Precocious Puberty In Girls Research Articles

Escherichia coli biotransformation of daidzein fermentation products from soy‐based foods—relevance to food oestrogenicity‐based functionality

SummaryOestrogenic isoflavones (e.g. daidzein) present in soy‐based foods are likely to be important in food functionality. Biotransformation of daidzein during fermentation‐based soy‐containing food manufacture forms three trihydroxy metabolites, 6‐ortho‐hydroxydaidzein (6‐OHD), 8‐ortho‐hydroxydaidzein (8‐OHD) and 3′‐ortho‐hydroxydaidzein (3′‐OHD) which alters the oestrogenicity of the final food product. We report that Escherichia coli (a key component of the gut microbiome) metabolism converts 8‐OHD to 6‐OHD with a likely concomitant increase in oestrogenicity. This means that the functionality of 8‐OHD‐containing soy‐based foods is altered by gut microbiome metabolism. This change in oestrogenicity‐based food functionality might have benefits for postmenopausal women, while being a feminising health risk for males and could add to the risk of oestrogen‐mediated precocious puberty in girls.

Serum Anti-Müllerian Hormone and Inhibin B as Potential Markers for Progressive Central Precocious Puberty in Girls

Study ObjectiveTo investigate the potential of serum anti-Müllerian hormone (AMH) and inhibin B (INHB) levels as markers for pubertal progression rate in girls with central precocious puberty (CPP). Design, Setting, Participants, Interventions, and Main Outcome MeasuresA total of 148 girls were enrolled, including 65 girls with premature thelarche and 83 girls with CPP, grouped on the basis of the results of gonadotropin-releasing hormone stimulation tests. Girls with CPP underwent a 6-month follow-up, and were further divided into 2 subgroups: the progressive CPP (P-CPP) group (n = 55) and the slowly P-CPP (SP-CPP) group (n = 28). Serum AMH and INHB levels were assessed in all enrolled girls. Using receiver operating characteristic curves, we analyzed the diagnostic performance of AMH and INHB to differentiate the 2 forms of CPP. ResultsOur data showed that AMH and INHB offer the potential to act as markers that distinguish SP-CPP from P-CPP. Compared with the SP-CPP group, girls with P-CPP showed lower AMH levels and higher INHB levels. On the basis of the receiver operating characteristics analysis, the area under the curve was 0.92 for the combination of AMH and INHB, with 80% sensitivity and 89.3% specificity. ConclusionOur results suggest that serum AMH and INHB levels provide a promising method in differentiating SP-CPP from P-CPP.

Serum Anti-Müllerian Hormone Levels in Precocious Puberty Girls according to Stage of GnRH Agonist Treatment.

Few studies have investigated the long-term effects of gonadotropin-releasing hormone (GnRH) agonist treatment on the reproductive function of central precocious puberty (CPP) girls. In this cross-sectional study, we assessed the ovarian function by analyzing the serum anti-Müllerian hormone (AMH) levels of CPP girls. Our study included 505 CPP girls subdivided into 5 groups according to the GnRH agonist treatment stage: group A (before treatment, n = 98), group B (3 months after initiation, n = 103), group C (12 months after initiation, n = 101), group D (24 months after initiation, n = 101), and group E (6 months after discontinuation, n = 102). We compared the serum AMH levels of the CPP girls with those of 100 bone age-matched controls (before treatment: n = 55; after discontinuation: n = 45). At baseline, the mean AMH level of the CPP girls was 5.9 ± 3.6 ng/mL. The mean AMH level after 3 months of the GnRH agonist treatment was lower (4.7 ± 3.2 ng/mL, P = 0.047) than that at baseline and recovered after 12 months of treatment. Six months after discontinuation, the AMH levels were similar to those at pre-treatment. Before and after the GnRH agonist treatment, the AMH levels were similar to those of the bone age-matched controls. In the precocious puberty girls, the AMH levels based on the GnRH agonist treatment stage were all within the normal reference range. The results of this study suggest that GnRH agonist treatment has no adverse effects on the reproductive function.

