under-explored. The objective of this study was to induce obesity in prepubertal female mice and assess puberty onset, follicle number, and abundance of oxidative stress, DNA repair and chemical biotransformation proteins basally and in response to 7,12-dimethylbenz(a)anthracene (DMBA) exposure. DMBA is a polycyclic aromatic hydrocarbon that has been shown to be ovotoxic. Lactating dams (C57BL6J) were fed either a normal rodent containing 3.5% kCal from fat (lean), or a high fat diet comprised of 60% kCal from fat, and 9% kCal from sucrose. The offspring were weaned onto the diet of their dam and exposed at postnatal day 35 to either corn oil or DMBA (1 mg/kg) for 7 d via intraperitoneal injection. Mice on the HFD had reduced (P < 0.05) age at puberty onset as measured by vaginal opening but DMBA did not impact puberty onset. Heart, spleen, kidney, uterus and ovary weight were increased (P < 0.05) by obesity and liver weight was increased (P < 0.05) by DMBA exposure in obese mice. Follicle number was largely unaffected by obesity or DMBA exposure, with the exception of primary follicle number, which were higher (P < 0.05) in lean DMBA exposed and obese control relative to lean control mice. There were also greater numbers (P < 0.05) of corpora lutea in obese relative to lean mice. In lean mice, DMBA exposure reduced (P < 0.05) the level of CYP2E1, EPHX1, GSTP1, BRCA1, and CAT but this DMBA-induced reduction was absent in obese mice. Basally, obesity reduced (P < 0.05) the abundance of CYP2E1, EPHX1, GSTP1, BRCA1, SOD1 and CAT. There was greater (P < 0.05) fibrotic staining in obese DMBA-exposed ovaries and PPP2CA was decreased (P < 0.05) in growing follicles by both obesity and DMBA exposure. Thus, prepubertal obesity alters the capacity of the ovary to respond to DNA damage, ovotoxicant exposure and oxidative stress.
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Affiliation(s)
- Kelsey Timme
- Department of Animal Science, Iowa State University, Ames, IA, USA
| | | | - Aileen F Keating
- Department of Animal Science, Iowa State University, Ames, IA, USA.
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Tzounakou AM, Stathori G, Paltoglou G, Valsamakis G, Mastorakos G, Vlahos NF, Charmandari E. Childhood Obesity, Hypothalamic Inflammation, and the Onset of Puberty: A Narrative Review. Nutrients 2024; 16:1720. [PMID: 38892653 PMCID: PMC11175006 DOI: 10.3390/nu16111720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The onset of puberty, which is under the control of the hypothalamic-pituitary-gonadal (HPG) axis, is influenced by various factors, including obesity, which has been associated with the earlier onset of puberty. Obesity-induced hypothalamic inflammation may cause premature activation of gonadotropin-releasing hormone (GnRH) neurons, resulting in the development of precocious or early puberty. Mechanisms involving phoenixin action and hypothalamic microglial cells are implicated. Furthermore, obesity induces structural and cellular brain alterations, disrupting metabolic regulation. Imaging studies reveal neuroinflammatory changes in obese individuals, impacting pubertal timing. Magnetic resonance spectroscopy enables the assessment of the brain's neurochemical composition by measuring key metabolites, highlighting potential pathways involved in neurological changes associated with obesity. In this article, we present evidence indicating a potential association among obesity, hypothalamic inflammation, and precocious puberty.
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Affiliation(s)
- Anastasia-Maria Tzounakou
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
| | - Galateia Stathori
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
| | - George Paltoglou
- Diabetes Unit, Second Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘P. & A. Kyriakou’ Children’s Hospital, 11527 Athens, Greece;
| | - Georgios Valsamakis
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - George Mastorakos
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - Nikolaos F. Vlahos
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.V.); (G.M.); (N.F.V.)
| | - Evangelia Charmandari
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.-M.T.); (G.S.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Sodero G, Pane LC, Malavolta E, Rotunno G, Sessa L, Fraccascia B, Candelli M, Rigante D, Cipolla C. Lipid Profile and Triglyceride-Glucose Index (TyG) Alterations in a Single-Center Cohort of Children Diagnosed with Central Precocious Puberty. CHILDREN (BASEL, SWITZERLAND) 2024; 11:639. [PMID: 38929219 DOI: 10.3390/children11060639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Background: A correlation between plasma lipids and timing of pubertal development has been hypothesized, though lipid influence remains unclear in central precocious puberty (CPP). Aim: To assess any possible alterations in the lipid profile and triglyceride glucose index (TyG) in children diagnosed with CPP. Patients and Methods: Retrospective single-center study conducted on children (aged 6.3 ± 2.1 years) evaluated for the suspicion of CPP. Results: Based on the results of the gonadotropin releasing hormone (GnRH) test, considering 5 IU/L as cut-off of the luteinizing hormone peak, CPP was confirmed in 43 patients (57.3%). Sixteen (37.2%) had a pathologic body mass index (BMI), with 9 (20.9%) being overweight and 7 (16.27%) obese. High total cholesterol was found in 3 patients with CPP (6.97%), high triglycerides were found in 11 patients with CPP (25.58%), high LDL cholesterol was found in 5 patients with CPP (11.62%), low HDL cholesterol was found in 12/43 patients with CPP (27.9%), a pathologic TyG was found in 13/43 patients with CPP (30.23%). No significant association was observed in the lipid profile for patients with or without CPP, except for HDL cholesterol, which was lower in the CPP group (47.1 ± 10.9; p = 0.033). However, the association between serum HDL cholesterol and CPP was not confirmed at the multivariate logistic regression analysis adjusted for patients' sex and age (p = 0.1; OR: 1.035; 95% CI: 0.993-1.078). Conclusion: The overall lipid profile of our pediatric patients diagnosed with CPP did not differ from patients having idiopathic precocious thelarche or normal variants of puberty development.
