Puberty In Children Research Articles

Effect of acute exercise on gene expression in peripheral blood mononuclear cells of puberty children.

Studies have shown that acute exercise alters the expression of circulating neutrophil and peripheral blood mononuclear cell (PBMC) genes, affecting a wide range of processes from cellular growth to the promotion of inflammatory and anti-inflammatory responses. In this study, we identified differential gene expression associated with acute exercise and PBMC in puberty children through the GEO database. We utilized bioinformatics technology to analyze the impact of acute exercise on PBMC and identified key genes involving the puberty children. Combining two datasets of gene expression, we identified 197 shared differentially expressed genes (DEGs) in PBMC before and after exercise. We conducted pathway analysis of these DEGs and built a gene co-expression network. The identification of hub genes was achieved through the utilization of protein-protein interaction (PPI) networks. 268 shared DEGs were identified in the GSE11761 dataset in pre- and post-exercise groups, while 352 differential genes were identified between the pre- and post-exercise groups of females in the GSE14642 dataset. A total of 197 shared genes were identified between the two datasets. Seven core genes were identified by MCODE and CytoHubba, namely IL2RB, KLRD1, GZMB, TBX21, PRF1, HAVCR2, and GZMA. Bioinformatics techniques are effective in screening and analyzing PBMC-associated DEGs in children undergoing acute pre- and post-exercise puberty. Microarray analysis of PBMCs in children undergoing puberty can identify molecules that may predict acute exercise responses. This study provides insights for further exploration of the mechanisms and targets of acute exercise on the organism.

7128 Efficacy and Safety of Leuprolide Acetate 3M Depot in Chinese Children with Central Precocious Puberty: Interim Analysis of Multicenter, Single-Arm, Prospective Study

Abstract Disclosure: X. Luo: Advisory Board Member; Self; Takeda. L. Hou: Advisory Board Member; Self; Takeda. Y. Li: Advisory Board Member; Self; Takeda. Y. Sun: Advisory Board Member; Self; Takeda. X.K. Jin: Employee; Self; Takeda. Background: Central precocious puberty (CPP) due to early activation of the hypothalamic-pituitary-gonadal axis leads to early puberty. CPP has a negative impact on adult height. Leuprolide acetate (LA), a gonadotropin-releasing hormone agonist (GnRHa) is the standard treatment for CPP. As CPP requires prolonged treatment, a 3-month (3M) depot formulation would increase patient compliance and reduce the injection burden. This interim analysis presents the effect of LA 3M depot on the gonadotropic axis and assesses safety in children with CPP. Methods: In this open-label, multicenter, single-arm, and prospective study, 31 children with CPP were included. Key inclusion criteria were the appearance of secondary sexual characteristics below the age of eight years in girls and nine years in boys with a confirmed diagnosis of CPP. Children treated with prior GnRHa and/or having underlying medical conditions were excluded. Eligible children were treated with LA 11.25 mg subcutaneously every 12 weeks. The primary endpoint of this interim analysis was the proportion of children achieving inhibition of peak LH defined as peak LH ≤ 3.0 IU/L in the GnRH stimulation test at weeks 24. The secondary endpoint was safety analysis in the children receiving at least one dose of LA 3M depot. Results: At baseline, 30 girls and one boy were enrolled. The median (95% CI) chronological age (CA) of the girls was 8.0 (7.0, 9.0) years and the boy was 10 years old. Girls had a median height of 136.95 (131.5, 139.7) cm, weight of 30 (27, 34) kg, and BMI of 16.4 (15.1, 17.9) kg/m2. Baseline bone (BA) age was 11 (10, 11) years, and BA/CA was 1.24 (1.2, 1.3). Boy’s characteristics at baseline differed in CA (10 years), height (144 cm), and BMI (17.4 kg/m2) from girls of this cohort. Due to the data collection time points for the interim analysis, 8 out of the 31 enrolled subjects had a visit at week 24, and 30 subjects reached the week 12 visit time point and had a visit at week 12. The percentage of children achieving inhibition of peak LH (≤ 3.0 IU/L) in the GnRH stimulation test at week 12 was 100 (88.4, 100) %. At week 24, all of them achieved inhibition of LH in the GnRH stimulation test 100 (63, 100) %. Decreases in BA/CA from baseline at weeks 12 and 24 are 93 (77.9, 99.2) % and 50 (15.7, 84.3) % respectively. No progression of the Tanner stage was observed in 96.7 (82.8, 99.9) % and 100 (63, 100) % at weeks 12 and 24. At the data cut-off, 4 (13.33%) patients experienced a total of 5 treatment-emergent adverse events (TEAEs) in the safety population of 30 subjects. No grade ≥3 AE or serious AE was reported. The incidence of injection site reaction was 3.33%. Conclusion: LA at 11.25mg/3M depot effectively suppresses the gonadotropic axis at weeks 12 and 24, normalizing growth and reversibly slowing the early onset of puberty in children with CPP. LA in a 3-month injecting frequency is a safe and convenient treatment option to improve patient compliance. Presentation: 6/3/2024

