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Angelopoulou A, Athanasiadou KI, Zairi M, Zapanti E, Vasileiou V, Paschou SA, Anastasiou E. Early age at menarche and the risk of gestational diabetes mellitus: a cohort study. Endocrine 2024; 85:1222-1227. [PMID: 38498127 DOI: 10.1007/s12020-024-03776-6] [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: 12/07/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE To evaluate whether there is an association between age at menarche (AAM) and the risk of gestational diabetes mellitus (GDM). METHODS A retrospective cohort study was conducted, including 5390 pregnant women who were screened for GDM at Alexandra Hospital in Athens, Greece over a 15-year period (2000-2014). Maternal age, pre-pregnancy body mass index (BMI), height, family history of type 2 diabetes mellitus, parity, educational and smoking status, and AAM were recorded. The results were expressed as odds ratios (OR) with a 95% confidence interval (95% CI). RESULTS Pregnant women with GDM experienced earlier menarche compared to normoglycemic women (12.9 ± 1.5 vs 13.1 ± 1.6, p < 0.001, respectively). The OR for a woman with AAM <12 years to develop GDM was 1.08 (95% CI 1.03-1.14), while the OR to be obese was 1.70 (95% CI 1.50-1.90). The multivariate logistic regression analysis showed that AAM is a risk factor for GDM. However, that effect was lost after adjusting for BMI. CONCLUSION Early AAM may be associated with an increased risk of GDM. Therefore, it can be used to identify high-risk women and implement preconception interventions for GDM prevention. Future studies should be conducted to confirm these findings.
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Affiliation(s)
| | - Kleoniki I Athanasiadou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Zairi
- Department of Endocrinology and Diabetes Centre, Alexandra Hospital, Athens, Greece
| | - Evangelia Zapanti
- Department of Endocrinology and Diabetes Centre, Alexandra Hospital, Athens, Greece
| | - Vasiliki Vasileiou
- Department of Endocrinology and Diabetes Centre, Alexandra Hospital, Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Eleni Anastasiou
- Department of Endocrinology and Diabetes Centre, Alexandra Hospital, Athens, Greece
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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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Wu J, Chen J, Huang R, Zhu H, Che L, Lin Y, Chang Y, Shen G, Feng J. Metabolic characteristics and pathogenesis of precocious puberty in girls: the role of perfluorinated compounds. BMC Med 2023; 21:323. [PMID: 37626398 PMCID: PMC10463894 DOI: 10.1186/s12916-023-03032-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Precocious puberty (PP) in girls is traditionally defined as the onset of breast development before the age of 8 years. The specific biomarkers of premature thelarche (PT) and central precocious puberty (CPP) girls are uncertain, and little is known about their metabolic characteristics driven by perfluorinated compounds (PFCs) and clinical phenotype. This study aimed to screen specific biomarkers of PT and CPP and elucidate their underlying pathogenesis. The relationships of clinical phenotype-serum PFCs-metabolic characteristics were also explored to reveal the relationship between PFCs and the occurrence and development of PT and CPP. METHODS Nuclear magnetic resonance (NMR)-based cross-metabolomics strategy was performed on serum from 146 PP (including 30 CPP, 40 PT, and 76 unspecified PP) girls and 64 healthy girls (including 36 prepubertal and 28 adolescent). Specific biomarkers were screened by the uni- and multivariate statistical analyses. The relationships between serum PFCs and clinical phenotype were performed by correlation analysis and weighted gene co-expression network analysis to explore the link of clinical phenotype-PFCs-metabolic characteristics in PT and CPP. RESULTS The disordered trend of pyruvate and butyrate metabolisms (metabolites mapped as formate, ethanol, and 3-hydroxybutyrate) were shared and kept almost consistent in PT and CPP. Eight and eleven specific biomarkers were screened for PT and CPP, respectively. The area under curve of specific biomarker combination was 0.721 in CPP vs. prepubertal, 0.972 in PT vs. prepubertal, 0.646 in CPP vs. prepubertal integrated adolescent, and 0.822 in PT vs. prepubertal integrated adolescent, respectively. Perfluoro-n-heptanoic acid and perfluoro-n-hexanoic acid were statistically different between PT and CPP. Estradiol and prolactin were significantly correlated with PFCs in CPP and PT. Clinical phenotypes and PFCs drive the metabolic characteristics and cause metabolic disturbances in CPP and PT. CONCLUSIONS The elevation of formate, ethanol, and 3-hydroxybutyrate may serve as the early diagnostic indicator for PP in girls. But the stratification of PP still needs to be further determined based on the specific biomarkers. Specific biomarkers of CPP and PT exhibited good sensitivity and can facilitate the classification diagnosis of CPP and PT. PFC exposure is associated with endocrine homeostasis imbalance. PFC exposure and/or endocrine disturbance directly or indirectly drive metabolic changes and form overall metabolic network perturbations in CPP and PT.
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Affiliation(s)
- Jinxia Wu
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Siming District, 422 Siming South Road, Xiamen, 361005, Fujian, China
| | - Jing Chen
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Rong Huang
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Hongwei Zhu
- Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical College, Anhui, Bengbu, 233000, China
| | - Lin Che
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, China
| | - Yanyan Lin
- Department of Child Health, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, China
| | - Yajie Chang
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Siming District, 422 Siming South Road, Xiamen, 361005, Fujian, China
| | - Guiping Shen
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Siming District, 422 Siming South Road, Xiamen, 361005, Fujian, China.
| | - Jianghua Feng
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Siming District, 422 Siming South Road, Xiamen, 361005, Fujian, China
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Wang G, Radovick S, Buckley JP, Hauser R, Williams PL, Hong X, Pearson C, Adams WG, Wang X. Plasma Insulin Concentration in Newborns and Children and Age at Menarche. Diabetes Care 2023; 46:1231-1238. [PMID: 37018448 PMCID: PMC10234748 DOI: 10.2337/dc22-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To investigate the association of plasma insulin levels and their trajectories from birth to childhood with the timing of menarche. RESEARCH DESIGN AND METHODS This prospective study included 458 girls recruited at birth between 1998 and 2011 and followed prospectively at the Boston Medical Center. Plasma nonfasting insulin concentrations were measured at two time points: at birth (cord blood) and in childhood (age 0.5-5 years). Age at menarche was obtained from a pubertal developmental questionnaire or abstracted from electronic medical records. RESULTS Three hundred six (67%) of the girls had reached menarche. The median (range) age at menarche was 12.4 (9-15) years. Elevated plasma insulin concentrations at birth (n = 391) and in childhood (n = 335) were each associated with an earlier mean age at menarche: approximately 2 months earlier per doubling of insulin concentration (mean shift, -1.95 months, 95% CI, -0.33 to -3.53, and -2.07 months, 95% CI, -0.48 to -3.65, respectively). Girls with overweight or obesity in addition to elevated insulin attained menarche about 11-17 months earlier, on average, than those with normal weight and low insulin. Considering longitudinal trajectories (n = 268), having high insulin levels both at birth and in childhood was associated with a roughly 6 months earlier mean age at menarche (mean shift, -6.25 months, 95% CI, -0.38 to -11.88), compared with having consistently low insulin levels at both time points. CONCLUSIONS Our data showed that elevated insulin concentrations in early life, especially in conjunction with overweight or obesity, contribute to the earlier onset of menarche, suggesting the need for early screening and intervention.
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Affiliation(s)
- Guoying Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Sally Radovick
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Paige L. Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xiumei Hong
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Colleen Pearson
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
- Department of Pediatrics, Boston Medical Center, Boston, MA
| | - William G. Adams
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
- Department of Pediatrics, Boston Medical Center, Boston, MA
| | - Xiaobin Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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Santos-Silva R, Fontoura M, Severo M, Santos AC. Dehydroepiandrosterone sulfate levels at 7 years old and cardio-metabolic factors at 10 and 13 years old - the generation XXI birth cohort. J Pediatr Endocrinol Metab 2023:jpem-2022-0593. [PMID: 37141272 DOI: 10.1515/jpem-2022-0593] [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: 11/23/2022] [Accepted: 04/17/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Premature adrenarche is often linked to a cluster of endocrine-metabolic risk factors. Our objective was to explore the association of dehydroepiandrosterone sulfate (DHEAS) levels at age 7 with cardio-metabolic traits at ages 10 and 13, independently of adiposity and pubertal stage. METHODS Longitudinal study of 603 individuals (301 girls/302 boys) from the Generation XXI birth cohort. DHEAS at age 7 was measured by immunoassay. Anthropometrics, pubertal staging, blood pressure, and metabolic outcomes were evaluated at ages 7, 10, and 13. Pearson correlations between DHEAS and cardio-metabolic traits (insulin, HOMA-IR, triglycerides, LDL-cholesterol, high-sensitivity C-reactive protein, and systolic and diastolic blood pressure) were computed. Path analysis was used to estimate the effect of DHEAS at age 7 on cardiometabolic traits at ages 10 and 13, adjusted for body mass index (BMI) z-score and Tanner stage. RESULTS DHEAS at age 7 correlated positively with insulin and HOMA-IR at ages 7 and 10 in both sexes, and at age 13 in girls, but not in boys. In girls, DHEAS levels at age 7 directly influenced HOMA-IR at age 13, controlling for BMI and Tanner stage. In boys, DHEAS at age 7 did not influence HOMA-IR at ages 10 and 13. DHEAS at age 7 did not influence the other cardio-metabolic outcomes analyzed. CONCLUSIONS DHEAS levels in mid-childhood have a positive longitudinal association with on insulin-resistance that persists, in girls, but not in boys, at least until age 13. No association was found regarding dyslipidemia, hypertension, or low-grade inflammation.
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Affiliation(s)
- Rita Santos-Silva
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Unidade de Endocrinologia Pediátrica, Serviço de Pediatria, Centro Hospitalar Universitário de S. João, Porto, Portugal
- Departamento de Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- ITR - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Manuel Fontoura
- Unidade de Endocrinologia Pediátrica, Serviço de Pediatria, Centro Hospitalar Universitário de S. João, Porto, Portugal
- Departamento de Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- ITR - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- ITR - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Kjaer ASL, Jensen RB, Petersen JH, Linneberg A, Kårhus LL, Henriksen LS, Johannsen TH, Main KM, Hoffman AR, Juul A. Tracking and Cumulative Lifetime Exposure to IGF-I in 6459 Healthy Individuals and in SGA Children Treated With GH. J Clin Endocrinol Metab 2023; 108:642-652. [PMID: 36250350 DOI: 10.1210/clinem/dgac605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/13/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Supraphysiological serum insulin-like growth factor-I (IGF-I) concentrations have been a matter of concern in children treated with GH because high IGF-I levels were associated with risk of later disease in former epidemiological studies. OBJECTIVE To determine whether a single IGF-I measurement reliably reflects lifetime IGF-I exposure we evaluated intraindividual longitudinal tracking of IGF-I and IGF-binding protein-3 (IGFBP-3) levels and we estimated cumulative lifetime exposure to IGF-I in healthy and GH-treated individuals. METHODS We included 6459 healthy participants (cross-sectional = 5326; longitudinal = 1133) aged 0-76 years (9963 serum samples) and 9 patients born small-for-gestational-age (SGA) with 238 serum samples during GH treatment. Intraindividual tracking of IGF-I and IGFBP-3 (SD score [SDS]) was determined by intraclass correlation coefficients (ICCs). Cumulative lifetime IGF-I exposure was estimated by area under the curve of the predicted SDS trajectory from 0 to 76 years. RESULTS For IGF-I (SDS), ICCs were 0.50 (95% CI, 0.47-0.53) for male and 0.53 (0.50-0.56) for female participants. Lifetime IGF-I exposure was significantly higher in female (mean 12 723 ± 3691 SD) than in male participants (12 563 ± 3393); P = 0.02. In SGA children, treatment with GH increased the lifetime exposure to IGF-I from 9512 ± 1889 to 11 271 ± 1689, corresponding to an increase in lifetime IGF-I trajectory from -0.89 SD ± 0.57 to -0.35 SD ± 0.49. CONCLUSION Because IGF-I and IGFBP-3 levels track throughout life, a single measurement reliably reflects lifetime exposure. GH therapy increased the lifetime exposure to IGF-I only slightly and it remained below the average lifetime exposure in the reference population.