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Affiliation(s)
- Giorgio Sodero
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Lucia Celeste Pane
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Elena Malavolta
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giulia Rotunno
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Linda Sessa
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Barbara Fraccascia
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Marcello Candelli
- Department of Emergency Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Donato Rigante
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Clelia Cipolla
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Wang Q, Wu D, Zeng Q, Ban C, Wang L, Lv X. Diagnostic Value of Single LH and LH/FSH Ratio at 60-minute after GnRHa Stimulation Test for Central Precocious Puberty. Indian J Pediatr 2024:10.1007/s12098-024-05137-7. [PMID: 38739362 DOI: 10.1007/s12098-024-05137-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES To evaluate the diagnostic value of luteinizing hormone (LH) and LH/follicle stimulating hormone (FSH) ratio at 60 min after gonadotropin-releasing hormone analogs (GnRHa) stimulation test for central precocious puberty (CPP) in girls. METHODS Two hundred and fifty-seven girls, aged 3 to 7.5 y, suspected of precocious puberty at authors' hospital from April 2020 through November 2023 were enrolled in the study. The blood was taken at 0, 30, 60 min after GnRHa stimulation test, and LH and LH/FSH were detected by chemiluminescence assay. The diagnostic efficacy was analysed by Mann-Whitney U test, spearman's correlation analysis and receiver operating characteristic (ROC) analysis. The proportion of obesity was analysed by Chi-square test. RESULTS LH and LH/FSH at different times were statistically significantly different (P <0.05) between the CPP and non-CPP groups. Spearman's correlation analysis showed that the level of LH and LH/FSH at 60 min had the strongest consistency with the peak of LH (r = 0.9988, P <0.001) and LH/FSH (r = 0.9981, P <0.001). ROC curve analysis showed that the area under the ROC curves at 60 min of LH and LH/FSH were 0.975 and 0.997 with a cut-off value of 5.70 IU/L and 0.609, respectively. CONCLUSIONS The peak of LH and LH/FSH in the diagnosis of CPP can be determined by LH and LH/FSH at 60 min after the triptorelin acetate is injected. This will reduce the number of blood draws required compared with the traditional stimulation test, which is more effective and acceptable for children.
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Affiliation(s)
- Qingling Wang
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China
| | - Dan Wu
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China
| | - Qian Zeng
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China
| | - Chuanwei Ban
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China
| | - Ling Wang
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China.
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China.
| | - Xin Lv
- Clinical Laboratory, Children's Hospital Affiliated to Shandong University, 23976 Jing-Shi Road, Jinan, 250022, Shandong Province, People's Republic of China.
- Clinical Laboratory, Jinan Children's Hospital, Jinan, China.
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Suutela M, Hero M, Kosola S, Miettinen PJ, Raivio T. Prenatal, newborn and childhood factors and the timing of puberty in boys and girls. Pediatr Res 2024:10.1038/s41390-024-03159-7. [PMID: 38594422 DOI: 10.1038/s41390-024-03159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/29/2023] [Accepted: 01/21/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Our aim was to determine if prenatal factors, gestational age, birth weight and length, and childhood body mass index (BMI) are associated with the timing of puberty. METHODS Our population-based study comprised 4826 girls and 5112 boys born between 1997 and 2002. Multiple linear regression modeled the relationships between the maternal and child predictors and the age at peak height velocity (PHV). RESULTS Maternal smoking throughout pregnancy was associated with earlier age at PHV (-1.8 months in girls, 95%CI = -3.2 to -0.3, p = 0.015 and -1.7 months in boys, 95%CI = -3.1 to -0.3, p = 0.016). Older gestational age predicted later age at PHV in boys. One SDS increase in birth weight led to 1.7 months later age at PHV in girls (95%CI = 1.2 to 2.2, p < 0.001) and 0.8 months in boys (95%CI = 0.2 to 1.3, p = 0.005). At the age of 9 years, each increment of BMI by 1 kg/m2 was associated with 1.7 months (95%CI = -1.9 to -1.6, p < 0.001) and 1.3 months (95%CI = -1.4 to -1.1, p < 0.001) earlier age at PHV in girls and boys, respectively. CONCLUSIONS Fetal exposure to smoking can potentially exert enduring effects on pubertal timing. Birth weight and childhood nutritional status are significant determinants of pubertal timing in both sexes. IMPACT Maternal smoking was associated with earlier timing of puberty and greater birth weight with later timing of puberty in both girls and boys. Most previous studies have focused on girls and used surveys to assess pubertal development, but we studied both sexes and used the same objective measure (age at peak height velocity) for the timing of puberty. Our study increases knowledge especially regarding factors associated with the timing of puberty among boys.