Pseudo-precocious puberty in children exposed to exogenous sex hormone: case report series

Pseudo-precocious puberty in children exposed to exogenous sex hormone: case report series

Dietary Contribution to the Development of Precocious Puberty in Children

This study examined seven dietary factors contributing to precocious puberty in 200 children, with an age and gender-matched control group of 200 healthy children. The case group was classified according to Traditional Chinese Medicine principles; their dietary habits were investigated by questionnaire, with dietary statistics compiled for each Traditional Chinese Medicine evidence group. The χ2 test revealed a statistically significant higher exposure in the case group to five factors, namely frequent consumption of nutritional supplements, foods with high hormone content, anti-seasonal fruits and vegetables, products with high trace elements of zinc, and foods packaged in plastic (P < 0.01 or P < 0.05). The results of logistic regression analysis showed that frequent consumption of nutritional supplements (odds ratio = 13.558), foods containing high levels of hormones (odds ratio = 11.829), anti-seasonal fruits and vegetables (odds ratio = 8.114), products containing high trace elements of zinc (odds ratio = 6.734 ), and plastic wrapped food (odds ratio = 3.419) were high-risk factors; the order of preference in dietary habits was as follows: salty > greasy > sweet > spicy > cold > hot > light.

Association of Traditional dietary pattern with early and precocious puberty: a population-based cross-sectional study.

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. 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. 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. Traditional dietary patterns were protective associated with early and precocious puberty among Chinese children. 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.

EFFECT OF YOGIC PRACTICES WITH AND WITHOUT WALKING ON SELECTED PSYCHOLOGICAL VARIABLE AMONG WOMEN SENIOR CITIZENS

Old Age is a natural part of the life cycle. All living organism including humans undergo the process from conception to infancy, child hood puberty, maturity and senescence. Longer life means more frailty and more disability. Apart from economic problem they face in their life, the common diseases like ortho, visual, audio and mental some face grave diseases of heart, blood etc. The care of old people in a separate branch of medicine called Geriatrics and scientific study of old age and process of growing old is called Gerontology. The definition of ageing varies from society to society and has been modified considerably over time. The purpose of this study was to find out the effect of Yogic practices with and without Walking on selected Psychological variable in Women senior citizens. The selected subjects 45 were randomly divided into three groups equally of which experimental Group – I underwent yogic practices with Walking, Group – II underwent yogic practices without Walking Group – II acted as Control Group. The subjects selected for this study were in the age group of above 60 years. Each group consisting of fifteen subjects, there experimental group as Group I & II and Control group as Group III. The following psychological variable was selected as dependent variables such as stress and the stress questionnaire constructed by Dr.Latha Satish (1997) consisting of 52 questions. , and the following variable was selected as independent variable as yogic practices and walking. The data collected on selected criterion variables were subjected to statistical analysis using analysis of covariance (ANCOVA) to find out any significant difference between the three groups on stress.

RELATIONSHIP BETWEEN MATERNAL CHARACTERISTICS AND MENARCHE IN SCHOOLGIRLS AGED 10-12

Adolescence is a period of change or transition from childhood to adulthood which includes biological, psychological and social changes. The most important event in a child's puberty is the first menstruation or menarche, which is a biological sign of sexual maturity. Examine the correlation between maternal characteristics and menarche readiness for female students aged 10-12 years. This study used correlational analysis with a cross sectional approach. Data collection technique used a questionnaire which was conducted on 89 respondents with menarche readiness students aged 10-12 years at SDK Santo Yusup III Malang. The statistical test used the contingency coefficient test. The results of this study indicated that there was correlation between maternal characteristics and readiness for menarche for students aged 10-12 years at SDK Santo Yusup III Malang, the mother's age had p value = 0.000 (r = 0.372), the last education of the mother was p value of 0.001 (r = 0.480), and mother's menarche age p = 0.002 (r = 0.453), which means there was a correlation between the two variables. The correlation value in this study indicated that the direction of the correlation was positive with a fairly strong correlation strength.