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Affiliation(s)
- Anna Sophie L Kjaer
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- Department of Medicine, VA Palo Alto Health Care System and Stanford University School of Medicine, Palo Alto CA-94304, USA
| | - Rikke Beck Jensen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Jørgen H Petersen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- Section of Biostatistics, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Allan Linneberg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Frederiksberg DK-2000, Denmark
| | - Line Lund Kårhus
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Frederiksberg DK-2000, Denmark
| | - Louise Scheutz Henriksen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
| | - Trine Holm Johannsen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Andrew R Hoffman
- Department of Medicine, VA Palo Alto Health Care System and Stanford University School of Medicine, Palo Alto CA-94304, USA
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen DK-2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark
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Obesity-Related Factors in Adult Women with Early Menarche. Healthcare (Basel) 2023; 11:healthcare11040557. [PMID: 36833092 PMCID: PMC9957266 DOI: 10.3390/healthcare11040557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
The average menarche age among South Korean women has decreased over time. Early menarche in women causes a higher incidence of obesity owing to the continuous fat accumulation induced by prolonged exposure to estrogen and adrenal steroids. Identifying the factors affecting obesity in women who experience early menarche is essential for managing obesity in adult women. This study aimed to analyze the factors associated with obesity in adult women who experienced early menarche and to provide basic data for obesity management. This study was a cross-sectional and descriptive survey from the seventh Korea National Health and Nutrition Examination. A total of 371 women aged ≥ 19 years experienced early menarche, and the propensity matching method was used to analyze the obesity-related factors identified in previous studies. The results showed that obesity in adult women with early menarche was negatively associated with the level of aerobic exercise (OR = 0.53, 95% CI = 0.30-0.93, p = 0.028) and muscle-strengthening exercise (OR = 0.33, 95% CI = 0.17-0.64, p = 0.001). Future longitudinal studies on girls who experience early menarche are needed to address female obesity prevention at every stage of life, and, based on these findings, obesity management programs can be developed and applied and their effectiveness determined.
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Baier I, Pereira A, Ferrer P, Iñiguez G, Mericq V. Higher Prepubertal IGF-1 Concentrations Associate to Earlier Pubertal Tempo in Both Sexes. Horm Res Paediatr 2022; 96:404-411. [PMID: 36513037 DOI: 10.1159/000528662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Pubertal onset is triggered by multiple neuroendocrine interactions. The role of prepubertal IGF-1 in this process has not been explored in both sexes. Our objective was to analyze the association of prepubertal IGF-1 concentration with age at thelarche (B2) and menarche (M) in girls and age at gonadarche (G2) in boys. METHODS This is a longitudinal study (n = 1,196 boys and girls) within the Growth and Obesity Chilean Cohort Study (GOCS). At age ≈ 6.7 years, blood sample was taken for IGF-1. Subjects were divided into 4 groups according to the onset age of the pubertal event. RESULTS Higher prepubertal IGF-1 levels were observed at earlier ages of B2 (p = 0.003) and M onset (p = 0.041). A taller prepubertal height was observed at younger ages of B2 and M (p=<0.001 and 0.002, respectively). The hazard proportional regression models (HR) showed that with an increase of 1 SD in IGF-1, the HR of presenting B2 at younger ages was 1.25, and this association was maintained when adjusted for confounding variables. Similarly, the HR of presenting M at earlier ages was 1.21. This association was maintained only when adjusting for body mass index but not using further confounders. In boys, prepubertal IGF-1 showed a tendency to be significantly higher in children with earlier G2 and taller height (both p < 0.001). The HR of presenting G2 at younger ages was 1.22, and this association was maintained after adjusting for confounders. CONCLUSIONS Higher IGF-1 levels in mid-childhood are associated with earlier puberty onset. The role of IGF-1 in the onset of puberty requires further investigation.
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Affiliation(s)
- Ingrid Baier
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Pedro Ferrer
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - German Iñiguez
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Verónica Mericq
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
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Santos-Silva R, Fontoura M, Severo M, Santos AC. Dehydroepiandrosterone sulphate levels at 7 years old are positively associated with more advanced pubertal development between 10 and 13 years old in girls. Clin Endocrinol (Oxf) 2022; 97:747-754. [PMID: 35918802 DOI: 10.1111/cen.14805] [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: 04/13/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We aimed to explore the association between dehydroepiandrosterone sulphate (DHEAS) levels at age 7, pubertal development between ages 10 and 13, and age at menarche. DESIGN AND PARTICIPANTS This is a longitudinal study of 603 individuals (301 girls, 302 boys) from the Generation XXI cohort. MEASUREMENTS Evaluation of the participants at ages 7, 10 and 13 included anthropometry and Tanner staging. Pubertal development between ages 10 and 13 was categorized using latent class analysis, based on Tanner stages. The association between DHEAS at age 7 and pubertal development between ages 10 and 13 was conducted with binomial logistic regression, adjusted for BMI z-score. The variation of age at menarche in relation to DHEAS levels at age 7, controlling for maternal age at menarche, birth weight z-score and BMI z-score, was estimated fitting a linear regression model. RESULTS Pubertal development at ages 10-13 was categorized into two classes-Class 1 had a higher probability for the lower Tanner stage (less advanced sexual maturation) and Class 2 had a higher probability for the higher Tanner stage (more advanced sexual maturation). In girls, taking Class 1 as a reference, Class 2 was positively associated with BMI z-score and DHEAS. In boys, Class 2 was positively associated with BMI, but not with DHEAS. DHEAS levels at age 7 were negatively associated with age at menarche, after adjustment for maternal age at menarche, birth weight and BMI. CONCLUSION In girls, but not in boys, DHEAS at age 7 was positively associated with more advanced pubertal development between ages 10 and 13, and with earlier age at menarche.
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Affiliation(s)
- Rita Santos-Silva
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Unidade de Endocrinologia Pediátrica, Serviço de Pediatria, Centro Hospitalar Universitário de S. João, Porto, Portugal
- Departamento de Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Manuel Fontoura
- Unidade de Endocrinologia Pediátrica, Serviço de Pediatria, Centro Hospitalar Universitário de S. João, Porto, Portugal
- Departamento de Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- ITR-Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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10
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Upners EN, Raket LL, Petersen JH, Thankamony A, Roche E, Shaikh G, Kirk J, Hoey H, Ivarsson SA, Söder O, Juul A, Jensen RB. Timing of Puberty, Pubertal Growth, and Adult Height in Short Children Born Small for Gestational Age Treated With Growth Hormone. J Clin Endocrinol Metab 2022; 107:2286-2295. [PMID: 35521800 DOI: 10.1210/clinem/dgac282] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Growth hormone (GH) is used to treat short children born small for gestational age (SGA); however, the effects of treatment on pubertal timing and adult height are rarely studied. OBJECTIVE To evaluate adult height and peak height velocity in short GH-treated SGA children. METHODS Prospective longitudinal multicenter study. Participants were short children born SGA treated with GH therapy (n = 102). Adult height was reported in 47 children. A reference cohort of Danish children was used. Main outcome measures were adult height, peak height velocity, age at peak height, and pubertal onset. Pubertal onset was converted to SD score (SDS) using Danish reference data. RESULTS Gain in height SDS from start of treatment until adult height was significant in both girls (0.94 [0.75; 1.53] SDS, P = .02) and boys (1.57 [1.13; 2.15] SDS, P < .001). No difference in adult height between GH dosage groups was observed. Peak height velocity was lower than a reference cohort for girls (6.5 [5.9; 7.6] cm/year vs 7.9 [7.4; 8.5] cm/year, P < .001) and boys (9.5 [8.4; 10.7] cm/year vs 10.1 [9.7; 10.7] cm/year, P = .002), but no difference in age at peak height velocity was seen. Puberty onset was earlier in SGA boys than a reference cohort (1.06 [-0.03; 1.96] SDS vs 0 SDS, P = .002) but not in girls (0.38 [-0.19; 1.05] SDS vs 0 SDS, P = .18). CONCLUSION GH treatment improved adult height. Peak height velocity was reduced, but age at peak height velocity did not differ compared with the reference cohort. SGA boys had an earlier pubertal onset compared with the reference cohort.
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Affiliation(s)
- Emmie N Upners
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Lars Lau Raket
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jørgen H Petersen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Ajay Thankamony
- Department of Pediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Edna Roche
- Department of Pediatrics, CHI at Tallaght University Hospital, Trinity College Dublin, The University of Dublin, Dublin 24, Ireland
| | - Guftar Shaikh
- Department of Endocrinology, Royal Hospital for Children, Glasgow G51 4TF, UK
| | - Jeremy Kirk
- Department of Endocrinology, Birmingham Children's Hospital, Birmingham B4 6NH, UK
| | - Hilary Hoey
- Department of Pediatrics, CHI at Tallaght University Hospital, Trinity College Dublin, The University of Dublin, Dublin 24, Ireland
| | - Sten-A Ivarsson
- Department of Clinical Sciences, Endocrine and Diabetes Unit, University of Lund, 22100 Lund, Sweden
| | - Olle Söder
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institute, 17177 Stockholm, Sweden
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Rikke Beck Jensen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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11
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Shalitin S, Gat-Yablonski G. Associations of Obesity with Linear Growth and Puberty. Horm Res Paediatr 2022; 95:120-136. [PMID: 34130293 DOI: 10.1159/000516171] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of obesity in childhood has increased dramatically in recent decades with increased risk of developing cardiometabolic and other comorbidities. Childhood adiposity may also influence processes of growth and puberty. SUMMARY Growth patterns of obesity during childhood have been shown to be associated with increased linear growth in early childhood, leading to accelerated epiphyseal growth plate (EGP) maturation. Several hormones secreted by the adipose tissue may affect linear growth in the context of obesity, both via the growth hormone IGF-1 axis and via a direct effect on the EGP. The observation that children with obesity tend to mature earlier than lean children has led to the assumption that the degree of body fatness may trigger the neuroendocrine events that lead to pubertal onset. The most probable link between obesity and puberty is leptin and its interaction with the kisspeptin system, which is an important regulator of puberty. However, peripheral action of adipose tissue could also be involved in changes in the onset of puberty. In addition, nutritional factors, epigenetics, and endocrine-disrupting chemicals are potential mediators linking pubertal onset to obesity. In this review, we focused on interactions of obesity with linear growth and pubertal processes, based on basic research and clinical data in humans. KEY MESSAGE Children with obesity are subject to accelerated linear growth with risk of impaired adult height and early puberty, with its psychological consequences. The data highlight another important objective in combatting childhood obesity, for the prevention of abnormal growth and pubertal patterns.
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Affiliation(s)
- Shlomit Shalitin
- National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Gat-Yablonski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Felsenstein Medical Research Center, Petach Tikva, Israel
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12
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Papadimitriou A, Marakaki C, Papadimitriou DT. Growth variations with opposite clinical outcomes and the emerging role of IGF-1. Trends Endocrinol Metab 2022; 33:359-370. [PMID: 35331614 DOI: 10.1016/j.tem.2022.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Normal growth pattern variations [i.e., constitutional advancement and constitutional delay of growth and puberty (CAGP and CDGP)] are the mirror image of each other and are associated with early puberty (EP) and delayed puberty (DP), respectively. Differences between CAGP and CDGP relate not only to auxological characteristics (height, weight) but also to insulin-like growth factor-1 (IGF-1). IGF-1 levels in CAGP are above average whereas in CDGP they are below average, suggesting a role for IGF-1 in the induction of these growth patterns. Herein, we provide data suggesting that early activation of the growth hormone (GH)/IGF-1 axis induces the growth pattern of CAGP. Moreover, we suggest that IGF-1 is a decisive factor for the release of the gonadotropin-releasing hormone (GnRH) inhibition brake that occurs in prepuberty. It is therefore crucial for puberty onset.