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Affiliation(s)
- Maria Suutela
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Western Uusimaa, Finland
| | - Päivi J Miettinen
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Taneli Raivio
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
- Stem Cells and Metabolism Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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Sada V, Puliani G, Feola T, Pirchio R, Pofi R, Sesti F, De Alcubierre D, Amodeo ME, D'Aniello F, Vincenzi L, Gianfrilli D, Isidori AM, Grossman AB, Sbardella E. Tall stature and gigantism in transition age: clinical and genetic aspects-a literature review and recommendations. J Endocrinol Invest 2024; 47:777-793. [PMID: 37891382 DOI: 10.1007/s40618-023-02223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE Tall stature is defined as height greater than the threshold of more than 2 standard deviations above the average population height for age, sex, and ethnicity. Many studies have described the main aspects of this condition during puberty, but an analysis of the characteristics that the physician should consider in the differential diagnosis of gigantism-tall stature secondary to a pituitary tumour-during the transition age (15-25 years) is still lacking. METHODS A comprehensive search of English-language original articles was conducted in the MEDLINE database (December 2021-March 2022). We selected all studies regarding epidemiology, genetic aspects, and the diagnosis of tall stature and gigantism during the transition age. RESULTS Generally, referrals for tall stature are not as frequent as expected because most cases are familial and are usually unreported by parents and patients to endocrinologists. For this reason, lacking such experience of tall stature, familiarity with many rarer overgrowth syndromes is essential. In the transition age, it is important but challenging to distinguish adolescents with high constitutional stature from those with gigantism. Pituitary gigantism is a rare disease in the transition age, but its systemic complications are very relevant for future health. Endocrine evaluation is crucial for identifying conditions that require hormonal treatment so that they can be treated early to improve the quality of life and prevent comorbidities of individual patient in this age range. CONCLUSION The aim of our review is to provide a practical clinical approach to recognise adolescents, potentially affected by gigantism, as early as possible.
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Affiliation(s)
- V Sada
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - G Puliani
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - T Feola
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Neuroendocrinology, Neuromed Institute, IRCCS, Pozzilli, Italy
| | - R Pirchio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Degli Studi di Napoli "Federico II", Naples, Italy
| | - R Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Oxford Centre for Diabetes, Endocrinology, and Metabolism, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - F Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - D De Alcubierre
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - M E Amodeo
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children Hospital, Rome, Italy
| | - F D'Aniello
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children Hospital, Rome, Italy
| | - L Vincenzi
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Centre for Rare Diseases (ENDO-ERN Accredited), Policlinico Umberto I, Rome, Italy
| | - A B Grossman
- Green Templeton College, University of Oxford, Oxford, UK
- Centre for Endocrinology, Barts and the London School of Medicine, London, UK
| | - E Sbardella
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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Zhou F, Mao J, Jin Z, Zhu L, Li X. Multi-omic analysis of precocious puberty girls: pathway changes and metabolite validation. Front Endocrinol (Lausanne) 2024; 15:1285666. [PMID: 38487340 PMCID: PMC10937432 DOI: 10.3389/fendo.2024.1285666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/15/2024] [Indexed: 03/17/2024] Open
Abstract
Objective Precocious puberty (PP) is a prevalent endocrine disorder affecting the physical and mental wellbeing of children. Identifying the triggering factors of PP has become a central issue. This study seeks to investigate the metabolomic and transcriptomic alterations in PP. Material and methods First, 37 school-aged girls diagnosed with PP and 25 age-matched prepubertal control girls were recruited, and the fecal samples were collected for non-targeted metabolomic analysis to screen for differentially expressed metabolites (DEMs). Subsequently, an animal model of PP was constructed by danazol administration to neonatal female rats, and both fecal non-targeted metabolomics and serum next-generation transcriptomic sequencing were performed to screen DEMs and differentially expressed genes (DEGs) in PP. Moreover, the DEM co-existing in clinical and animal models was administrated to PP rats to explore the role of the target metabolite in PP. Results A total of 24 DEMs in PP clinical samples and 180 DEMs and 425 DEGs in PP animal samples were identified. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that these DEMs and DEGs were enriched in disease-associated pathways, including fatty acid synthesis, glycerolipid metabolism, pyrimidine metabolism, steroid hormone biosynthesis, progesterone-mediated oocyte maturation, and gonadotropin-releasing hormone (GnRH) signaling pathway, forming a tight DEM-DEG pathway regulatory network. Further DEM validation demonstrated that thymine supplementation delayed the opening of the vagina and development of PP in model rats. Conclusion This study reveals that the metabolomic and transcriptomic changes, along with enriched pathways, are implicated in PP based on clinical and animal analyses. The findings may provide new strategies and research avenues for PP treatment.