The effect of gonadoliberin analog treatment in precocious puberty on polycystic ovarian syndrome prevalence in adulthood.

The study group consists of 24 women (median age 22 88 years, median BMI 23.5) treated with GnRHa for central precocious puberty in childhood. The control group includes 40 women (median age 23 years, median BMI 25.6) diagnosed with isolated premature thelarche and not using GnRHa in the childhood. Anthropometric measurements, ultrasound examination of minor pelvis and hormonal profile were performed. PCOS diagnosis was based on Rotterdam criteria. The study confirmed a higher prevalence of PCOS in the study group (50%) than in the control group (10%); p=0.0006. Significant, linear correlation between free testosterone levels and ovarian size was found in the study group (R=0.45 p= 0.03). GnRHa therapy during childhood may have a potential influence on incidence of PCOS in the adulthood. Therefore, in this group of patients long-term follow-up focused on screening for PCOS would seem beneficial.

사춘기 자녀에 관한 부모의 이야기: 토픽 모델링을 활용한 네이버 카페 게시물 분석

The purpose of this study is to examine the content of Naver Cafe posts related to parenting puberty children. We aim to uncover narratives regarding adolescent child-rearing that may not have been elucidated through surveys or interviews. The analy-sis focused on 160,074 posts related to adolescent written on Naver Cafe from April 1, 2018, to March 31, 2023. Frequency analysis, word clouds, and topic modeling were used. The analysis yielded the following results. First, frequently appearing words in posts about adolescent children included words related to family members, words related to the ado-lescent stage, and other words such as speech, thoughts, and studies. Second, posts about puberty encompassed 17 different topics, which could be broadly categorized into five main topics. These five main topics were preparing for a child's adolescent year, un-derstanding biological changes, concerns related to academics, challenges and crises, and parental growth and resilience. Third, parent-child relationships and growth topics showed a decreasing trend. The results of this study suggest the need for not only sharing information and emotional support, but also efforts to promote the sharing of growth experiences.

PREVALENCE AND CAUSES OF AUTONOMIC DYSFUNCTION SYNDROME IN PUBERTY CHILDREN

Annotation. This scientific study is devoted to the study of autonomic dysfunction syndrome (АVD), which is most often formed in adolescents. The results of the analysis of outpatient records of children are presented, the frequency of occurrence is determined and risk factors for АVD in students of secondary specialized educational institutions are identified. The purpose of the study: is to study the frequency of occurrence and identify risk factors for the development of autonomic dysfunction in puberty children. Materials and methods: To study the frequency of occurrence and identify risk factors for the development of autonomic dysfunction syndrome, 100 adolescents enrolled in secondary specialized educational institutions aged 12-17 years were examined. A prerequisite was the informed consent of the teenager or parents to participate in the study. The study was conducted in the form of a questionnaire and a survey algorithm was created. Questionnaire forms with the identified factors were filled out for all examined adolescents. Results and discussions According to the survey data, it was revealed that the greatest factors of the development of АVD in children aged 12-15 years are mental fatigue (50%), hormonal imbalance, pre- and puberty (44%), stress during pregnancy (41%), etc. Therefore, taking into account the established risk factors, it is possible to predict the development of АVD in children, especially with burdened obstetric pathologies and hereditary factors. Conclusion. The problem of АVD in children and adolescents is relevant not only for pediatricians and pediatric cardiologists but also for doctors of other medical specialties: therapists, neurologists, psychotherapists, and endocrinologists. The syndrome of autonomic dysfunction (АVD) and its manifestations in children still cause a large number of questions to which there are the same set of answers, and not always unambiguous.

Magnetic resonance imaging of knees: a novel approach to predict recombinant human growth hormone therapy response in short-stature children in late puberty.