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Affiliation(s)
- Anastasios Papadimitriou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece.
| | - Chrisanthi Marakaki
- Pediatric Endocrinology Unit, Third Department of Pediatrics, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Haidari, Athens, Greece
| | - Dimitrios T Papadimitriou
- Pediatric-Adolescent Endocrinology and Diabetes, Athens Medical Center, Marousi and Endocrine Unit, Aretaeion University Hospital, Athens, Greece
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13
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Kanellakis S, Karalexi MA, Apostolidou E, Skoufas E, Kontoe M, Bacopoulou F, Tsitsas G, Migdanis A, Boudouvi E, Canellopoulos L, Manios Y. Earlier Age at Menarche Is Associated with Body Fat and Negative Body Image in Adult Life. Behav Med 2022; 49:105-114. [PMID: 35387571 DOI: 10.1080/08964289.2022.2033158] [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] [Indexed: 11/02/2022]
Abstract
Earlier age at menarche is one of the well-documented antecedents of a range of adverse health effects in adulthood including obesity and psychopathological effects. Yet, few researchers have examined the potential association of menarcheal age with body fat distribution, self-perception, and body image. We retrospectively tested a sample (N = 392) of adult women (18-80 years) to examine the associations of age at menarche with body composition and body image indices. Analyses of covariance and multivariable logistic and linear regression were fitted adjusting for age, physical activity level, smoking, and alcohol consumption. Further adjustment was made for body mass index (BMI) and percentage of fat mass. Earlier age at menarche was associated with slightly increased odds of higher BMI and abdominal fat percentage; of note is the positive correlation with lower body composition indices including hip and calf circumferences/skinfolds. Additionally, earlier age at menarche was associated with higher scores in the negative body image scales, namely overweight preoccupation and self-classified weight, whereas lower risks were found for higher scores in the positive body image scales, namely appearance evaluation and body area satisfaction scales. These findings remained significant after correcting for body fat percentage. The present results showed positive associations for earlier age at menarche with gross indices of obesity with the associations mainly confined to distribution of body fat in the lower part of the body, whereas an increased risk of negative body image was also found. Future research could refine our understanding of the biological and psychological mechanisms underlying these associations.
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Affiliation(s)
- Spyridon Kanellakis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Maria A Karalexi
- Third Department of Pediatrics, General University Hospital "Attikon," National and Kapodistrian University of Athens, Athens, Greece
| | - Eftychia Apostolidou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Estathios Skoufas
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Maria Kontoe
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgios Tsitsas
- Counseling Psychology, Harokopio University of Athens, Athens, Greece
| | - Athanasios Migdanis
- Nutrition, Dietetics and Food Technology Department, ATEI of Thessaly, Larissa, Greece
| | - Evangelia Boudouvi
- Third Department of Pediatrics, General University Hospital "Attikon," National and Kapodistrian University of Athens, Athens, Greece
| | - Lissy Canellopoulos
- Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
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14
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The Impact of Macronutrient Intake on Sex Steroids During Onset of Puberty. J Adolesc Health 2022; 70:483-487. [PMID: 34836804 PMCID: PMC8860866 DOI: 10.1016/j.jadohealth.2021.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Increased fiber intake has been associated with decreased breast cancer risk, while increased animal protein intake with increased risk. The objective of this study is to examine the relationship of dietary fiber and protein intake to estrogen and sex hormone-binding globulin (SHBG) concentrations at puberty onset. METHODS These analyses were conducted using the Cincinnati puberty cohort of the Breast Cancer and the Environment Research Program, with girls followed every 6 months from ages 6 and 7. The analyses included serum measurements at 6-month intervals for estrogen and SHBG concentrations, from 18 months prior to breast stage 2 (onset of puberty). Dietary intake was documented via 24-hour dietary recalls every 3 months. Dietary factors of interest included total energy intake; total and animal protein; total, soluble, and insoluble fiber; and lignan and flavanol intake. RESULTS This study included 260 participants who generated 871 serum specimens and 3,000 days of diet intake. In longitudinal models, estradiol was associated inversely with insoluble fiber intake; estrone positively with animal protein intake; SHBG with greater insoluble fiber and lower total protein intake; and ratio of estrone to SHBG, a measure of bioavailable estrogen, positively with animal protein. CONCLUSIONS Greater protein intake, especially animal protein, led to greater estrogen concentrations and lower SHBG; greater animal protein and greater caloric intake led to increased bioavailable estrogen. This relationship may have served an evolutionary advantage in the past for greater fertility with adequate high-quality protein; in contemporary women, a modest decrease in animal protein may be beneficial in reducing breast cancer risk.
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15
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Soliman A, Alaaraj N, Hamed N, Alyafei F, Ahmed S, Shaat M, Itani M, Elalaily R, Soliman N. Review Nutritional interventions during adolescence and their possible effects. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022087. [PMID: 35315384 PMCID: PMC8972883 DOI: 10.23750/abm.v93i1.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/21/2022]
Abstract
Nutrition is one of the most important factors affecting pubertal development. Increasing demands for energy proteins and micronutrients are necessary to cope with the rapid linear pubertal growth and development, change in body composition, and increased physical activity. Adequate nutrition is a key permissive factor for the normal timing and tempo of pubertal development. Severe primary or secondary malnutrition also can adversely delay the onset and progression of puberty. The higher incidence of anorexia nervosa and bulimia in adolescents imposes a nutritional risk on pubertal development. Here we provide an overview of nutritional requirements (macronutrients and micronutrients) necessary to cope with these changes. In addition, we discuss possible nutritional interventions trials and their effects on several aspects of growth and development in undernourished and stunted adolescents, in low- and middle-income countries (LMIC), who require nutritional rehabilitation. This mini-review sums up some important findings in this important complex that links between nutrition, nutritional interventions, and pubertal development.
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Affiliation(s)
- Ashraf Soliman
- Department of Pediatrics, Hamad General Hospital, Doha, Qatar; Qatar
| | - Nada Alaaraj
- Department of Pediatrics, Hamad General Hospital, Doha, Qatar; Qatar
| | - Noor Hamed
- Department of Pediatrics, Hamad General Hospital, Doha, Qatar; Qatar
| | - Fawzia Alyafei
- Department of Pediatrics, Hamad General Hospital, Doha, Qatar; Qatar
| | - Shayma Ahmed
- Department of Pediatrics, Hamad General Hospital, Doha, Qatar; Qatar
| | - Mona Shaat
- Dietetics and Nutrition, Hamad General Hospital
| | - Maya Itani
- Dietetics and Nutrition, Hamad General Hospital
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16
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Calcaterra V, Verduci E, Magenes VC, Pascuzzi MC, Rossi V, Sangiorgio A, Bosetti A, Zuccotti G, Mameli C. The Role of Pediatric Nutrition as a Modifiable Risk Factor for Precocious Puberty. Life (Basel) 2021; 11:1353. [PMID: 34947884 PMCID: PMC8706413 DOI: 10.3390/life11121353] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022] Open
Abstract
Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The timing of puberty has important public health, clinical, and social implications. In fact, it is crucial in psychological and physical development and can impact future health. Nutritional status is considered as one of the most important factors modulating pubertal development. This narrative review presents an overview on the role of nutritional factors as determinants of the timing of sexual maturation, focusing on early-life and childhood nutrition. As reported, breast milk seems to have an important protective role against early puberty onset, mainly due to its positive influence on infant growth rate and childhood overweight prevention. The energy imbalance, macro/micronutrient food content, and dietary patterns may modulate the premature activation of the hypothalamic-pituitary-gonadal axis, inducing precocious activation of puberty. An increase in knowledge on the mechanism whereby nutrients may influence puberty will be useful in providing adequate nutritional recommendations to prevent PP and related complications.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Vittoria Carlotta Magenes
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
| | - Arianna Sangiorgio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Chiara Mameli
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.); (V.C.M.); (M.C.P.); (V.R.); (A.S.); (A.B.); (G.Z.); (C.M.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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17
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Abstract
Adrenarche is the maturational increase in adrenal androgen production that normally begins in early childhood. It results from changes in the secretory response to adrenocorticotropin (ACTH) that are best indexed by dehydroepiandrosterone sulfate (DHEAS) rise. These changes are related to the development of the zona reticularis (ZR) and its unique gene/enzyme expression pattern of low 3ß-hydroxysteroid dehydrogenase type 2 with high cytochrome b5A, sulfotransferase 2A1, and 17ß-hydroxysteroid dehydrogenase type 5. Recently 11-ketotestosterone was identified as an important bioactive adrenarchal androgen. Birth weight, body growth, obesity, and prolactin are related to ZR development. Adrenarchal androgens normally contribute to the onset of sexual pubic hair (pubarche) and sebaceous and apocrine gland development. Premature adrenarche causes ≥90% of premature pubarche (PP). Its cause is unknown. Affected children have a significantly increased growth rate with proportionate bone age advancement that typically does not compromise growth potential. Serum DHEAS and testosterone levels increase to levels normal for early female puberty. It is associated with mildly increased risks for obesity, insulin resistance, and possibly mood disorder and polycystic ovary syndrome. Between 5% and 10% of PP is due to virilizing disorders, which are usually characterized by more rapid advancement of pubarche and compromise of adult height potential than premature adrenarche. Most cases are due to nonclassic congenital adrenal hyperplasia. Algorithms are presented for the differential diagnosis of PP. This review highlights recent advances in molecular genetic and developmental biologic understanding of ZR development and insights into adrenarche emanating from mass spectrometric steroid assays.
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Affiliation(s)
- Robert L Rosenfield
- University of Chicago Pritzker School of Medicine, Section of Adult and Pediatric Endocrinology, Metabolism, and Diabetes, Chicago, IL, USA.,Department of Pediatrics, University of California, San Francisco, CA, USA
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18
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Theodoropoulou S, Papadopoulou A, Karapanou O, Priftis K, Papaevangelou V, Papadimitriou A. Study of Xbal and Pvull polymorphisms of estrogen receptor alpha (ERα) gene in girls with precocious/early puberty. Endocrine 2021; 73:455-462. [PMID: 33948784 DOI: 10.1007/s12020-021-02695-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies examining association of estrogen receptor alpha (ERα) polymorphisms with early puberty are scarce and results are controversial; data in Caucasian girls are lacking. Main objective was to determine association of Xbal and Pvull polymorphisms of ERα gene in Greek girls with precocious/early puberty METHODS: We studied 107 girls with idiopathic precocious/early puberty and 81 young women with pubertal maturation within normal age (controls). Pubertal stage, height SDS (HSDS), and BMI z-score were determined in patients. In controls, height was measured and menarcheal age was self-reported. All participants in the study were genotyped for XbaI and PvuII polymorphisms of the ERα gene. RESULTS There was no significant difference in XbaI and PvuII polymorphisms between patients and controls. Homozygous, xx and pp, girls had an earlier onset of puberty, although non-significant, than heterozygous or with no polymorphisms p = 0.9; in girls with pubertal onset <7 years, the association tended to become significant, p = 0.09. Girls with xxpp genotype were significantly taller, HSDS 1.63, p = 0.014. In controls, homozygosity for Xbal (xx) and PvuII (pp) was associated with significantly earlier menarche than in women with no polymorphism, p = 0.013 and p = 0.026, respectively, and xxpp genotype was associated with taller adult height, p = 0.017. CONCLUSION XbaI and PvuII polymorphisms are not related to idiopathic precocious/early puberty. Early pubertal girls homozygous for both polymorphisms presented earlier onset of puberty, although statistically non-significant, and taller height than girls heterozygous or without these polymorphisms. Homozygosity for both polymorphisms is associated with earlier menarche and taller adult height.
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Affiliation(s)
- Sofia Theodoropoulou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Papadopoulou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Olga Karapanou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Priftis
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Papaevangelou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Papadimitriou
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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19
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Guo JY, Zhang YQ, Li Y, Li H. Comparison of the difference in serum insulin growth factor-1 levels between chronological age and bone age among children. Clin Biochem 2021; 96:63-70. [PMID: 34256051 DOI: 10.1016/j.clinbiochem.2021.07.008] [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: 03/15/2021] [Revised: 06/22/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE By measuring serum insulin-like growth factor-1 (IGF-1) levels in children aged 2-16, we aimed to analyze the changes in IGF-1 levels in different sex and age groups, and compare the consistency of IGF-1 results evaluated by chronological age (CA) and bone age (BA) in children. METHODS A cross-sectional study was conducted between January 2017 and December 2020 among 2979 relatively healthy children who attended the Department of Growth and Development outpatient clinic and health care center of the Affiliated Children's Hospital of the Capital Institute of Pediatrics and underwent health examination and development assessment. Height, weight, and Tanner pubertal stage were measured by pediatricians. The CHN method was used to estimate BA. Venous blood samples were collected from the children, and IGF-1 levels were determined via chemiluminescence. RESULTS IGF-1 levels in childhood increased slowly with age, dramatically during puberty,and continuously withgrowth until to 15 years for boys and reached a peak value at 13 years for girls based on CA. IGF-1 levels reached peak values at 14 and 13 years for boys and girls, respectively, based on BA. There were differences in IGF-1 values between the CA and BA groups at the age of 10-11 years for boys and 7-11 years for girls. A total of 103 boys (7.7%) and 17 girls (1.0%) had IGF-1 levels below the lower limit of the reference range based on CA; evaluating based on BA, there were 82 boys (6.1%) and 15 girls (0.9%) still had IGF-1 values less than the lower limit of the reference range. Eighteen boys (1.3%) and 173 girls (10.5%) had IGF-1 levels above the upper limit of the reference range based on CA; evaluating based on BA, these numbers reduced to 5 (0.4%) among boys and 41 (2.5%) among girls. CONCLUSIONS There is a significant difference between BA and CA in evaluating IGF-1 levels in children, which can significantly reduce the proportion of IGF-1 values above the upper limit of the kit reference range in children. This suggests that children with BA advanced in pubertal period, the evaluating results of IGF-1 should be corrected by using BA.