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Affiliation(s)
- Fang Zhou
- Department of Pediatrics, Traditional Chinese Medicine Hospital of Zhuji, Zhuji, Zhejiang, China
| | - Jianhong Mao
- Department of Clinical Lab, Traditional Chinese Medicine Hospital of Zhuji, Zhuji, Zhejiang, China
| | - Zhenzhen Jin
- Department of Pediatrics, Traditional Chinese Medicine Hospital of Zhuji, Zhuji, Zhejiang, China
| | - Li Zhu
- Department of Pediatrics, Traditional Chinese Medicine Hospital of Zhuji, Zhuji, Zhejiang, China
| | - Xiaofang Li
- Department of Chinese Materia Medica, Traditional Chinese Medicine Hospital of Zhuji, Zhuji, Zhejiang, China
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Hoskyns RB, Howard SR. Effects of the COVID-19 pandemic on the incidence of central precocious puberty; a narrative review. J Pediatr Endocrinol Metab 2024; 37:102-109. [PMID: 38097507 DOI: 10.1515/jpem-2023-0507] [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: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 02/09/2024]
Abstract
Central precocious puberty (CPP) is the premature activation of the hypothalamus-pituitary-gonadal axis, resulting in the early development of secondary sexual characteristics. CPP classically occurs before the age of 8 years in girls and 9 years in boys. The aetiology of this precocious onset of puberty is governed by complex mechanistic interactions between genetic and environmental factors. The rates of CPP have been documented to have been rising before the COVID-19 pandemic; despite this, the incidence of CPP has increased exponentially since the start of the pandemic. There are multiple theories potentially explaining this change in incidence of CPP over COVID-19. These include the direct effect of SARS-coV-2 infection, increasing body mass index of adolescents over sequential lockdowns, changes in sleep patterns, increased use of electronic devices and levels of stress, and additionally potential earlier detection of signs of CPP by parents and carers. Whilst there is evidence from observational cohorts, case studies and animal models for each of these factors, it is difficult to definitively prove which has had the greatest impact due to the mainly retrospective nature of the human research that has been conducted. Moreover, studies set in diverse settings with varying population make comparison complex. Additionally, each country responded differently to the COVID-19 pandemic and the lockdowns varied between locations, hence the effect of lockdown was not equal or universal. Despite this, similar trends have been identified, with various lifestyle changes that occurred over the pandemic being potentially influential factors on the development of CPP.
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Affiliation(s)
- Rebecca B Hoskyns
- Barts and the London School of Medicine and Dentistry, QMUL, London, UK
| | - Sasha R Howard
- Centre for Endocrinology, William Harvey Research Institute, QMUL, London, UK
- Department of Paediatric Endocrinology, Royal London Children's Hospital, Barts Health NHS Trust, London, UK
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9
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Ciężki S, Odyjewska E, Bossowski A, Głowińska-Olszewska B. Not Only Metabolic Complications of Childhood Obesity. Nutrients 2024; 16:539. [PMID: 38398863 PMCID: PMC10892374 DOI: 10.3390/nu16040539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
The increasing incidence of obesity in the pediatric population requires attention to its serious complications. It turns out that in addition to typical, well-known metabolic complications, obesity as a systemic disease carries the risk of equally serious, although less obvious, non-metabolic complications, such as cardiovascular diseases, polycystic ovary syndrome, chronic kidney disease, asthma, thyroid dysfunction, immunologic and dermatologic conditions, and mental health problems. They can affect almost all systems of the young body and also leave their mark in adulthood. In addition, obesity also contributes to the exacerbation of existing childhood diseases. As a result, children suffering from obesity may have a reduced quality of life, both physically and mentally, and their life expectancy may be shortened. It also turns out that, in the case of obese pregnant girls, the complications of obesity may also affect their unborn children. Therefore, it is extremely important to take all necessary actions to prevent the growing epidemic of obesity in the pediatric population, as well as to treat existing complications of obesity and detect them at an early stage. In summary, physicians treating a child with a systemic disease such as obesity must adopt a holistic approach to treatment.