There is no appropriate tool to predict recombinant human growth hormone (rhGH) response before therapy initiation in short-stature children in late puberty. The current study aimed to explore the associations between magnetic resonance imaging (MRI) stages of the knee growth plates and rhGH response in short-stature children in late puberty. In this prospective cohort study, short-stature children in late puberty were treated with rhGH and followed up for 6 months. We proposed a novel knee MRI staging system according to the growth plate states of distal femurs or proximal tibias and divided the participants into three groups: unclosed growth plate group, marginally closed growth plate group, and nearly closed growth plate group. The primary outcomes were height gain and growth velocity (GV), which were assessed three months later. Fifty participants were enrolled, including 23 boys and 27 girls. GV and height gain after 6 months of rhGH therapy decreased successively in the three groups with an increased degree of growth plate fusion, especially when grouped by proximal tibias (GV1-3 mon from 9.38 to 6.08 to 4.56cm/year, GV4-6 mon from 6.75 to 4.92 to 3.25cm/year, and height gain from 4.03 to 2.75 to 1.95cm, all P < 0.001). Moreover, the MRI stages of growth plates independently served as a significant variable for GV and height gain after therapy, especially when grouped by proximal tibias (all P < 0.01). The MRI staging method is expected to be an effective tool for predicting rhGH response before therapy initiation in short-stature children in late puberty.

Time trends towards earlier puberty in boys and girls with type 1 diabetes: Insights from the German Diabetes Prospective Follow-up (DPV) registry, 2000 to 2021.

To examine the time trends and factors associated with the onset of puberty in children with type 1 diabetes (T1D) using data from the German Diabetes Prospective Follow-up (Diabetes-Patienten-Verlaufsdokumentation [DPV]) registry. A total of 13 127 children with T1D, aged 6 to 18 years, were included in the analysis. Regression analysis was performed to investigate the relationship between diabetes duration, body mass index (BMI) standard deviation score (SDS), glycated haemoglobin (HbA1c) level, migration background, and the onset of puberty, stratified by sex. Our findings revealed a significant trend towards earlier puberty in both girls and boys with T1D over the observed period (2000 to 2021). Puberty onset in girls (thelarche Tanner stage B2) decreased from 11.48 (11.35-11.65) years in 2000 to 10.93 (10.79-11.08) years in 2021 and gonadarche (Tanner stage G2/testicular volume >3 mL) decreased from 12.62 (12.42-12.82) years in 2000 to 11.98 (11.79-12.16) years in 2021 in boys (both P < 0.001). Longer diabetes duration, higher BMI SDS, and lower HbA1c level were associated with earlier puberty in both sexes (P < 0.001). Our study highlights earlier puberty in children with T1D, influenced by BMI SDS, HbA1c level, and migration background. This has important implications for diabetes management and supporting healthy development. Further research is needed to understand the underlying mechanisms and develop potential interventions for this vulnerable population.

THU202 Peripheral Precocious Puberty In A 7-year-old Female As A Result Of Exposure To Bath Bombs

Abstract Disclosure: C.C. Gordner: None. Introduction: Recent studies have demonstrated a progressive decrease in the age of onset of puberty in children. Endocrine disrupters are increasingly being identified as an important contributing factor to this shift in pubertal timing. We present here a case of peripheral precocious puberty in a 7-year-old female after a brief intense exposure to bath bombs. Clinical Case: A healthy pre-pubertal 7-year-old female used daily bath bombs for 7 days. She developed tender Tanner II breast buds the following week with no other pubertal or adrenarchal signs. Growth chart review revealed stable linear growth without growth acceleration. Bone age x-ray was consistent with chronologic age (CA 7y0m, BA 6y10m). LH, ECL, was 0.058 miU/mL (ref: 0.02-0.3), Estradiol, LCMS, was 2.0 pg/mL (ref &amp;lt; 15), DHEA-Sulfate, LCMS, was 45 mcg/dL (ref: 6-7y: &amp;lt; 72). The breast buds started to resolve after 2 months and were completely gone after 3 months from the initial exposure. Clinical Lessons: Endocrine-disrupting chemicals are found in pesticides, plasticizers, lavender, fennel, and tea tree oils and can lead to precocious puberty, delayed puberty, and/or impact sexual differentiation. Consumer products are often not well labeled to identify these chemicals and often use confusing terminology like “all-natural” and “organic” which can be misleading. Conclusions: Bath bombs should now be added to the growing list of consumer products associated with precocious puberty. Leaders should advocate for better labeling of consumer products to help identify potentially harmful products. Presentation: Thursday, June 15, 2023

2.49 Association Between SSRIs and Delayed Puberty in Children

2.49 Association Between SSRIs and Delayed Puberty in Children

Hyperphagia, Growth, and Puberty in Children with Angelman Syndrome.