성조숙 증상을 보이는 여아들의 HRV의 특성 연구

ABSTRACT A Study of the Characteristics of the HRV of the Girl Showing a Precocious PubertySeung-Jeong Yang, Kyung-Mi Park, Seong-Hee ChoDept. of Oriental Gynecology, College of Oriental Medicine, Dong-Shin UniversityObjectives: The aim of the study was to investigate the characteristics of the autonomic innervation of the hea rt in Precocious Puberty (PP) G irls. Methods: We studied 87 girls visiting Dongshin University Suncheon Orie ntal Medicine hospital from first Januarty 2013 to 31th December 201 5. Among the 87 girls who were selected 14 people under the age of 8. The subje cts were categorized in two groups, 2 PP girls and 12 healthy controls. We studied t he difference of Heart rate variability (HRV) between two groups by Independent sample s T-test using SPSS for windows (version 22.0).Results: The Standard deviation of all normal R-R intervals (SDNN), The spuare root of the sum of the spuare of difference between adja cent normal R-R intervals (RMS-SD) of PP group was non-significantly lower than non-PP group.Total power (TP), Very low frequency power (VLF), High frequenc y power (HF), Low frequency power (LF) of PP group was non-significantly lower than non-PP group, LF/HF ratio of PP group was significantly higher than no n-PP group.Normalized high frequency power (HF norm) of PP group was non-s ignificantly lower than non-PP group. Normaliz ed low frequency power (LF nor m) of PP was non-signficantly higher than non-PP group.Conclusion: The results suggest that imbalance of sympathetic and parasymp athetic nervous system from girls of precocious puberty can be seen.Key Words: Precocious Puberty, Heart Rate Variability, Autonomic Nervous System

Long-term outcomes of letrozole treatment for precocious puberty in girls with McCune-Albright syndrome.

McCune-Albright syndrome (MAS) is a rare disorder with a broad spectrum including precocious puberty (PP) due to recurrent estrogen-secreting ovarian cysts. This study evaluates the long-term safety and efficacy of letrozole treatment in large cohort of girls with MAS-associated PP. Retrospective cohort analysis. Clinical data, including history and physical examination, bone age, and pelvic ultrasounds, were reviewed on 28 letrozole-treated girls. Adult height was reviewed for 42 historical controls. Outcomes included rate of skeletal maturation, growth velocity, predicted adult height and adult height. Twenty-eight girls received letrozole treatment. Treatment duration was 4.1 ± 2.6 years (mean ± 1 s.d.) (range: 0.5-10.9) and mean follow-up was 6.0 ± 3.3 years (range: 0.5-15.0), for a total of 135.9 person-years of follow-up. Letrozole treatment was highly effective at decreasing the rate of skeletal maturation, with a decline in change in bone age over change in chronological age (ΔBA/ΔCA) from 1.7 (IQR: 2.3) to 0.5 (IQR: 0.4) (P < 0.0001), and growth velocity Z-scores, which declined from 2.2 ± 2.3 to -0.6 ± 1.6 (P = 0.0004). Predicted adult height Z-scores increased significantly from -2.9 ± 3.2 to -0.8 ± 1.5 for subjects on treatment (P = 0.004). Four subjects who completed treatment reached adult height Z-scores ranging from -1.5 to 1.7 (median: -0.6), which were increased in comparison with untreated historical controls (P = 0.02). There was no change in uterine size or ovarian volumes, and no adverse events over the treatment period. In this study with the longest follow-up to date, letrozole treatment resulted in sustained beneficial effects on skeletal maturation, growth velocity and predicted adult height.

Assessment of Estradiol Response after Depot Triptorelin Administration in Girls with Central Precocious Puberty

Background: Estradiol at baseline or after a classical gonadotropin-releasing hormone test did not reflect ovarian steroidogenesis in central precocious puberty (CPP) girls. Aims: To evaluate estradiol response to depot triptorelin, both at start and during therapy to determine how active ovarian steroidogenesis is at pubertal stage and under therapy. Methods: A prospective study was performed in 43 CPP girls. Serum luteinizing hormone and follicle-stimulating hormone at 3 h (LH-3h, FSH-3h) and estradiol at 24 h (E₂-24h) after injection of depot triptorelin 3.75 mg were measured, at first dose and at 3, 6, 12, 18 and 24 months of treatment. Results: E₂-24h after depot triptorelin was >100 pg/ml after the first dose. Estradiol response (E₂-24h) fell to levels <14 pg/ml in 78 out of 82 follow-up visits along 2 years of therapy. Concomitantly, LH-3h and FSH-3h were <4.0 and <6.3 IU/l, respectively. In 4 patients with inadequate treatment, E₂-24h, LH-3h and FSH-3h rose to pubertal values similar to those observed at first dose. Conclusion: Estradiol (<14 pg/ml) assessment 24 h after depot triptorelin administration is a reliable and simple manner to confirm ovarian suppression in CPP girls during treatment.