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Affiliation(s)
- Sebastian Ciężki
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Emilia Odyjewska
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Artur Bossowski
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
| | - Barbara Głowińska-Olszewska
- Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, 15-274 Białystok, Poland
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10
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Gunawan SP, Huang SY, Wang CC, Huynh LBP, Nguyen NN, Hsu SY, Chen YC. Sleep deprivation alters pubertal timing in humans and rats: the role of the gut microbiome. Sleep 2024; 47:zsad308. [PMID: 38065690 DOI: 10.1093/sleep/zsad308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/27/2023] [Indexed: 02/09/2024] Open
Abstract
STUDY OBJECTIVES Evidence implied that sleeping duration is associated with the timing of puberty and that sleep deprivation triggers early pubertal onset in adolescents. Sleep deprivation can affect metabolic changes and gut microbiota composition. This study investigated the effects of sleep deprivation on pubertal onset and gut microbiota composition in animal models and a human cohort. METHODS This study comprised 459 boys and 959 girls from the Taiwan Pubertal Longitudinal Study. Sleep duration was evaluated using the self-report Pittsburgh Sleep Quality Index questionnaire. Early sexual maturation was defined by pediatric endocrinologist assessments. Mediation analyses were done to examine the association between sleep parameters, obesity, and early sexual maturation. Besides, Sprague Dawley juvenile rats were exposed to 4 weeks of chronic sleep deprivation. Vaginal opening (VO) and preputial separation (PS) were observed every morning to determine pubertal onset in female and male rats. RESULTS The sleep-deprived juvenile rats in the sleep-deprived-female (SDF) and sleep-deprived-male (SDM) groups experienced delayed VO (mean VO days: 33 days in control; 35 days in SDF; p-value < 0.05) and PS (mean PS days: 42 days in control; 45 days in SDM; p-value < 0.05), respectively. Relative to their non-sleep-deprived counterparts, the sleep-deprived juvenile rats exhibited lower body weight and body fat percentage. Significant differences in relative bacterial abundance at genus levels and decreased fecal short-chain-fatty-acid levels were identified in both the SDF and SDM groups. In the human cohort, insufficient sleep increased the risk of early sexual maturation, particularly in girls (OR, 1.44; 95% CI: 1.09 to 1.89; p-value < 0.01). Insufficient sleep also indirectly affected early sexual maturation in girls, with obesity serving as the mediator. CONCLUSIONS Overall, sleep deprivation altered the timing of puberty in both animal and human models but in different directions. In the rat model, sleep deprivation delayed the pubertal onset in juvenile rats through gut dysbiosis and metabolic changes, leading to a low body weight and body fat percentage. In the human model, sleep deprivation led to fat accumulation, causing obesity in girls, which increased the risk of early puberty.
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Affiliation(s)
| | - Shih-Yi Huang
- Graduate Institute of Metabolism and Obesity Sciences Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chi Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Linh Ba Phuong Huynh
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Nam Nhat Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Yuan Hsu
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yang-Ching Chen
- Graduate Institute of Metabolism and Obesity Sciences Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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11
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Gu Q, Wu Y, Feng Z, Chai Y, Hou S, Yu Z, Shen X. Dietary pattern and precocious puberty risk in Chinese girls: a case-control study. Nutr J 2024; 23:14. [PMID: 38291391 PMCID: PMC10829199 DOI: 10.1186/s12937-024-00916-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The role of dietary intake on precocious puberty remains unclear. This study aimed to investigate the association between the amount and frequency of dietary intake and the risk of precocious puberty in Chinese girls. METHODS In this case-control study, we enrolled 185 precocious puberty girls and 185 age-matched controls. Their dietary intake was assessed through a semi-quantitative food frequency questionnaire. Their sociodemographic and lifestyle data were collected. The associations between dietary intake and risk of precocious puberty were assessed by conditional logistic regression models. RESULTS After multivariate adjustment, consuming a higher amount of red meat was associated with higher precocious puberty risk (OR = 2.74, 95% CI: 1.25-6.02), while a higher frequency of fruit ( P for trend = 0.024) and amount of vegetable intake was associated with a lower risk of precocious puberty (P for trend = 0.002). The high vegetable and protein dietary pattern was significantly negatively associated with precocious puberty (OR = 0.78, 95% CI: 0.63-0.97), whereas the high animal food and fruits dietary pattern was remarkably positively associated with precocious puberty (OR = 1.36, 95% CI: 1.09-1.69), after adjusting for age and body mass index. CONCLUSIONS High vegetable and protein dietary pattern is a protective factor against precocious puberty, while high animal food and fruits dietary pattern is a risk factor for precocious puberty in Chinese girls. Attentions should be paid to a reasonable intake of red meat, eggs, and fruits in children's daily diet, increase their intake of vegetables, in order to reduce the risk of precocious puberty.