Angelman Syndrome (AS) is a rare genetic disorder caused by lack of maternal UBE3A protein due to a deletion of the chromosome 15q11.2-q13 region, uniparental paternal disomy, imprinting center defect, or pathogenic variant in the UBE3A gene. Characteristics are developmental delay, epilepsy, behavioral, and sleep problems. There is some evidence for hyperphagia, shorter stature, and higher BMI compared to neurotypical children, but longitudinal studies on growth are lacking. In this study, we analyzed prospectively collected data of 145 children with AS, who visited the ENCORE Expertise Center between 2010 and 2021, with a total of 853 visits. Children showed an elevated mean score of 25 on the Dykens Hyperphagia questionnaire (range 11-55) without genotype association. Higher scores were significantly associated with higher body mass index (BMI) standard deviation scores (SDS) (p = 0.004). Mean height was -1.2 SDS (SD 1.3), mean BMI-SDS was 0.6 (SD 1.7); 43% had a BMI-SDS > 1 and 20% had a BMI-SDS > 2. Higher BMI-SDS was significantly associated with non-deletion genotype (p = 0.037) and walking independently (p = 0.023). Height SDS decreased significantly with age (p < 0.001) and BMI-SDS increased significantly with age (p < 0.001. Onset of puberty was normal. In conclusion, children with AS showed moderate hyperphagia, lower height SDS, and higher BMI-SDS compared to norm data, with increasing deviation from the norm with age. It is uncertain how loss of maternal UBE3A function may influence growth. Attention to diet, exercise, and hyperphagia from an early age is recommended to prevent obesity and associated health problems.

Pubertal patterns in children with sickle cell anemia: A case–control study in Cameroon

BackgroundPuberty may be impaired in children with sickle cell anemia (SCA). Therefore, we aimed to explore the clinical and hormonal features of puberty in Cameroonian children. MethodsIn a case–control study, we included 64 children aged 8–18 years with SCA matched to healthy controls. We assessed height, weight, body mass index, body composition, and Tanner stages. Hormonal measurements included anti-mullerian hormone, follicle-stimulating hormone, luteinizing hormone, and sex hormones (estrogens/testosterone). We used the Mann–Whitney Wilcoxon test to compare the median values between cases and controls. We looked for associations between the severity criteria of SCA and delayed puberty through multivariate analysis. ResultsDelayed puberty was reported in 27.3% of girls and 10% of boys with SCA. The median age of menarche was delayed by 2 years compared to controls. SCA patients had a low lean body mass compared to controls (p = 0.03). Anti-mullerian hormone levels were significantly higher in boys with SCA than those of controls (45.9 ng/mL vs. 17.65 ng/mL; p = 0.018). A history of severe infection, acute chest syndrome, and low hemoglobin level was associated with delayed sexual maturation in children with SCA. ConclusionOur study revealed delayed puberty in children with SCA. Moreover, puberty is affected by the severity of the disease. This highlights the importance of regular monitoring of puberty during the follow-up of these children.

Analysis of risk factors of precocious puberty in children

BackgroundThe purpose of this study is to explore the related factors of precocious puberty in children.Methods1239 children who underwent physical examination in our hospital from January 2020 to December 2022 were analyzed, including 198 precocious children and 1041 normal children. According to the age of 198 precocious children and 1041 normal children, 205 normal children were selected, and the remaining 836 normal children were excluded. They were divided into precocious group and normal group. The general data of the two groups were recorded. Logistic regression was used to analyze the influencing factors of precocious puberty in children.ResultsThere were statistically significant differences (P < 0.05) between the two groups in sex, bone age, daily exercise time, E2, FSH, LH, leptin, mother’s menarche time, living environment, consumption of nutritional supplements, consumption of foods containing pigments and preservatives, consumption of high-protein foods, and sleeping time. The multifactor logistic regression analysis shows that the risk factors of children’s precocious puberty included gender (female), bone age (> 10 years old), and daily exercise time (< 0.9 h), E2 (≥ 66.00pmol/L), FSH (≥ 6.00U/L), LH (≥ 3.50U/L), leptin (≥ 8.00 µ G/L), mother’s menarche time (< 12 years old), living environment (chemical industry zone), consumption of nutritional supplements (often), consumption of high-protein food (often), and sleep time (< 10 h).ConclusionIn conclusion, children’s gender, bone age, exercise habits, E2, FSH, LH, leptin, mother’s menarche time, living environment, eating habits, sleep time and other factors are closely related to precocious puberty in children. Reminding parents to actively prevent related factors in clinical work is helpful to prevent the occurrence of precocious puberty in children.