Implications for the Future of Pediatric and Adolescent Girls With McCune-Albright Syndrome: Long Term Obstetrical and Gynecologic Outcomes

McCune-Albright Syndrome (MAS) is defined clinically by the triad of fibrous dysplasia of bone (FD), café-au-lait spots and precocious puberty. Precocious puberty in girls is secondary to intermittent autonomous activation of ovarian tissue, resulting in high serum estradiol. Although activation of the hypothalamic–pituitary–adrenal–gonadotropic axis ensues at puberty, many girls continue to have intermittent irregular bleeding due to persistent autonomous ovarian function. The goal of this study was to determine if there are any long term gynecologic abnormalities in adults with MAS.

Partial Merosin Deficiency and Precocious Puberty

The congenital muscular dystrophies (CMD) are autosomal-recessive disorders. Classical congenital muscular dystrophy is grouped as merosin-positive and merosin-negative (MN-CMD). Precocious puberty in girls has been defined by Marshal and Tanner in 1969. In most of the cases, precocious puberty is idiopathic and is related to premature release of gonadotrophins. So far, the association between merosin deficiency and precocious puberty has not been identified. We report a case of a child with precocious puberty who was diagnosed with merosin deficiency in infancy.

Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls.

PurposeIt is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development.MethodsThis study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test.ResultsA total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, 2.45±0.50 cm vs. 2.63±0.49 cm, P=0.015; uterine volume, 0.95±0.62 cm3 vs. 1.35±0.76 cm3, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least 1.07 cm3 was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747).ConclusionUterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

Treatment of central precocious puberty and early puberty with GnRH analog in girls with Williams-Beuren syndrome.

Little has been published on treatment of precocious puberty in girls with Williams-Beuren syndrome (WBS), a condition occurring frequently in this group. We analyzed our own data on growth/age at menarche of now adult female patients with WBS being diagnosed with central precocious puberty or early puberty. Data of patients treated with gonadotropin-releasing hormone (GnRH) analog (n=13) were compared with those not treated (control group, n=11). Longitudinal data on the somatic development of 24 now adult female patients were analyzed. Medium final height was 157.2±6.5 cm compared to 151.4±5.6 cm in the control group. No significant difference could be found in the discrepancy of genetic target height and final height. Prepubertally girls were normal weight in both groups; in adulthood the majority of patients were overweight/obese. Menarche commenced 11 months after cessation of therapy. As already known from other studies, hormonal suppression via GnRH analog was well tolerated.

Evaluating the diagnostic value of basal LH and LHRH test in predicting progression into precocious puberty in girls

Evaluating the diagnostic value of basal LH and LHRH test in predicting progression into precocious puberty in girls

Utility of basal LH in comparison to the GnRH test for identifying central precocious puberty in girls

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

The usefulness of the leuprolide stimulation test as a diagnostic method of idiopathic central precocious puberty in girls.

Central precocious puberty (CPP) diagnosis is based on clinical evaluation, but hormonal evaluation is crucial. The aim of the study was to evaluate the usefulness of the leuprolide stimulation test for diagnosis of idiopathic CPP. Sixty-one girls, aged 5-8 years, were evaluated retrospectively for premature breast development. According to clinical evolution, 28 had progressive puberty and 33 nonprogressive puberty. All underwent a leuprolide stimulation test. Cutoff points, sensitivity, and specificity for gonadotropins and estradiol were determined by receiver operating characteristic (ROC) curves. Cutoff points for CPP were: baseline LH: > 0.1 mUI/l, FSH: > 2.3 mUI/l, LH/FSH ratio: > 0.23, estradiol: > 12 pg/ml; and stimulated LH: > 5.5 mUI/l, LH/FSH ratio: > 0.24, estradiol: > 79.67 pg/ml. The best diagnostic efficiency for progressive puberty were stimulated LH/FSH ratio (sensitivity: 100%, specificity 94%) followed by stimulated LH (sensitivity: 93%, specificity: 100%). Stimulated LH/FSH ratio and LH resulted in the most useful parameters for the diagnosis of CPP. Stimulated estradiol did not add more information.

특발성 성조숙증 여아의 유형별 분류에 따른 신체발육 및 성호르몬 분비

Abstract Recently, As the prevalence of precocious is increased in Korea This study was evaluated the physical growth and female sex hormone characteristics of girls with Idiopathic precocious puberty. Retrospective analysis about the medical record of 113 girls for evaluation of signs of precocious puberty except for organic causes was done. Physical growth features and Female sexual hormone were analyzed. Height SDS and Weight SDS were significantly increased in true sexual precocity compared to pseudo sexual precocity. Hormone studies showed that the level of basal LH, FSH, E2 was significantly higher in true precocious puberty. The finding of this study suggest that we need to develop intervention about physical and psychological problems for precocious puberty girls. Key Words : Precocious puberty, True precocious puberty, Pseudo precocious puberty, Physical growth, Female sexual hormone Received 21 June 2014, Revised 29 August 2014Accepted 20 September 2014Corresponding Author: Myung Kim(Dept. of Health Education and Management, Health Science College, Ewha Womans University) Email: mykim@ewha.ac.krⒸ The Society of Digital Policy & Management. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is 1738-1916 properlyISSN: cited.