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Affiliation(s)
- Qiuyun Gu
- Department of Nutrition, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Youmei Wu
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Statistics, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang, China
| | - Zhuowei Feng
- Department of Paediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yimeng Chai
- Department of Paediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Hou
- Department of Paediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Xiuhua Shen
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Nutrition, School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
- Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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Hong Y, Ullah R, Wang JB, Fu JF. Trends of obesity and overweight among children and adolescents in China. World J Pediatr 2023; 19:1115-1126. [PMID: 36920656 PMCID: PMC10015139 DOI: 10.1007/s12519-023-00709-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Recent decades have shown a rapid increase in the prevalence of overweight and obesity among Chinese children based on several national surveys. Restrictions due to the coronavirus disease 2019 outbreak have worsened its epidemiology. This review updates the trends in the prevalence of overweight and obesity among Chinese children and adolescents and analyzes the underlying reasons to provide evidence for better policy making. METHODS Studies published in English and Chinese were retrieved from PubMed, Google Scholar, China National Knowledge Infrastructure and Wanfang. RESULTS The prevalence of overweight and obesity has been increasing for decades and varies with age, sex and geography but is more pronounced in primary school students. The increase in obesity in boys appeared to be slower, whereas that in girls showed a declining trend. The northern areas of China have persistently maintained the highest levels of obesity with a stable trend in recent years. Meanwhile, the prevalence in eastern regions has dramatically increased. Notably, the overall prevalence of obesity in children has shown a stabilizing trend in recent years. However, the occurrence of obesity-related metabolic diseases increased. The effect of migrants floating into east-coast cities should not be neglected. CONCLUSIONS The high prevalence of overweight and obesity among Chinese children and adolescents persists but with varying patterns. Obesity-related metabolic diseases occur more frequently despite a stable trend of obesity. Multiple factors are responsible for the changing prevalence. Thus, comprehensive and flexible policies are needed to effectively manage and prevent the burden of obesity and its related complications.
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Affiliation(s)
- Ye Hong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - Rahim Ullah
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - Jian-Bing Wang
- Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Jun-Fen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China.
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13
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Heidarianpour A, Shokri E, Sadeghian E, Cheraghi F, Razavi Z. Combined training in addition to cortisol reduction can improve the mental health of girls with precocious puberty and obesity. Front Pediatr 2023; 11:1241744. [PMID: 38027308 PMCID: PMC10680081 DOI: 10.3389/fped.2023.1241744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Obesity and central precocious puberty (CPP) are associated with increased anxiety, depression, and anger in girls. The contribution of exercise as an efficacious component in decreasing anxiety, depression, and anger has been increasingly recognized. Objectives This study aims to evaluate the effects of combined training on cortisol, anxiety, depression, and anger in overweight and obese girls with CPP. Methods The study involved 30 girls aged 7-9 years diagnosed with CPP (undergoing triptorelin treatment) and dealing with obesity. In addition, these girls scored higher than the cut-off line for anxiety, depression, and anger. The participants were divided into two groups, with 15 individuals in each group. The exercise group engaged in 60 min of combined aerobic and resistance training three times per week for a duration of 12 weeks. On the other hand, the control group did not receive any training. Throughout the study, the serum cortisol levels were measured in both groups. Anxiety, anger, and depression questionnaires were also completed at three different stages, namely, baseline, 12 weeks, and 16 weeks (after a 4-week period of detraining). Results In the exercise group, there was a significant decrease (P < 0.05) in cortisol serum levels and anxiety, depression, and anger scores. These changes were observed consistently during detraining (P > 0.05). However, in the control group, only the depression score significantly decreased (P < 0.05). Conclusions Based on the results, it can be concluded that combined training is a method to improve the mental health of CPP girls. Clinical Trial Registration https://en.irct.ir/trial/61990, identifier IRCT20170411033378N10.
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Affiliation(s)
| | - Elnaz Shokri
- Faculty of Sports Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Efat Sadeghian
- Department of Nursing, School of Nursing and Midwifery, Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Cheraghi
- Department of Pediatric Nursing, School of Nursing and Midwifery, Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Razavi
- Department of Pediatrics Endocrinology, School of Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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14
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Lee J, Lee SI, Lee YM, Hong YH. Prevalence of Attention Deficit Hyperactivity Disorder in Girls With Central Precocious Puberty. J Atten Disord 2023; 27:1460-1466. [PMID: 37449382 DOI: 10.1177/10870547231180116] [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] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The purpose of the current study was to examine the prevalence of attention deficit hyperactivity disorder (ADHD) in girls with central precocious puberty. METHOD Girls with central precocious puberty were prospectively recruited from the pediatric clinic. Screening was done with ADHD Rating Scale (ADHD-RS) and Child Behavior Checklist (CBCL). Those who screened positive on ADHD-RS were referred for the diagnostic evaluation which included a Computerized Performance Test (CPT) and a clinical interview conducted by a child adolescent psychiatrist. RESULTS Among the 81 girls (mean age = 8.97 ± 0.91) who completed the study, 11 girls (13.58%) were diagnosed with ADHD: 5 of them were inattentive type and 6 of them were combined type. CONCLUSION The present exploratory study showed that the prevalence of ADHD in girls with central precocious was higher than the known worldwide prevalence of ADHD in children.