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Affiliation(s)
- Jia-Yun Guo
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Ya-Qin Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Yang Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Hui Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
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20
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Upners EN, Busch AS, Almstrup K, Petersen JH, Assens M, Main KM, Jensen RB, Juul A. Does height and IGF-I determine pubertal timing in girls? Pediatr Res 2021; 90:176-183. [PMID: 33142306 DOI: 10.1038/s41390-020-01215-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/08/2020] [Accepted: 09/23/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pubertal timing is closely linked to growth regulated by the growth hormone/insulin-like factor (GH/IGF) axis that includes IGF-regulating factors such as pregnancy-associated plasma protein-A/A2 (PAPP-A/PAPP-A2) and stanniocalcin 2 (STC2). We investigated the association between height, IGF-I concentration, and PAPPA, PAPPA2, and STC2 genotypes on the timing of female pubertal milestones. METHODS Height, IGF-I, and genotypes were analyzed in 1382 Danish girls from the general population, 67 patients with tall stature (height ≥2 SD), and 124 patients with short stature (height ≤-2 SD). The main outcomes were breast stage and menarche. RESULTS Thelarche occurred significantly earlier in patients with tall stature (mean age 9.37 years [95% confidence interval (CI) 8.87-9.87]) and later in patients with short stature (11.07 years [95% CI 10.7-11.43]) compared with girls within the normal range (9.96 years [95% CI 9.85-10.07]) (p = 0.02 and p < 0.01, respectively). Girls with higher IGF-I levels experienced thelarche and menarche earlier compared with the rest of the cohort (p < 0.01). Genotypes were not associated with age at thelarche nor menarche, but the PAPPA2 minor allele carriers were shorter compared with major allele carriers, p = 0.03. CONCLUSIONS Height and IGF-I, but not PAPP-A, PAPP-A2, and STC2 genotypes, were negatively associated with age at thelarche and menarche. IMPACT Girls with tall and short stature enter puberty earlier and later compared with girls with normal height. Girls with higher insulin-growth factor-I in childhood enter puberty earlier. Pubertal timing is influenced by longitudinal growth and IGF-I levels earlier in childhood. Childhood growth and the levels of IGF-I in childhood may be biomarkers of pubertal timing.
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Affiliation(s)
- Emmie N Upners
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Alexander S Busch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kristian Almstrup
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Jørgen H Petersen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Maria Assens
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Rikke B Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
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21
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Endocrine-Disrupting Chemicals and Early Puberty in Girls. CHILDREN-BASEL 2021; 8:children8060492. [PMID: 34200537 PMCID: PMC8226958 DOI: 10.3390/children8060492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022]
Abstract
In recent decades, pubertal onset in girls has been considered to occur at an earlier age than previously. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with alterations in pubertal timing, with several reports suggesting that EDCs may have a role in the secular trend in pubertal maturation, at least in girls. However, relevant studies give inconsistent results. On the other hand, the majority of girls with idiopathic precocious or early puberty present the growth pattern of constitutional advancement of growth (CAG), i.e., growth acceleration soon after birth. Herein, we show that the growth pattern of CAG is unrelated to exposure to endocrine-disrupting chemicals and is the major determinant of precocious or early puberty. Presented data suggest that EDCs, at most, have a minor effect on the timing of pubertal onset in girls.
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22
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Lunddorf LLH, Brix N, Ernst A, Arendt LH, Støvring H, Clemmensen PJ, Olsen J, Ramlau-Hansen CH. Hypertensive disorders in pregnancy and timing of pubertal development in daughters and sons. Hum Reprod 2021; 35:2124-2133. [PMID: 32766758 DOI: 10.1093/humrep/deaa147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 05/18/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Do maternal hypertensive disorders affect pubertal development in daughters and sons? SUMMARY ANSWER Pubertal development tended to occur earlier in daughters of mothers with 'preeclampsia, eclampsia or HELLP syndrome' (hemolysis, elevated liver enzymes and low blood platelets) or hypertension in pregnancy compared to daughters born of normotensive mothers. WHAT IS KNOWN ALREADY The existing literature suggests some or no association between preeclampsia and pubertal development in daughters, but not in sons. None of the previous studies has investigated the possible association between other types of hypertensive disorders (hypertension, eclampsia or HELLP syndrome) and pubertal timing in children. STUDY DESIGN, SIZE, DURATION Longitudinal cohort study consisting of 15 819 mother-child pairs with information on maternal hypertensive disorders collected during pregnancy and information on pubertal development collected half-yearly from the age of 11 years and until fully developed or 18 years of age. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants are children from the Puberty Cohort nested within the Danish National Birth Cohort. The exposure was register-based and self-reported information on maternal hypertensive disorders during pregnancy. The outcomes were children's self-reported information on pubertal development, including Tanner stage 1-5 (pubic hair (both daughters and sons) and breast development (daughters) or genital development (sons)), first menstrual bleeding (daughters) or first ejaculation (sons), voice break episode (sons), axillary hair development and acne occurrence (both daughters and sons). The main outcome was mean difference in age at attaining each pubertal milestone and a combined pubertal marker in children of mothers with hypertensive disorders in pregnancy (either hypertension (n = 490), 'preeclampsia, eclampsia or HELLP syndrome' (n = 419) or 'unspecific hypertensive disorders' (n = 334) with unexposed children as reference (n = 14 576)). MAIN RESULTS AND THE ROLE OF CHANCE In daughters of mothers with 'preeclampsia, eclampsia or HELLP syndrome', we observed tendencies of earlier pubertal timing (combined marker: -2.0 (95% CI: -3.9; 0.0) months). In daughters of mothers with hypertension, several pubertal milestones tended to occur earlier than in daughters of normotensive mothers; however, all 95% CIs overlapped the null resulting in a combined pubertal marker of -1.0 (95% CI: -3.2; 1.1) months. In sons of mothers with any of the hypertensive disorders, we observed no difference in pubertal timing (combined markers: 'preeclampsia, eclampsia or HELLP syndrome': 0.1 (95% CI: -2.0; 2.1) months; hypertension: -0.6 (95% CI: -2.3; 1.1) months; 'unspecific hypertensive disorders': 0.2 (95% CI: -1.9; 2.2) months). LIMITATIONS, REASONS FOR CAUTION The study is subject to non-differential misclassification of self-reported information on maternal hypertensive disorders in pregnancy and current pubertal status; possibly causing bias toward the null. WIDER IMPLICATIONS OF THE FINDINGS Hypertensive disorders in pregnancy might accelerate pubertal timing in daughters; however, more studies are needed for causal conclusions. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | - Nis Brix
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark
| | - Andreas Ernst
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark.,Department of Urology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Linn H Arendt
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark.,Department of Gynecology and Obstetrics, Horsens Regional Hospital, 8700 Horsens, Denmark
| | - Henrik Støvring
- Department of Public Health, Research Unit for Biostatistics, Aarhus University, 8000 Aarhus C, Denmark
| | - Pernille J Clemmensen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark
| | - Jørn Olsen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Cecilia H Ramlau-Hansen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, 8000 Aarhus C, Denmark
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23
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Pubertal Growth, IGF-1, and Windows of Susceptibility: Puberty and Future Breast Cancer Risk. J Adolesc Health 2021; 68:517-522. [PMID: 32888770 PMCID: PMC7902462 DOI: 10.1016/j.jadohealth.2020.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Risk markers for breast cancer include earlier onset of menarche (age at menarche [AAM]) and peak height velocity (PHV). Insulin-like growth factor-1 (IGF-1) is associated with pubertal milestones, as well as cancer risk. This study examined the relationships between pubertal milestones associated with breast cancer risk and hormone changes in puberty. METHODS This is a longitudinal study of pubertal maturation in 183 girls, recruited at ages 6-7, followed up between 2004 and 2018. Measures included age at onset of puberty, and adult height attained; PHV; AAM; adult height, and serum IGF-1, and estrone-to-androstenedione (E:A) ratio. RESULTS PHV was greatest in early, and least in late maturing girls; length of the pubertal growth spurt was longest in early, and shortest in late maturing girls. Earlier AAM was related to greater PHV. IGF-1 concentrations tracked significantly during puberty; higher IGF-1 was related to earlier age of PHV, earlier AAM, greater PHV, and taller adult height. Greater E:A ratio was associated with earlier AAM. CONCLUSIONS Factors driving the association of earlier menarche and pubertal growth with breast cancer risk may be explained through a unifying concept relating higher IGF-1 concentrations, greater lifelong estrogen exposure, and longer pubertal growth period, with an expanded pubertal window of susceptibility.
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24
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Tenuta M, Carlomagno F, Cangiano B, Kanakis G, Pozza C, Sbardella E, Isidori AM, Krausz C, Gianfrilli D. Somatotropic-Testicular Axis: A crosstalk between GH/IGF-I and gonadal hormones during development, transition, and adult age. Andrology 2020; 9:168-184. [PMID: 33021069 DOI: 10.1111/andr.12918] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/31/2020] [Accepted: 09/28/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-somatotropic (HPS) axes are strongly interconnected. Interactions between these axes are complex and poorly understood. These interactions are characterized by redundancies in reciprocal influences at each level of regulation and the combination of endocrine and paracrine effects that change during development. OBJECTIVES To comprehensively review the crosstalk between the HPG and HPS axes and related pathological and clinical aspects during various life stages of male subjects. MATERIALS AND METHODS A thorough search of publications available in PubMed was performed using proper keywords. RESULTS Molecular studies confirmed the expressions of growth hormone (GH) and insulin-like growth factor-I (IGF-I) receptors on the HPG axis and reproductive organs, indicating a possible interaction between HPS and HPG axes at various levels. Insulin growth factors participate in sexual differentiation during fetal development, indicating that normal HPS axis activity is required for proper testicular development. IGF-I contributes to correct testicular position during minipuberty, determines linear growth during childhood, and promotes puberty onset and pace through gonadotropin-releasing hormone activation. IGF-I levels are high during transition age, even when linear growth is almost complete, suggesting its role in reproductive tract maturation. Patients with GH deficiency (GHD) and insensitivity (GHI) exhibit delayed puberty and impaired genital development; replacement therapy in such patients induces proper pubertal development. In adults, few studies have suggested that lower IGF-I levels are associated with impaired sperm parameters. DISCUSSION AND CONCLUSION The role of GH-IGF-I in testicular development remains largely unexplored. However, it is important to evaluate gonadic development in children with GHD. Additionally, HPS axis function should be evaluated in children with urogenital malformation or gonadal development alterations. Correct diagnosis and prompt therapeutic intervention are needed for healthy puberty, attainment of complete gonadal development during transition age, and fertility potential in adulthood.
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Affiliation(s)
- Marta Tenuta
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | | | - Biagio Cangiano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - George Kanakis
- Athens Naval and Veterans Affairs Hospital, Athens, Greece
| | - Carlotta Pozza
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Emilia Sbardella
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Csilla Krausz
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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25
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Żurawiecka M, Wronka I. Association between age at menarche and body mass index, waist circumference, waist to hip ratio, and waist to height ratio in adult women. Am J Hum Biol 2020; 33:e23523. [PMID: 33085157 DOI: 10.1002/ajhb.23523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of the present study was to examine associations between age at menarche and body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) in young adult women. METHODS Anthropometric data and age at menarche information were collected in two cross-sectional surveys conducted in the years 2004-2006 (Cohort 1) and 2016-2018 (Cohort 2). A total of 2419 women, aged 19-24 years., were included. RESULTS Statistically significant relationships between age at menarche and BMI, WHtR, and WC were observed. The values of the anthropometric parameters decreased with increasing age at menarche. The onset of menstruation before the age of 12 years. was linked to a heightened risk of overweight and obesity (BMI ≥ 25) and abdominal obesity defined as WC > 80 cm and/or WHtR ≥ 0.5. First menstruation after the age of 14 y. was associated with a lower risk of overweight and obesity (BMI ≥ 25, WC > 80 cm and/or WHtR ≥ 0.5), as well as a higher risk of being underweight (BMI < 18.5 and/or WHtR < 0.4). Associations between anthropometry and menarcheal timing were stronger in Cohort 1. CONCLUSION Both early and late onset of menarche are associated with abnormal body composition: Early menarche is associated with overweight, while later maturing girls have a heightened risk of underweight.