Value of color Doppler ultrasonography in the diagnosis of precocious puberty in girls

Objective To assess the role of pelvic ultrasound examination in discriminating between normal girls,isolated premature thelarche/pubarche /menarche and central precocious puberty (CPP).Methods Eighty-four isolated premature thelarche/pubarche /menarche cases,47 CPP cases,and 177 normal girls aged 0-10 years were recruited.All diagnoses were confirmed by the gonadotropin-releasing hormone-stimulation test.All subjects underwent pelvic ultrasound examination for the measurement of length,width,thickness,and volume of the uterine body,uterine cervix,and ovary,and the number of follicles with diameter≥ 4 mm.The groups were subdivided by age intervals when the difference in ultrasound measurements between CPP,isolated premature thelarche/pubarche/menarche,and normal girls were analyzed.Results 1) Differentiation between CPP and normal girls:for the 6-8 years,there were 11 variables elevated in CPP as compared to the normal girls.Uterine cervix thickness was the most efficient parameter as judged by the largest value of area under the ROC curve (0.958).The best cut-off,sensitivity,and specificity was 0.73 cm,93.30％,and 85.70％ respectively;for the 8-10 years,uterine body volume was the best parameter among the 10 elevated variables as judged by the largest area under the ROC curve (0.869),3.23 cm3 was the best cut-off limit with a sensitivity of 84.21％ and a specificity of 52.11％.2) Differentiation between isolated premature thelarche/pubarche/menarche and normal girls:for the 0-6 years,ovary thickness was the best variable as judged by the largest area under the ROC curve (0.806),0.98cm was the best cut-off limit with a sensitivity of 76.46％ and a specificity of 84.85 ％ ;for the 6-8 years,ovary width was the best variable among the 8 valuable variables for its largest area under the ROC curve (0.843),1.39 cm was the best cut-off limit with a sensitivity of 85.71％ and a specificity of 73.81％ respectively;for the 8-10 years,uterine cervix thickness was the best variable among the 5 valuable variables for its largest area under ROC curve (0.841),0.75 cm was the best cut-off limit with a sensitivity of 90.48％ and a specificity of 64.21％.3) Differentiation between CPP and isolated premature thelarche/ pubarche/menarche cases:for the 6-8 years,uterine cervix length and width were potential parameters.Uterine cervix length was the best variable for its largest area under the ROC curve(0.764),and 1.49 cm was the best cut-off limit,the corresponding sensitivity and specificity was 93.33％ and 55.17％ respectively;for the 8-10 years,3 variables could be used,among which uterine cervix length was the best variable for its largest area under the ROC curve (0.893),1.88 cm was the best cut-off limit with a sensitivity of 100％ and a specificity of 71.43％.Condusions Pelvic ultrasound examination is a valuable tool for the diagnosis and differentiation between CPP,isolated premature thelarche/pubarche /menarche and normal girls. Key words: Ultrasonography; Puberty, precocious

A case-control study on the influential factors of precocious puberty girls

Objective To investigate the relenvant factors of precocious puberty and provide the basis for precaution of high risk group of precocious puberty .Methods A 1：1 case-control study was performed on 50 healthy girls and 50 precocious puberty girls .Results Univariate analysis showed an significant differences in the exposure rates of following five factors between cases and controls：intake of nutritious and health products ,favoring meat and poultry,long time watching television,addiction to TV ads,family economic condition （The Chi-square values are 7.045,9.073,17.478,14.063,12.246 respectively,all P〈0.05）.The Logisitc regression showed that favoring meat and poultry,long time watching television and addiction to TV ads had significant differences among precocious puber -ty children（The Wald′s Value were 4.846,6.850,5.662 respectively,all P〈0.05）.Conclusion favoring meat and poultry,long time watching television and addiction to TV play an important roles in precocious puberty . Key words: Precocious puberty; Influential factors; Girls