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Affiliation(s)
- Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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15
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Stathori G, Tzounakou AM, Mastorakos G, Vlahos NF, Charmandari E, Valsamakis G. Alterations in Appetite-Regulating Hormones in Girls with Central Early or Precocious Puberty. Nutrients 2023; 15:4306. [PMID: 37836591 PMCID: PMC10574110 DOI: 10.3390/nu15194306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
The prevalence of central precocious puberty (CPP) in girls has increased worldwide and is often associated with obesity in childhood as well as high fat/high glycemic index diets. Evidence suggests that subjects with obesity present with alterations in appetite-regulating hormones. The arcuate and paraventricular nuclei of the hypothalamus are the centers of action of appetite hormones, as well as the location of gonadotropin-releasing hormone (GnRH) neurons, the activation of which results in the onset of puberty. This anatomical proximity raises the question of possible alterations in appetite-regulating hormones in patients with CPP. Furthermore, diet-induced hypothalamic inflammation constitutes a probable mechanism of the pathophysiology of CPP, as well as alterations in appetite-regulating hormones in young children. In this article, we summarize the evidence investigating whether girls with CPP present with alterations in appetite-regulating hormones. We present evidence that leptin concentrations are elevated in girls with CPP, ghrelin concentrations are lower in girls with CPP, nesfatin-1 and orexin-A concentrations are elevated among girls with premature thelarche, and insulin concentrations are increased in girls with early menarche.
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Affiliation(s)
- Galateia Stathori
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.S.); (A.-M.T.)
| | - Anastasia-Maria Tzounakou
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.S.); (A.-M.T.)
| | - George Mastorakos
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.M.); (N.F.V.); (G.V.)
| | - Nikolaos F. Vlahos
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.M.); (N.F.V.); (G.V.)
| | - Evangelia Charmandari
- Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.S.); (A.-M.T.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Georgios Valsamakis
- Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, ‘Aretaieion’ University Hospital, 11528 Athens, Greece; (G.M.); (N.F.V.); (G.V.)
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16
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Babarinsa IA, Bashir M, AbdelRahman Ahmed H, Ahmed B, Konje JC. Bariatric surgery and reproduction-implications for gynecology and obstetrics. Best Pract Res Clin Obstet Gynaecol 2023; 90:102382. [PMID: 37506498 DOI: 10.1016/j.bpobgyn.2023.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
As the rates of obesity continue to rise across the world, there has been an increasing resort to bariatric surgery amongst the options for treatment. Through the reproductive lifespan, between menarche and menopause, women might benefit from this surgical intervention, which may have a bearing on other aspects of their health. The consequences of bariatric surgery have been reported and evaluated from various perspectives in obstetrics and gynecology. Fertility and sexuality are enhanced, but not all gynecological diseases are ameliorated. There are also psychological and behavioral sequelae to be cognizant of. With multi-disciplinary and responsive care, most post-bariatric pregnancies have satisfactory outcomes. The effects of bariatric surgery on the babies conceived thereafter remains a subject of interest, whereas the possible effect on the climacteric is speculative.
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Affiliation(s)
- Isaac A Babarinsa
- Women's Wellness and Research Centre, Hamad Medical Corporation, Doha.
| | | | | | - Badreldeen Ahmed
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Qatar University, Qatar
| | - Justin C Konje
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Department of Health Sciences University of Leicester, UK
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17
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Zhu Z, Yin P. Overweight and obesity: The serious challenge faced by Chinese children and adolescents. J Glob Health 2023; 13:03036. [PMID: 37469286 DOI: 10.7189/jogh.13.03036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Affiliation(s)
- Zhenggang Zhu
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ping Yin
- Hunan Provincial Maternal and Child Health Care Hospital, Kaifu District, Changsha, Hunan, China
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18
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Joseph R, Etterman E. Prosopagnosia (face blindness) and child health during the COVID-19 pandemic. Nurs Child Young People 2023; 35:27-33. [PMID: 36688257 DOI: 10.7748/ncyp.2023.e1480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 08/08/2023]
Abstract
Prosopagnosia or 'face blindness' is the inability to recognise people's faces. There are two types: congenital or developmental prosopagnosia, which is the most common, and acquired prosopagnosia, which may occur secondary to brain tumours, stroke or other brain disorders. The authors of this article explored if mask wearing as a result of the restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic may affect social and developmental outcomes in children, including the development of prosopagnosia. Limited research on this topic is available and, although some relevant publications were found, no definitive evidence of mask-induced prosopagnosia in children was identified. However, nurses should be aware of this issue and discuss coping strategies to support children with the condition. Longitudinal studies on outcomes in children from different age groups who grew up during the COVID-19 pandemic will provide further insight.
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Affiliation(s)
- Rachel Joseph
- school of nursing, Liberty University, Lynchburg, Virginia, US
| | - Emily Etterman
- school of nursing, Liberty University, Lynchburg, Virginia, US
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19
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Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020285. [PMID: 36832413 PMCID: PMC9955505 DOI: 10.3390/children10020285] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions.