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Affiliation(s)
- Martyna Żurawiecka
- Department of Anthropology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Krakow, Krakow, Poland
| | - Iwona Wronka
- Department of Anthropology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Krakow, Krakow, Poland
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26
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Duan R, Chen Y, Qiao T, Duan R, Chen M, Zhao L, Gong Y, Cheng G. Modern dietary pattern is prospectively associated with earlier age at menarche: data from the CHNS 1997-2015. Nutr J 2020; 19:95. [PMID: 32907571 PMCID: PMC7488069 DOI: 10.1186/s12937-020-00622-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022] Open
Abstract
Background Early age at menarche is associated with risk of several chronic diseases. Prospective study on the association between dietary pattern and timing of menarche is sparse. We examined whether dietary patterns prior to the menarche onset were prospectively associated with menarcheal age in Chinese girls. Methods One thousand one hundred eighteen girls aged 6–13 y in the China Health and Nutrition Survey (CHNS) with three-day 24-h recalls and information on potential confounders at baseline were included in the study. Dietary patterns were identified using principal component analysis. Age at menarche was self-reported at each survey. Cox proportional hazard regression models were performed to examine the associations of premenarcheal dietary patterns and menarcheal timing. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results Three major dietary patterns were identified: modern dietary pattern, animal food pattern, and snack food pattern. After adjustment for age at baseline, region, ethnicity, maternal education level, energy intake at baseline, and body mass index Z-score at baseline, girls in the highest quartile of modern dietary pattern score had a 33% higher probability of experiencing menarche at an earlier age than those in the lowest quartile (HR: 1.33, 95% CI: 1.002–1.77, p for trend = 0.03). No significant association was found for the animal food pattern or snack food pattern. Conclusions Higher adherence to modern dietary pattern during childhood is associated with an earlier menarcheal age. This association was independent of premenarcheal body size.
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Affiliation(s)
- Ruonan Duan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, PR China
| | - Yue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, PR China
| | - Tian Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, PR China
| | - Ruotong Duan
- Department of Clinical Medicine, Changzhi Medical College, Changzhi, Shanxi, PR China
| | - Mengxue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, PR China
| | - Li Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, PR China
| | - Yunhui Gong
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, PR China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, PR China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
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Abstract
The relationship between obesity and puberty remains controversial. Whereas cross-sectional and longitudinal studies show a clear shift toward earlier puberty in obese girls, the trend in obese boys remains less obvious. Overweight boys mature earlier whereas obese boys mature later compared to healthy weight boys. Newer epidemiologic studies attempt to address these knowledge gaps. This review provides a detailed overview of the recent literature regarding secular trends in pubertal onset and tempo, and the connection with obesity. Additionally, this review summarizes potential mediators that permit obesity to promote early puberty. Other factors such as socioeconomic status, in utero exposures, nutritional, and even endocrine disrupting chemicals can cause perturbation of both metabolism and the endocrine axis that can ultimately have effects on pubertal development.
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Nutrient Intake through Childhood and Early Menarche Onset in Girls: Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12092544. [PMID: 32842616 PMCID: PMC7551779 DOI: 10.3390/nu12092544] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/15/2022] Open
Abstract
Among the genetic and environmental risk factors, nutrition plays a crucial role in determining the timing of puberty. Early menarche onset (EMO) is defined as when girls reach menarche onset at an age which is earlier than the mean/median age of menarche, between 12 and 13 years of age, according to individual ethnicity. The present study examined the association between nutrient intake in childhood and EMO risk in healthy girls by performing a systematic review and meta-analysis of prospective studies. We screened EMBASE, Cochrane Library, PubMed/MEDLINE, and Web of Science databases for 16 eligible studies with all medium-to-high quality scores ranging from 3 to 5 of 6 possible points with 10,884 subjects. Higher intakes of energy (risk ratio (RR) = 3.32, 95% confidence interval (CI) = 1.74–6.34, I2 = 97%), and protein (RR = 3.15, 95% CI = 2.87–3.44, I2 = 0%) were associated with EMO risk. For each additional 1 g/day animal protein intake in childhood, the age at menarche was approximately two months earlier (β = −0.13, I2 = 55%), and high iron intake was associated with EMO (RR = 1.20, 95% CI = 1.03–1.40, I2 = 0%). Polyunsaturated fatty acid (PUFAs) intake was associated with EMO risk with a dose-response effect (RR = 1.25, 95% CI = 1.05–1.49, I2 = 44%). Girls with a high intake of fiber and monosaturated fatty acids (MUFAs) in childhood experienced later menarche onset (RR = 0.83, 95% CI = 0.69–1.00, I2 = 31%; RR = 0.66, 95% CI = 0.50–0.86, I2 = 0%, respectively). Thus, adherence to a high intake of animal proteins-, iron- and PUFA-rich food diet makes girls more likely to have EMO, while a high intake of fiber- and MUFA-rich foods may protect girls from EMO. Further studies are expected to investigate the role of specific types of PUFAs and MUFAs on EMO to promote healthy sexual maturity in girls.
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Association between pubertal development stages and body adiposity in children and adolescents. Health Qual Life Outcomes 2020; 18:93. [PMID: 32252769 PMCID: PMC7137486 DOI: 10.1186/s12955-020-01342-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 03/25/2020] [Indexed: 12/26/2022] Open
Abstract
Background The study aimed to analyze the association between pubertal development stages and adiposity in children and adolescents. Methods Cross-sectional study conducted in 2007 in Florianópolis, Brazil, with 2339 schoolchildren 32 aged 8 to 14 years old (1107 males). The outcome (adiposity) was evaluated using Z score and 33 percentilee values > = 85 of four skinfolds (triceps, subscapular, suprailiac and calf) and waist 34 circumference. Total body adiposity (Z score of the sum of skinfolds), central adiposity (Z score 35 of waist circumference) and peripheral adiposity (Z scores of triceps and calf skinfolds) were 36 estimated. Pubertal development stages was self-assessed according to Tanner stages of development. Thirty-seven Children and adolescents were classified according to tertiles of age for each pubertal development stages 38 stage - early, normal and late. Statistical analysis was performed using univariate and 39 multivariate Poisson regression models. Results Children and adolescent from both sexes with early pubertal development stages presented higher prevalence of central adiposity (waist circumference), with adjusted prevalence ratio (CI 95%) of 2.21 (1.12; 4.35) for males and 2.18 (1.04; 4.57) for females (reference group: normal pubertal development stages). Among females, there was a reduction in the prevalence of excess adiposity with decreased occurrence of early pubertal development stages. There was a strong relationship between adiposity and pubertal development stages. Conclusions Excess adiposity was higher in both sexes for those with early pubertal development stages.
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Cheng TS, Day FR, Lakshman R, Ong KK. Association of puberty timing with type 2 diabetes: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003017. [PMID: 31905226 PMCID: PMC6944335 DOI: 10.1371/journal.pmed.1003017] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Emerging studies have investigated the association between puberty timing, particularly age at menarche (AAM), and type 2 diabetes. However, whether this association is independent of adiposity is unclear. We aimed to systematically review published evidence on the association between puberty timing and type 2 diabetes (T2D) or impaired glucose tolerance (IGT), with and without adjustment for adiposity, and to estimate the potential contribution of puberty timing to the burden of T2D in the United Kingdom (UK). METHODS AND FINDINGS We searched PubMed, Medline, and Embase databases for publications until February 2019 on the timing of any secondary sexual characteristic in boys or girls in relation to T2D/IGT. Inverse-variance-weighted random-effects meta-analysis was used to pool reported estimates, and meta-regression was used to explore sources of heterogeneity. Twenty-eight observational studies were identified. All assessed AAM in women (combined N = 1,228,306); only 1 study additionally included men. In models without adjustment for adult adiposity, T2D/IGT risk was lower per year later AAM (relative risk [RR] = 0.91, 95% CI 0.89-0.93, p < 0.001, 11 estimates, n = 833,529, I2 = 85.4%) and higher for early versus later menarche (RR = 1.39, 95% CI 1.25-1.55, p < 0.001, 23 estimates, n = 1,185,444, I2 = 87.8%). Associations were weaker but still evident in models adjusted for adiposity (AAM: RR = 0.97 per year, 95% CI 0.95-0.98, p < 0.001, 12 estimates, n = 852,268, I2 = 51.8%; early menarche: RR = 1.19, 95% CI 1.11-1.28, p < 0.001, 21 estimates, n = 890,583, I2 = 68.1%). Associations were stronger among white than Asian women, and in populations with earlier average AAM. The estimated population attributable risk of T2D in white UK women due to early menarche unadjusted and adjusted for adiposity was 12.6% (95% CI 11.0-14.3) and 5.1% (95% CI 3.6-6.7), respectively. Findings in this study are limited by residual and unmeasured confounding, and self-reported AAM. CONCLUSIONS Earlier AAM is consistently associated with higher T2D/IGT risk, independent of adiposity. More importantly, this research has identified that a substantial proportion of T2D in women is related to early menarche, which would be expected to increase in light of global secular trends towards earlier puberty timing. These findings highlight the need to identify the underlying mechanisms linking early menarche to T2D/IGT risk.
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Affiliation(s)
- Tuck Seng Cheng
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Felix R. Day
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Rajalakshmi Lakshman
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Ken K. Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
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Juul A, Skakkebæk NE. Why Do Normal Children Have Acromegalic Levels of IGF-I During Puberty? J Clin Endocrinol Metab 2019; 104:2770-2776. [PMID: 30840065 DOI: 10.1210/jc.2018-02099] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/21/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT The rapid pubertal height growth is unique to humans, but why do we have it? Although the spurt contributes 13% to 15% to the final adult height, we hypothesized that the biological significance of the high acromegalic levels of GH and IGF-I, which are behind the pubertal growth spurt, might primarily occur to stimulate the reproductive organs. EVIDENCE SYNTHESIS Animal data have demonstrated that adult Igf1 and Igf2 gene knockout mice that survive show a dramatic reduction in the size of the reproductive organs and are infertile. In humans, case reports of mutations in the genes affecting the GH-IGF axis and growth (GH, GHRH, GH-R, STAT5b, IGF-I, IGF-II, IGF-1R, PAPPA2) are also characterized by delayed pubertal onset and micropenis. Furthermore, GH treatment will tend to normalize the penile size in patients with GH deficiency. Thus, the endocrine effects of high IGF-I levels might be needed for the transition of the sexual organs, including the secondary sex characteristics, from the "dormant" stages of childhood into fully functioning reproductive systems. The peak IGF-I levels, on average, occur 2 years after the peak height growth velocity, suggesting reasons other than longitudinal growth for the high IGF-I levels, and remain high in the years after the height spurt, when the reproductive systems become fully functional. CONCLUSION We suggest that the serum levels of IGF-I should be monitored in children with poor development of sexual organs, although it remains to be investigated whether GH should be added to sex steroids in the management of hypogonadism for some pubertal children (e.g., boys with micropenis).