Evaluation of etiology and clinical feature of precocious puberty among children presenting in a pediatric endocrinology department in a tertiary care hospital.

Objective: To find the frequency of precocious puberty in children and to compare the clinical and laboratory parameters of central &amp; peripheral precocious puberty. Study Design: Cross-sectional study. Setting: Karachi's National Institute of Child Health's Paediatric &amp; endocrinology Division. Period: December 2016 and 2021. Material &amp; Methods: All patients with precocious puberty will be taken from files through non-probability convenience sampling method. Data was analyzed on SPSS version 22.0. Results: Total 65 patients were included. The mean age was 6+3.35years. Precocious puberty was classified as peripheral precocious puberty in 38 (58.4%), central precocious puberty in 20 (30.76%), premature thelarche in 5(7.69%) and premature1pubarche in 2 (3.07%). In the peripheral precocious1puberty group, CAH was found in 22(78.5%), out of which 2 patients were of rare mutation of CAH presenting with peripheral precocious puberty (DAX mutation and 11 B hydroxylase mutation, adenocarcinoma was observed in 2(7.14%) followed by Mu-cane- Albright syndrome was in 4(14.28%) and van wykgrumbach syndrome in 10 patients. Central precocious puberty was found in 20 patients hypothalamic harmartoma in 4(20%), craniopharyngioma 3(15%), hypothalamic astrocytoma 1(5.0%), genetically proven neurofibromatosis in 1(5.0%) patient and hydrocephalus 1(5.0%) and in 10(50%) patients no cause was found. Conclusion: The conclusion of the study that Peripheral precocious puberty was more common than central precocious puberty. The common cause of peripheral precocious puberty was CAH, while central precocious puberty was idiopathic. Children with central precocious puberty had greater height SDS, weight SDS, FSH, and LH levels compared to children who had peripheral precocious puberty.

An 8-Year-Old Girl with Drug Hypersensitivity to First Triptorelin Acetate Administration

Triptorelin is a synthetic gonadotropin-releasing hormone agonist for the treatment of precocious puberty in children. Among the triptorelin side effects, drug hypersensitivity reactions, including anaphylaxis, can rarely occur, mostly after repeated exposure to the drug. We present a first case of an 8-year-old girl with central precocious puberty who developed anaphylaxis to the first injection of decapeptyl depot, which contains triptorelin acetate (D,L lactide coglycolide), dextran 70, and polysorbate 80. She showed 2 positive reactions in an intradermal test to decapeptyl depot, suggesting that it is an IgE-mediated reaction to one of its components. Considering this was the first exposure to triptorelin, it might be a reaction to polysorbate. As there are many therapeutic products containing polysorbate which can cross-react with polyethylene glycols, physicians should pay attention to immediate reactions to drugs containing polysorbate.

Identification of urine biomarkers associated with early puberty in children: An untargeted metabolomics analysis

A trend toward earlier pubertal maturation in both sexes has been shown in many countries. Early puberty affects an increasing proportion of children for reasons that remain obscure. Novel candidate biomarkers are strongly needed. We sought to apply untargeted metabolomic profiling to identify triggering mechanisms and candidate biomarkers in children with early puberty. Participants aged 7 – 12 years old were recruited directly from two elementary schools of Bengbu, Anhui Province, China, from Feb 2021 to May 2021. Early puberty was determined by breast and testicular development at baseline (May 2021) and 6-month later. Ultra-high-performance liquid chromatography-based untargeted metabolomic profiling was performed on urine samples of children with early puberty and control subjects. Metabolomic profiling for early puberty in a sex dependent manner. For boys, we identified several perturbed pathways, including histidine metabolism, glycine, serine and threonine metabolism, and selenoamino acid metabolism, associated with early puberty. In contrast, there were differences in pyruvate metabolism, one carbon pool by folate, and D-glutamine and D-glutamate metabolism pathways in girls with early puberty compared with controls. In addition, 4-hydroxyhippuric acid and 5-methoxytryptophol were shown as potential independent diagnostic biomarker for early puberty in boys, 3-hydroxybenzoic acid and glutaminylproline were shown as early biomarker for early puberty in girls, achieving area under the ROC curve of 0.71 and 0.72 in discriminating early puberty boys, and 0.70 and 0.74 in discriminating early puberty girls from controls. Through metabolomic analysis, we have identified metabolic perturbations and potential biomarkers of early puberty.