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20
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Chen D. Commentary: Gut microbiota and its derived SCFAs regulate the HPGA to reverse obesity-induced precocious puberty in female rats. Front Endocrinol (Lausanne) 2023; 14:1121124. [PMID: 36761186 PMCID: PMC9905803 DOI: 10.3389/fendo.2023.1121124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
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21
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Gea M, Toso A, Bentivegna GN, Buganza R, Abrigo E, De Sanctis L, Schilirò T. Oestrogenic Activity in Girls with Signs of Precocious Puberty as Exposure Biomarker to Endocrine Disrupting Chemicals: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:14. [PMID: 36612336 PMCID: PMC9819927 DOI: 10.3390/ijerph20010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The relationship between endocrine disrupting chemical (EDC) exposure and Precocious Puberty (PP) was investigated in this pilot study, involving girls with signs of PP (P) and pre-pubertal girls (C). Risk factors for PP were assessed through questionnaires, while 17β-oestradiol (E2) levels and oestrogenic activity were quantified on sera. The oestrogenic activity, expressed as E2 equivalent concentration (EEQ), was applied as EDC exposure biomarker. Questionnaires showed a low EDC knowledge, a high EDC exposure, and a potential relationship between some habits at risk for EDC exposure and PP. EEQs were similar between C and P; however, they were significantly higher in girls living in an urban environment than in girls living in a rural environment, suggesting a potential higher EDC exposure in cities. The results of this pilot study highlighted the need to raise awareness on EDCs and can be considered a starting point to clarify the relationship between EDC exposure and PP.
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Affiliation(s)
- Marta Gea
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Anna Toso
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Institut régional du Cancer de Montpellier (ICM), Université Montpellier, 34090 Montpellier, France
| | | | - Raffaele Buganza
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Enrica Abrigo
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Luisa De Sanctis
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Tiziana Schilirò
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
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22
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Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121975. [PMID: 36553418 PMCID: PMC9776766 DOI: 10.3390/children9121975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.
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23
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Shi L, Jiang Z, Zhang L. Childhood obesity and central precocious puberty. Front Endocrinol (Lausanne) 2022; 13:1056871. [PMID: 36465655 PMCID: PMC9716129 DOI: 10.3389/fendo.2022.1056871] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
Childhood obesity is a major public health problem worldwide, and the relationship between obesity and central precocious puberty has long been confirmed, however, the mechanisms underlying this association remain elusive. This review provides an overview of the recent progress regarding how childhood obesity impacts on hypothalamic-pituitary-gonadal axis and pubertal onset, focusing on adipokines (leptin and ghrelin), hormone (insulin), and lipid (ceramide), as well as critical signaling pathways (AMPK/SIRT, mTOR) that integrate the peripheral metabolism and central circuits. Notably, prevention of obesity and CPP is beneficial for the adult life of the children, thus we further summarize the potential strategies in treating and preventing childhood obesity and CPP. The updated understanding of metabolic stress and pediatric endocrine disease will arise the attention of society, and also contribute to preventing more serious comorbidities in the later period of life in children.
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Affiliation(s)
- Li Shi
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiyan Jiang
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li Zhang
- Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Analysis of the Relationship between Nutritional Status and Bone Age and Sexual Development in Children and Adolescents. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8325756. [PMID: 36062175 PMCID: PMC9436596 DOI: 10.1155/2022/8325756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Abstract
Purpose To observe the correlation between nutritional status, bone age, and sexual development in children and adolescents. Methods 895 children and adolescents who underwent physical examination in the growth and development clinic and height clinic of our hospital from 2019 to 2021 were selected as the research objects. The subjects were divided into emaciation group, normal group, overweight group, and obesity group. The bone age level, bone age assessment, sexual development, and early maturity rate of each group were compared. Results The bone age difference (BAD) of the overweight and obesity groups was higher than that of the normal group, and the BAD of the obesity group was higher than that of the emaciation group (P < 0.05). Compared with the normal group, the risk of advancement of bone age in the overweight group increased by 2.674 times (male) and 1.908 times (female), the risk of advancement of bone age in the obesity group increased by 6.376 times (male) and 14.687 times (female), the risk of retardation of bone age in the emaciation group increased by 2.150 times (male) and 3.092 times (female). Whether it was male or female, the sexual development of overweight and obese was higher than that of the normal weight group in the same age group. Among female children, the sexual precocious puberty rate of the overweight + obesity group is higher. Conclusion The nutritional status of children and adolescents is closely related to their bone age and sexual development.
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Pang B, Wang Q, Yang M, Xue M, Zhang Y, Deng X, Zhang Z, Niu W. Identification and Optimization of Contributing Factors for Precocious Puberty by Machine/Deep Learning Methods in Chinese Girls. Front Endocrinol (Lausanne) 2022; 13:892005. [PMID: 35846287 PMCID: PMC9279618 DOI: 10.3389/fendo.2022.892005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022] Open
Abstract
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 via 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 via 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.
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Affiliation(s)
- Bo Pang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qiong Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Min Yang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Mei Xue
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Yicheng Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Xiangling Deng
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Zhixin Zhang
- International Medical Services, China-Japan Friendship Hospital, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Wenquan Niu, ; Zhixin Zhang,
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Wenquan Niu, ; Zhixin Zhang,
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