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Affiliation(s)
- Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Niels E Skakkebæk
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
- The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
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Fernández M, Pereira A, Corvalán C, Mericq V. Precocious pubertal events in Chilean children: ethnic disparities. J Endocrinol Invest 2019; 42:385-395. [PMID: 30047066 DOI: 10.1007/s40618-018-0927-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Puberty onset exhibits remarkable inter-individual and ethnic differences. 5% of Chileans are indigenous but puberty ethnic disparities have not been studied. We aim for evaluating precocious puberty prevalence in children with Mapuche ancestry vs non-indigenous Chilean children (according to their surnames). METHODS Longitudinal cohort study: 1003 children (50.2% girls) participating in the Growth and Obesity Chilean Cohort Study (GOCS) were studied. Annual anthropometry was measured since 4-7 years. Subsequently, Tanner staging and anthropometry were measured every 6 months. In girls, Tanner stage was assessed by breast palpation and in boys by testicular volume measurements. The cohort was stratified in three groups depending on Mapuche surname numbers as follows: (A) no indigenous surnames (n = 811), (B) one to two indigenous surnames (n = 147), and (C) three or more indigenous surnames (n = 45). We evaluated the prevalence of precocious thelarche, pubarche, menarche and gonadarche (testicular volume ≥ 4 ml-G2), using a cutoff age of 8 years in girls and 9 years in boys while controlling for socioeconomic status, body mass index, waist circumference, IGF-1 and DHEAS at 7 years. RESULTS In girls, no significant differences were observed. On the contrary, in boys, precocious gonadarche prevalence was higher in group C (29.2%) vs group A (6.0%) and vs group B (10.5%) (p =0.001, p = 0.004, respectively). Increased precocious gonadarche and pubarche risks in group C were observed even after adjustment [OR 7.31; 95% IC (2.32-23.51); p = 0.001] and [OR 6.17, 95% CI (1.62-23.49); p = 0.008], respectively. CONCLUSION Indigenous origin in Chile is an independent risk factor for precocious gonadarche and pubarche in boys but not in girls.
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Affiliation(s)
- M Fernández
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile
| | - A Pereira
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - C Corvalán
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - V Mericq
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile.
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Relationship between umbilical cord sex hormone binding globulin, sex steroids, and age at menarche: a prospective cohort study. Fertil Steril 2019; 110:965-973. [PMID: 30316444 DOI: 10.1016/j.fertnstert.2018.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/03/2018] [Accepted: 06/04/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To study the role of the prenatal environment in regulating reproductive development by measuring the prospective association between umbilical cord concentrations of sex hormone binding globulin (SHBG; principal regulator of sex steroid activity), bioavailable sex steroids, and age at menarche. DESIGN Prospective population-based cohort. SETTING Not applicable. PATIENT(S) In 286 female members of the Western Australian Pregnancy (Raine) cohort, concentrations of SHBG and steroids (estrogens: estrone, estradiol, estriol and estetrol [E4]; androgens: total testosterone, Δ4-androstenedione, androstenedione and dehydroepiandrosterone) were measured by liquid chromatography-tandem mass spectrometry from archived umbilical cord blood samples collected at birth. Bioavailable concentrations of testosterone and estradiol were calculated along with total composite measures of androgen and estrogen bioactivity. SHBG was measured by ELISA. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Age of menarche was calculated from date of menarche, collected prospectively by questionnaire sent home with participants at the year 10 follow-up. RESULT(S) Higher maternal education, higher body mass index, and the presence of antepartum hemorrhage were all significantly associated with earlier age at menarche. The bioavailable sex steroid measures accounted for 8.3% of the variance in age at menarche. Further, both SHBG and E4 concentrations accounted for a significant proportion of unique variance in age at menarche. CONCLUSION(S) Lower SHBG and higher E4 concentrations in umbilical cord blood were associated with earlier age at menarche. These results suggest that the prenatal sex steroid environment contributes toward pubertal development and age at menarche.
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Prentice A, Ward KA, Nigdikar S, Hawkesworth S, Moore SE. Pregnancy supplementation of Gambian mothers with calcium carbonate alters mid-childhood IGF1 in a sex-specific manner. Bone 2019; 120:314-320. [PMID: 30465917 DOI: 10.1016/j.bone.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/02/2018] [Accepted: 11/17/2018] [Indexed: 01/01/2023]
Abstract
CONTEXT Sex-specific effects of pregnancy calcium carbonate supplementation have been reported in 8-12 year old Gambian children, indicating faster growth in boys but slower growth in girls born to calcium-supplemented mothers. OBJECTIVE To determine whether the pregnancy supplement resulted in sex-specific effects on offspring IGF1 and other growth-related indices in mid-childhood. DESIGN Analysis of archived data obtained in mid-childhood from the children of rural Gambian mothers who had been randomised to 1500 mgCa/d (Ca) or placebo (P) from 20 weeks pregnancy to delivery (ISRCTN96502494). PARTICIPANTS AND METHODS Of the 526 children born and followed in infancy, 290 had early-morning, fasting plasma assayed for IGF1, IGFBP3, leptin, insulin and calcium-related indices and had anthropometry performed at age 7.5 (SD1.2) years (N/group: Males(M)-Ca = 64, Females(F)-Ca = 77; M-P = 76, F-P = 73). Sex-specific effects of maternal supplementation were considered using regression with sexes separated and together to test for sex ∗ supplement interactions. RESULTS Boys had lower IGF1, IGFBP3, leptin and insulin than girls (P ≤ 0.004). IGF1 was higher in M-Ca than M-P (+14.2 (SE7.7)%, P = 0.05) but lower in F-Ca than F-P (-17.8 (SE7.4)%, P = 0.01); sex ∗ supplement interaction P = 0.001. IGF1 concentrations (ng/ml, geometric mean [-1SE,+1SE]) were M-Ca = 78.1[4.3,4.5], M-P = 67.8[3.4,3.6]; F-Ca = 99.5[4.8,5.1], F-P = 118.9[6.4,6.8]. Similar sex ∗ supplement interactions were seen for IGFBP3 and IGF1-adjusted-for-IGFBP3 but group differences were smaller. There were no significant supplement effects on the other biochemical indices. CONCLUSIONS Calcium carbonate supplementation of pregnant Gambian mothers resulted in higher IGF1 in boys and lower IGF1 in girls during mid-childhood, consistent with the reported maternal supplement effects on growth of the offspring in later childhood.
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Affiliation(s)
- Ann Prentice
- Medical Research Council Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom; Medical Research Council Keneba, MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, P.O. Box 273, The Gambia.
| | - Kate A Ward
- Medical Research Council Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom; Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Shailja Nigdikar
- Medical Research Council Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom
| | - Sophie Hawkesworth
- Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Sophie E Moore
- Medical Research Council Keneba, MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, P.O. Box 273, The Gambia; Department of Women and Children's Health, King's College London, London SE1 7EH, United Kingdom
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Wiley AS. The Evolution of Lactase Persistence: Milk Consumption, Insulin-Like Growth Factor I, and Human Life-History Parameters. QUARTERLY REVIEW OF BIOLOGY 2018. [DOI: 10.1086/700768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty? THE LANCET CHILD & ADOLESCENT HEALTH 2018; 3:44-54. [PMID: 30446301 DOI: 10.1016/s2352-4642(18)30306-7] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/06/2018] [Accepted: 09/11/2018] [Indexed: 12/11/2022]
Abstract
The onset of puberty in adolescents and whether it is related to obesity is an ongoing topic for debate. Epidemiological cross-sectional and longitudinal studies show a shift towards earlier onset of puberty in girls who are obese; however, the situation is less clear in boys. Boys who are overweight seem to mature earlier, and boys who are obese mature later, than boys at a healthy weight. The underlying mechanisms are not yet fully understood, and whether earlier onset of puberty in obese girls is based on the activation of the hypothalamic-pituitary-gonadal axis is unclear. The most promising link between obesity and puberty is the adipokine leptin and its interaction with the kisspeptin system, which is an important regulator of puberty. However, peripheral action of adipose tissue (eg, via other adipokines, aromatase activity) could also be involved in changes to the onset of puberty. In addition, nutritional factors, epigenetics, or endocrine disrupting chemicals are potential mediators linking the onset of puberty to obesity. This Review summarises our knowledge concerning the relationship between obesity and onset and tempo of puberty, and the consequences of early puberty on obesity.
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Affiliation(s)
- Thomas Reinehr
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, 45711 Datteln, Germany.
| | - Christian Ludwig Roth
- Center for Integrative Brain Research, Division of Endocrinology, Seattle Children's Research Institute, Seattle, WA, USA; Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA, USA
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Sumi A, Iwase M, Nakamura U, Fujii H, Ohkuma T, Ide H, Jodai‐Kitamura T, Komorita Y, Yoshinari M, Kitazono T. Impact of age at menarche on obesity and glycemic control in Japanese patients with type 2 diabetes: Fukuoka Diabetes Registry. J Diabetes Investig 2018; 9:1216-1223. [PMID: 29575815 PMCID: PMC6123051 DOI: 10.1111/jdi.12839] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/14/2018] [Accepted: 02/28/2018] [Indexed: 12/18/2022] Open
Abstract
AIMS/INTRODUCTION A younger age at menarche is associated with obesity and type 2 diabetes in adult life. The impact of early-onset menarche on obesity and glycemic control in type 2 diabetes has not been investigated. The present study examined the relationship between age at menarche and obesity and glycemic control in type 2 diabetes. MATERIALS AND METHODS A total of 2,133 patients with type 2 diabetes aged ≥20 years were divided into groups according to age at menarche (≤11, 12, 13, 14 and ≥15 years). A retrospective cohort study examined the association of menarcheal age with adiposity and hemoglobin A1c . RESULTS Age at menarche was inversely associated with body mass index (BMI) and abdominal circumference (P < 0.001). Each 1-year decrease in age at menarche was associated with a 0.25-kg/m2 and 0.6-cm increase in BMI and abdominal circumference, respectively, using a multivariate-adjusted model. Odds ratios for obesity and abdominal obesity significantly increased in participants with age at menarche ≤11 years after multivariable adjustments when age at menarche of 13 years was used as the reference (odds ratio 1.95, 95% CI 1.33-2.88, odds ratio 1.95, 95% CI 1.32-2.87, respectively). Younger age at menarche was significantly associated with higher hemoglobin A1c (P < 0.001); however, the association was not statistically significant after adjusting for BMI. CONCLUSIONS Age at menarche of ≤11 years was associated with obesity after adjusting for confounding factors, and poor glycemic control associated with high BMI in type 2 diabetes. Age at menarche should be considered during clinical assessments.
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Affiliation(s)
- Akiko Sumi
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Masanori Iwase
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Diabetes CenterHakujyuji HospitalFukuokaJapan
| | - Udai Nakamura
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiroki Fujii
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- The George Institute for Global HealthUniversity of New South WalesSydneyNSWAustralia
| | - Hitoshi Ide
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Division of General Internal MedicineSchool of Oral Health ScienceKyushu Dental UniversityKitakyushuFukuokaJapan
| | - Tamaki Jodai‐Kitamura
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yuji Komorita
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Masahito Yoshinari
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanari Kitazono
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
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Jansen EC, Zhou L, Song PXK, Sánchez BN, Mercado A, Hu H, Solano M, Peterson KE, Tellez-Rojo MM. Prenatal lead exposure in relation to age at menarche: results from a longitudinal study in Mexico City. J Dev Orig Health Dis 2018; 9:467-472. [PMID: 29706142 PMCID: PMC6070415 DOI: 10.1017/s2040174418000223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Animal and cross-sectional epidemiological studies suggest that prenatal lead exposure is related to delayed menarche, but this has not been confirmed in longitudinal studies. We analyzed this association among 200 girls from Mexico City who were followed since the first trimester of gestation. Maternal blood lead levels were analyzed once during each trimester of pregnancy, and daughters were asked about their first menstrual cycle at a visit between the ages of 9.8 and 18.1 years. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) for probability of menarche over the follow-up period using interval-censored Cox models, comparing those with prenatal blood lead level ⩾5 µg/dl to those with prenatal blood lead <5 µg/dl. We also estimated HRs and 95% CI with conventional Cox regression models, which utilized the self-reported age at menarche. In adjusted analyses, we accounted for maternal age, maternal parity, maternal education, and prenatal calcium treatment status. Across trimesters, 36-47% of mothers had blood lead levels ⩾5 µg/dl. Using interval-censored models, we found that during the second trimester only, girls with ⩾5 µg/dl prenatal blood lead had a later age at menarche compared with girls with prenatal blood lead levels <5 µg/dl (confounder-adjusted HR=0.59, 95% CI 0.28-0.90; P=0.05). Associations were in a similar direction, although not statistically significant, in the conventional Cox regression models, potentially indicating measurement error in the self-recalled age at menarche. In summary, higher prenatal lead exposure during the second trimester could be related to later onset of sexual maturation.
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Affiliation(s)
- E C Jansen
- 1Department of Nutritional Sciences,University of Michigan,Ann Arbor,MI,USA
| | - L Zhou
- 2Department of Biostatistics,University of Michigan,Ann Arbor,MI,USA
| | - P X K Song
- 2Department of Biostatistics,University of Michigan,Ann Arbor,MI,USA
| | - B N Sánchez
- 2Department of Biostatistics,University of Michigan,Ann Arbor,MI,USA
| | - A Mercado
- 3Center for Nutrition and Health Research,National Institute of Public Health,Cuernavaca,Morelos,Mexico
| | - H Hu
- 4Occupational and Environmental Health,Dalla Lana School of Public Health,University of Toronto,Toronto,ON,Canada
| | - M Solano
- 3Center for Nutrition and Health Research,National Institute of Public Health,Cuernavaca,Morelos,Mexico
| | - K E Peterson
- 1Department of Nutritional Sciences,University of Michigan,Ann Arbor,MI,USA
| | - M M Tellez-Rojo
- 1Department of Nutritional Sciences,University of Michigan,Ann Arbor,MI,USA
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Binder AM, Corvalan C, Calafat AM, Ye X, Mericq V, Pereira A, Michels KB. Childhood and adolescent phenol and phthalate exposure and the age of menarche in Latina girls. Environ Health 2018; 17:32. [PMID: 29615064 PMCID: PMC5883544 DOI: 10.1186/s12940-018-0376-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 03/20/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND The age of menarche has been associated with metabolic and cardiovascular disease, as well as cancer risk. The decline in menarcheal age over the past century may be partially attributable to increased exposure to endocrine disrupting chemicals (EDCs). METHODS We assessed the influence of 26 phenol and phthalate biomarkers on the timing of menarche in a longitudinal cohort of Chilean girls. These EDCs were quantified in urine collected prior to the onset of breast development (Tanner 1; B1), and during adolescence (Tanner 4; B4). Multivariable accelerated failure time (AFT) models were used to analyze associations between biomarker concentrations and the age of menarche adjusting for body mass index (BMI) Z-score and maternal education, accounting for within-subject correlation. RESULTS Several biomarkers were significantly associated with the age at menarche; however, these associations were dependent on the timing of biomarker assessment. A log(ng/ml) increase in B1 concentrations of di(2-ethylhexyl) phthalate biomarkers was associated with later menarche (hazard ratio (HR): 0.77; 95% CI: 0.60, 0.98), whereas higher B1 concentrations of 2,5-dichlorophenol and benzophenone-3 were associated with earlier menarche (HR: 1.13; 95% CI: 1.01, 1.27; HR: 1.17; 95% CI: 1.06, 1.29, respectively). Elevated B4 concentrations of monomethyl phthalate were similarly associated with earlier menarche (HR: 1.30; 95% CI: 1.10, 1.53). The impact of monoethyl phthalate and triclosan concentrations on pubertal timing were significantly modified by BMI Z-score. Higher monoethyl phthalate and triclosan concentrations were associated with earlier menarche among overweight or obese girls, but not among those that were normal weight. CONCLUSIONS This study identifies modulation of sexual maturation by specific EDC biomarkers in Latina girls.
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Affiliation(s)
- Alexandra M. Binder
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA USA
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Verónica Mericq
- Institute of Maternal and Child Research, University of Chile, Santiago, Chile
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Karin B. Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA USA
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Guevara-Aguirre J, Guevara A, Guevara C. Treatment of growth failure in the absence of GH signaling: The Ecuadorian experience. Growth Horm IGF Res 2018; 38:53-56. [PMID: 29306560 DOI: 10.1016/j.ghir.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/17/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022]
Abstract
Recombinant human insulin-like growth factor-1 (rhIGF-1) treatment studies of growth failure in absence of growth hormone (GH) signaling (GH insensitivity -GHI, Laron syndrome -LS, GH Receptor deficiency -GHRD) have taken place in many locations around the globe. Results from these trials are comparable, and slight differences reported can be attributed to specific circumstances at different research sites. rhIGF-I treatment studies of GHI in Ecuador included various trials performed on children belonging to the largest and only homogeneous cohort of subjects with this condition in the world. All trials were performed by the same team of investigators and, during study periods, subjects received similar nutritional, physical activity and medical advice. Combination of these inherent conditions most likely creates less sources of variability during the research process. Indeed, diagnosis, selection and inclusion of research subjects; methodology used; transport, storage and delivery of study drug; data collection, monitoring and auditing; data analysis, discussion of results, conclusion inferences and reporting, etc., were submitted to the same sources of error. For the above-mentioned reasons, we are hereby mainly covering conclusions derived from rhIGF-I treatment studies of Ecuadorian children whit GHRD due to homozygosity of a splice site mutation occurring at GHR gene, whose unaffected parents were both heterozygous for the same mutation. We also describe studies of rhIGF-I administration in adolescent and adult subjects with GHRD, from the same cohort and with the same genetic anomaly.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Universidad San Francisco de Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador.
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Mäntyselkä A, Jääskeläinen J, Eloranta AM, Väistö J, Voutilainen R, Ong K, Brage S, Lakka TA, Lindi V. Associations of lifestyle factors with serum dehydroepiandrosterone sulphate and insulin-like growth factor-1 concentration in prepubertal children. Clin Endocrinol (Oxf) 2018; 88:234-242. [PMID: 29112780 PMCID: PMC6195184 DOI: 10.1111/cen.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/07/2017] [Accepted: 10/31/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Little is known about the relationships of dietary factors, physical activity and sedentary behaviour to dehydroepiandrosterone sulphate (DHEAS) and insulin-like growth factor-1 (IGF-1) concentrations among prepubertal children. Therefore, we studied the associations of these lifestyle factors with serum DHEAS and IGF-1 in children. DESIGN AND SUBJECTS Cross-sectional analysis of a population sample of 431 prepubertal children aged 6-9 years. MEASUREMENTS Assessment of dietary factors by food records and physical activity and sedentary behaviour by a combined heart rate and movement monitor and a questionnaire. Measurement of serum DHEAS and IGF-1. RESULTS Consumption of low-fibre grain products (standardized regression coefficient β = .118, P = .017) and intake of vegetable protein (β = .100, P = .045) was positively and consumption of sugar-sweetened beverages (β = -.117, P = .018) was inversely associated with DHEAS after adjustment for sex, age and body fat percentage. Energy intake (β = .160, P = .001) was positively associated with IGF-1 adjusting for sex, age and body fat percentage. Vigorous physical activity was inversely associated with DHEAS after adjustment for sex and age (β = -.120, P = .027), and total (β = -.137, P = .007), moderate (β = -.130, P = .012), vigorous (β = -.136, P = .011) and moderate to vigorous physical activity (β = -.160, P = .003) were inversely and total sedentary behaviour (β = .151, P = .003) was positively associated with IGF-1 adjusting for sex and age. None of physical activity measures was associated with DHEAS or IGF-1 after additional adjustment for body fat percentage. CONCLUSIONS Lifestyle factors have weak and moderate associations with biochemical markers of adrenarche in prepubertal children. These associations indicate body fat independent and dependent influences of diet and physical activity, respectively.
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Affiliation(s)
- Aino Mäntyselkä
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Aino-Maija Eloranta
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Ken Ong
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Timo A. Lakka
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Virpi Lindi
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Age at menarche, androgen concentrations, and midlife obesity: findings from the Midlife Women's Health Study. Menopause 2018; 23:1182-1188. [PMID: 27433862 DOI: 10.1097/gme.0000000000000691] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Studies have shown that earlier age at menarche is associated with a higher risk of midlife obesity; however, the mechanism underlying this association is not known. The purpose of this study was to examine whether the association between age at menarche and midlife obesity is due to variation in circulating androgen concentrations. METHODS Baseline data were analyzed from 748 women aged 45 to 54 years enrolled in the Midlife Women's Health Study, a prospective cohort study conducted in the Baltimore, MD region. Information on age at menarche was collected through a self-administered questionnaire. Body mass index (BMI) was calculated using height and weight measured at a clinic visit. Obesity was defined as a BMI between 30 and 34.9 kg/m; super obesity was defined as a BMI greater than 35 kg/m. Testosterone, estradiol, and sex hormone-binding globulin were measured in blood samples using enzyme-linked immunosorbent assays. The free androgen index (FAI) was calculated using the formula: (testosterone × 3.467)/sex hormone-binding globulin × 100. RESULTS After adjustment for covariates, for each year increase in age at menarche, the odds of obesity and super obesity decreased by 31% (odds ratio (OR) 0.69; 95% confidence limits (CL) 0.59, 0.81) and 34% (OR 0.66; 95% CL 0.52, 0.83), respectively. Addition of the FAI into the models did not attenuate the observed estimates. CONCLUSIONS The results of this study indicate that age at menarche is associated with midlife obesity independent of free testosterone concentrations measured in adulthood.
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Pereira A, Iñiguez G, Corvalan C, Mericq V. High DHEAS Is Associated With Earlier Pubertal Events in Girls But Not in Boys. J Endocr Soc 2017; 1:800-808. [PMID: 29264531 PMCID: PMC5686671 DOI: 10.1210/js.2017-00120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/16/2017] [Indexed: 11/25/2022] Open
Abstract
Context: Premature adrenarche (PA) has been associated with increased metabolic risk. Objective: To describe the risk of precocious thelarche (PT; <8 years), pubarche (PP; girls <8 years, boys <9 years), and gonadarche (PG; <9 years) in children with high dehydroepiandrosterone sulphate (DHEAS [HD]) vs those with normal DHEAS (ND). Setting and Intervention: Longitudinal Chilean cohort (n = 1052, 49.9% girls). Annual clinical examination including secondary sex characteristics by Tanner staging. Logistic regression models were adjusted by age and BMI. Main Outcome: Assess the relationship between DHEAS and premature thelarche, gonadarche, and pubarche in both sexes. Results: At age of DHEAS determination, overweight/obesity was present in 44.3% of boys and 42.9% of girls. Incidences of any precocious event were observed in 17.2% of boys and in 25.4% of girls, presented as 8.7% of PG and 8.5% of PP in boys and as 21.3% of PT and 4.1% of PP in girls. In crude and adjusted models in boys, HD did not increase the risk of earlier pubertal events. Conversely, girls with HD had a 2.6 times greater risk of early thelarche and a three times greater risk of early pubarche compared with girls with ND concentrations. Conclusion: In Chilean adolescents, precocious events of pubertal development were in line with the worldwide secular trend of earlier sexual maturation. HD was only associated with PT and PP in girls. Continuous follow-up of this cohort is a unique opportunity to prospectively address and analyze the interrelationships among HD, early growth, and adiposity as determinants of gonadarche, pubertal rate/sequence progression, and ovarian function.
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Affiliation(s)
- Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile 8360168
| | - German Iñiguez
- Institute of Maternal and Child Research, University of Chile, Santiago, Chile 7830490
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile 8360168
| | - Verónica Mericq
- Institute of Maternal and Child Research, University of Chile, Santiago, Chile 7830490
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Farahmand M, Tehrani FR, Dovom MR, Azizi F. Menarcheal Age and Risk of Type 2 Diabetes: A Community-Based Cohort Study. J Clin Res Pediatr Endocrinol 2017; 9:156-162. [PMID: 27840328 PMCID: PMC5463289 DOI: 10.4274/jcrpe.3370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 11/05/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE It has been reported that early menarche is associated with higher risk for type 2 diabetes. We aimed to explore the association between age at menarche and risk of type 2 diabetes in a population-based cohort study. METHODS For the purpose of the present study, 5191 subjects of reproductive age who were participants of the Tehran Lipid and Glucose Study and also met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data as well as risk factors for metabolic diseases were collected. Menarcheal age was categorized into five categories, as <11 years, 11-12 years, 13-14 years, 15-16 years, and >17 years. Diabetes and pre-diabetes were defined according to the American Diabetes Association criteria. Logistic regression analysis was used to assess the risk of the menarcheal age group for type 2 diabetes and pre-diabetes. RESULTS Of 5625 participants, 673 women had pre-diabetes and 187 had diabetes. Early menarche was associated with higher risk of diabetes and pre-diabetes, compared to the reference group (13-14 years), (OR=3.55, 95% CI: 1.6-7.8 and OR=2.55, 95% CI:1.4-4.8, respectively), an association which remained after further adjustment for potential confounders including family history of diabetes, parity, education, age, body mass index, waist circumference, smoking history, physical activity, and duration of oral contraceptives use. CONCLUSION Results showed early menarche to be a potential risk factor for type 2 diabetes and pre-diabetes.
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Affiliation(s)
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center,Research Institute for Endocrine Sciences,Shahid Beheshti University of Medical Sciences, Tehran, Iran Phone:+98 212 243 25 00 E-mail:
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Reinehr T, Bosse C, Lass N, Rothermel J, Knop C, Roth CL. Effect of Weight Loss on Puberty Onset in Overweight Children. J Pediatr 2017; 184:143-150.e1. [PMID: 28238482 DOI: 10.1016/j.jpeds.2017.01.066] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 12/05/2016] [Accepted: 01/27/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess the impact of weight changes on the onset of puberty in overweight children. STUDY DESIGN We evaluated the timing of puberty onset in 160 prepubertal overweight children (aged 11.2 ± 1.0 years) depending on the changes of their weight status in a 1-year lifestyle intervention. We determined body mass index (BMI), pubertal stage, luteinizing hormone (LH), follicle-stimulating hormone, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein-3, insulin resistance index homeostatic model assessment, and serum gonadotropins at baseline and 1 year later. RESULTS Puberty onset during the 1-year follow-up was significantly (P = .014) more frequent in girls without BMI-SDS reduction (75.0%) compared with girls with BMI-SDS reduction (45.7%). The start of puberty was significantly (P = .024) more frequent in boys with BMI-SDS reduction (76.9%) compared with boys without BMI-SDS reduction (53.6%). In logistic regression analyses adjusted for baseline age and BMI-SDS, BMI-SDS reduction was associated with a decreased likelihood for puberty onset in girls (OR 0.24; 95% CI 0.07-0.85) and an increased likelihood in boys (OR 3.77; 95% CI 1.34-10.52). Central onset of puberty was confirmed by an increase of LH concentration and LH/follicle-stimulating hormone ratio in both boys and girls. Homeostatic model assessment, IGF-1, and IGF-1/insulin-like growth factor binding protein-3 ratio as marker for free IGF-1 at baseline or their changes were not associated with the onset of puberty. CONCLUSIONS BMI-SDS reduction in overweight children was associated with earlier gonadotropin-dependent onset of puberty in boys and later onset of puberty in girls, suggesting earlier puberty in obese girls and later puberty in obese boys. We found no evidence that insulin resistance or IGF-1 have an impact on the start of puberty in obese children. TRIAL REGISTRATION ClinicalTrials.gov: NCT00435734.
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Affiliation(s)
- Thomas Reinehr
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany.
| | - Christina Bosse
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany
| | - Nina Lass
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany
| | - Juliane Rothermel
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany
| | - Caroline Knop
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany
| | - Christian Ludwig Roth
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA; Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA
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Schoenaker DAJM, Mishra GD. Association Between Age at Menarche and Gestational Diabetes Mellitus: The Australian Longitudinal Study on Women's Health. Am J Epidemiol 2017; 185:554-561. [PMID: 28338812 DOI: 10.1093/aje/kww201] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/18/2016] [Indexed: 12/14/2022] Open
Abstract
In this study, we aimed to examine the association between age at menarche and gestational diabetes mellitus (GDM). Data were from 4,749 women participating in the Australian Longitudinal Study on Women's Health between 2000 and 2012. Age at menarche was reported at baseline in 2000 when women were aged 22-27 years. During 12 years of follow-up, information on GDM diagnosis was obtained for each live birth. Log-binomial regression analysis was used to estimate relative risks and 95% confidence intervals. Analyses adjusted for mother's highest completed educational qualification, nulliparity, polycystic ovary syndrome, physical activity, and body mass index. Mean age at menarche was 12.9 years (standard deviation, 1.4). A first diagnosis of GDM was reported by 357 women (7.5%). Compared with women with menarche at age 13 years, women who had their first menstruation at age ≤11 years had a 51% higher risk of developing GDM (95% confidence interval: 1.10, 2.07) after adjustment for GDM risk factors. Our findings indicate that a young age at menarche may identify women at higher risk of GDM. Further prospective studies are needed to confirm our findings and to elucidate the role of early-life exposures in age at menarche and subsequent GDM risk.
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Cao X, Zhou J, Yuan H, Chen Z. Duration of reproductive lifespan and age at menarche in relation to metabolic syndrome in postmenopausal Chinese women. J Obstet Gynaecol Res 2016; 42:1581-1587. [PMID: 27718299 DOI: 10.1111/jog.13093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 06/09/2016] [Indexed: 01/08/2023]
Abstract
AIM This study aimed to assess the associations between menstrual characteristics and the prevalence of metabolic syndrome (MetS) and non-alcoholic fatty liver disease. METHODS A cross-sectional study was conducted with a sample of 1625 postmenopausal women in China. Subjects were classified into three groups according to the tertiles of some variables related to the reproductive life. We assessed associations in multivariable-adjusted analyses, using logistic regressions. RESULTS After adjustments for confounding factors, the odds ratios (OR) for predicting the presence of MetS increased gradually: as the years of menstruation increased (18-34 years vs 35-37 years vs 38-46 years: OR [95% confidence interval (CI)] = 1 vs 1.231 [0.942-1.610] vs 1.309 [0.985-1.740], respectively); as age at menopause increased (31-48 years vs 49-51 years vs 52-59 years: OR [95%CI] = 1 vs 1.115 [0.846-1.469] vs 1.315 [0.986-1.753], respectively); and as age at menarche decrease (11-13 years vs 14-15 years vs 16-20 years: OR [95%CI] = 1 vs 0.950 [0.728-1.240] vs 0.862 [0.610-1.119], respectively). Among the components of MetS, the highest tertile of years of menstruation was significantly associated with elevated waist circumference (OR =1.401 [95%CI = 1.092-1.798]), and elevated triglyceride (OR =1.220 [95%CI = 0.934-1.593]). Nevertheless, the association between these reproductive factors and non-alcoholic fatty liver disease was not significant. CONCLUSION Longer duration of menstruation and earlier age at menarche were significantly associated with a higher risk of central obesity and MetS in postmenopausal Chinese women.
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Affiliation(s)
- Xia Cao
- Department of Health Management Center, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jiansong Zhou
- Department of Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hong Yuan
- Department of Clinical Pharmacology Center, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhiheng Chen
- Department of Health Management Center, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
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Gavela-Pérez T, Navarro P, Soriano-Guillén L, Garcés C. High Prepubertal Leptin Levels Are Associated With Earlier Menarcheal Age. J Adolesc Health 2016; 59:177-81. [PMID: 27297138 DOI: 10.1016/j.jadohealth.2016.03.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/17/2016] [Accepted: 03/19/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE Given the interplay between metabolic status and the reproductive system, factors governing energy homeostasis could influence the timing of pubertal onset. The aim of this longitudinal study was to determine the influence of metabolic peptides associated to adiposity on menarcheal age. METHODS The sample population included 168 girls. Anthropometric and biochemical variables were measured at a prepubertal baseline (6-8 years old) and 7 years later. Leptin and adiponectin levels were determined by Enzyme-Linked ImmunoSorbent Assay, insulin by radioimmunoassay and ghrelin by a multiplexed bead immunoassay. RESULTS Adjusted for body mass index, Spearman correlation analysis revealed a significant negative association between prepubertal leptin levels and menarche. The highest prepubertal leptin levels were observed in overweight girls with the earliest menarche. Menarcheal age was significantly associated with variation of adiponectin levels between both baseline and follow-up. Multiple regression analysis showed that prepubertal leptin was the only significant contributing factor, predicting 15.3% of variation in menarcheal age. CONCLUSIONS High leptin levels in prepubertal girls are associated with earlier menarcheal age, independent of body mass index. However, the relationship of ghrelin, insulin, or adiponectin levels with menarcheal age is not evident in our population.
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Affiliation(s)
- Teresa Gavela-Pérez
- Lipid Research Laboratory, IIS-Fundación Jimenez Díaz, Madrid, Spain; Department of Pediatrics, IIS-Fundación Jimenez Díaz, Madrid, Spain
| | - Pilar Navarro
- Lipid Research Laboratory, IIS-Fundación Jimenez Díaz, Madrid, Spain
| | - Leandro Soriano-Guillén
- Lipid Research Laboratory, IIS-Fundación Jimenez Díaz, Madrid, Spain; Department of Pediatrics, IIS-Fundación Jimenez Díaz, Madrid, Spain
| | - Carmen Garcés
- Lipid Research Laboratory, IIS-Fundación Jimenez Díaz, Madrid, Spain.
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Lopez-Espinosa MJ, Mondal D, Armstrong BG, Eskenazi B, Fletcher T. Perfluoroalkyl Substances, Sex Hormones, and Insulin-like Growth Factor-1 at 6-9 Years of Age: A Cross-Sectional Analysis within the C8 Health Project. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1269-75. [PMID: 26794451 PMCID: PMC4977043 DOI: 10.1289/ehp.1509869] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 12/18/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Exposure to some perfluoroalkyl substances (PFAS), such as perfluorohexane sulfonate (PFHxS), perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononanoic acid (PFNA), may alter levels of sex hormones and insulin-like growth factor-1 (IGF-1) in animals. Human studies on this topic are scarce, and none have been conducted in young children. OBJECTIVES We investigated the relationship between levels of PFAS and estradiol, total testosterone, and IGF-1 in 2,292 children (6-9 years of age) from the C8 Health Project who lived near a chemical plant in the Mid-Ohio Valley (USA) with local contamination from PFOA. METHODS Serum samples were collected in 2005-2006 and analyzed for PFAS, sex hormones, and IGF-1. Results from regression models were expressed as the adjusted percentage difference (95% CI) per sex-specific interquartile range (IQR) increment of each PFAS serum concentration. Analyses by PFAS quartiles were also conducted. RESULTS Median concentrations of PFHxS, PFOA, PFOS, and PFNA were 8, 35, 22, and 1.7 ng/mL in boys and 7, 30, 21, and 1.7 ng/mL in girls. In boys, PFOA concentrations were significantly associated with testosterone levels (-4.9%; 95% CI: -8.7, -0.8%); PFOS with estradiol (-4.0%; 95% CI: -7.7, -0.1%), testosterone (-5.8%; 95% CI: -9.4, -2.0%), and IGF-1 (-5.9%; 95% CI: -8.3, -3.3%); and PFNA with IGF-1 (-3.5%; 95% CI: -6.0, -1.0%). In girls, significant associations were found between PFOS and testosterone (-6.6%; 95% CI: -10.1, -2.8%) and IGF-1 (-5.6%; -8.2, -2.9%); and PFNA and IGF-1 (-3.8%; 95% CI: -6.4, -1.2%). In both sexes, the magnitudes of the associations decreased monotonically across quartiles for both testosterone and IGF-1 in relation to PFOS, and for IGF-1 and PFNA in girls. CONCLUSIONS To our knowledge, this is the first study suggesting that PFAS are associated with lower levels of IGF-1 and sex hormones in young children. CITATION Lopez-Espinosa MJ, Mondal D, Armstrong BG, Eskenazi B, Fletcher T. 2016. Perfluoroalkyl substances, sex hormones, and insulin-like growth factor-1 at 6-9 years of age: a cross-sectional analysis within the C8 Health Project. Environ Health Perspect 124:1269-1275; http://dx.doi.org/10.1289/ehp.1509869.
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Affiliation(s)
- Maria-Jose Lopez-Espinosa
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Epidemiology and Environmental Health Joint Research Unit, FISABIO (Foundation for the Promotion of Health and Biomedical Research in the Valencian Region)–Universitat Jaume I–Universitat de València, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Address correspondence to M.-J. Lopez-Espinosa, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain, Avda Catalunya 21, 46020 Valencia, Spain. Telephone: (34) 961925943. E-mail:
| | - Debapriya Mondal
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Environment and Life Sciences, University of Salford, The Crescent, Salford, United Kingdom
| | - Ben G. Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Brenda Eskenazi
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Tony Fletcher
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Abstract
The timing of puberty has important public health, clinical, and social implications. The plasticity of sexual development onset could be a mechanism that adapts to prevailing environmental conditions. Early-life nutrition may provide cues for the environment's suitability for reproduction. This review focuses on recent developments in our understanding of the role of diet in the timing of sexual maturation. Population-based observational studies consistently indicate that childhood obesity is related to the earlier onset of puberty in girls. Similarly, intake of animal foods has been associated with earlier sexual development, whereas vegetable protein intake is related to delayed maturation. Evidence for prenatal nutrition, infant feeding practices, and childhood intake of fat, carbohydrate, and micronutrients is inconsistent. Secondary analyses of prenatal and early-life randomized nutritional interventions with extended follow-up through peripubertal years would help clarify the role of nutrition in the timing of sexual maturation.
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Affiliation(s)
- Eduardo Villamor
- Department of Epidemiology, School of Public Health;,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan 48109; ,
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