Correlation of zearalenone pollution with precocious puberty girls

Objective To explore the relationship of zearalenone (ZEA) and precocious puberty in girls. Methods The peripheral serums from 71 cases of precocious puberty girls and 50 cases of healthy girls were collected respectively and concentrations of ZEA were detected by high performance liquid chromatography.Bone age, body mass index (BMI), volume of uterus and ovaries, concentrations of estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were detected, and the residence of each subject was recorded as well. Results (1)In 71 patients, 52 patients were diagnosed as idiopathic central precocious puberty, others were diagnosed as premature thelarche.(2) In 71 patients, serum ZEA was detected from 51 patients, and undetected in 20 patients.(3)Concentration of ZEA in precocious puberty girls [(318±34) ng/L ]was significantly increased than that in healthy girls [(143±35) ng/L, P=0.002], but no distinct difference existed between ICPP group and PT group(P=0.326). (4)Compared with uterus volume of ZEA in the undetected patients (1.975±0.150)cm3, the uterus volume of ZEA detected patients (2.972±0.180) cm3, which was significantly enlarged, there was significant difference (P=0.01); Percentage of overweight girls in ZEA detected patients (31.4%, 16/51 cases) was lower than which in ZEA undetected patients (65.0%, 13/20 cases, P=0.01); Although there was no statistical differences in the breast diameter, bone age, value of E2, LH and FSH between ZEA detected patients and undetected patients(all P>0.05), but the increased tendency in ZEA detected patients existed.(5) ZEA in serum was detected in 53.3%(16/30 cases) patients living in the cities, and the rate was obviously lower than 82.9% of the patients (34/41 cases) living in the countryside, there was significant difference (P=0.007). Conclusions ZEA is correlated with precocious puberty in girls.ZEA pollution might be one of reasons for precocious puberty occurrence. Key words: Precocious puberty; Environmental endocrine disruptors; Zearalenone; Food safety

Luteinising hormone levels to screen for precocious puberty in girls

Luteinising hormone levels to screen for precocious puberty in girls

Significance of Kisspeptin levels in diagnosis and therapeutic evaluation of idiopathic central precocious puberty in girls

Objective To explore the significance and value of Kisspeptin in the diagnosis and therapeutic evaluation for idiopathic central precocious puberty(ICPP) in girls. Methods Twenty-four girls with ICPP and 21 girls with premature thelarche(PT) who were hospitalized in the Children's Hospital of Jiangxi Province from Jun.2012 to Jan.2013 were selected as ICPP group and PT group, and 25 healthy girls were selected as healthy control group.The coagulation vein blood in ICPP girls before treatment and after 6 months treatment and PT girls and healthy girls were collected, and enzyme linked immunosorbent assay was used to detect the plasma Kisspeptin level, and t test was used to analyze the differences among the 4 groups. Results The Kisspeptin level of girls with ICPP[(1.80±0.13) μg/L] was apparently higher than that of PT groups [(1.41±0.10) μg/L] and healthy control group[(1.39±0.13) μg/L], and the differences were statistically significant(t=10.974, 14.787, all P=0.000). However, the difference of Kisspeptin between PT group and healthy control group was not statistically significant(t=10.970, P=0.095). In addition, the Kisspeptin level of ICPP girls who undewent 6-month treatment [(1.49±0.15) μg/L ]was significantly lower than that before treatment, and the difference was statistically significant(t=10.80, P<0.05); but, compared with PT group and healthy control group, there was no significant difference(t=6.32, P=0.060; t=7.44, P=0.214). Conclusions Kisspeptin level is related with pubertal development, and it can be used as an important evidence in ICPP diagnosis and an important parameter in ICPP therapeutic evaluation. Key words: Kisspeptin; Idiopathic central precocious puberty; Premature thelarche

Association of aromatase (TTTA)n repeat polymorphisms with central precocious puberty in girls

Precocious puberty is characterized by early activation of the pituitary-gonadal axis. Oestrogen is the final key factor to start the onset of puberty. The cytochrome P450 19A1 (CYP19A1) gene encodes an aromatase that is responsible for the conversion of androgens to oestrogen, which is a key step in oestrogen biosynthesis. The aim of this study was to identify CYP19A1 gene mutations or polymorphisms in girls with central precocious puberty (CPP). We evaluated the frequency of allelic variants of the CYP19A1 exons and the tetranucleotide tandem repeat (TTTA)n in intron 4 in 203 idiopathic central precocious puberty (CPP) girls and 101 normal healthy women. The genotype analysis of the CYP19A1 (TTTA)n polymorphism revealed six different alleles ranging from seven to 13 repeats. Among the six different repeat alleles detected in this study, the (TTTA)₁₃ repeat allele was only detected in the patient group and carriers of the (TTTA)₁₃ allele were significantly associated with an increased risk of CPP (OR = 1·509, 95% CI = 1·425-1·598, P = 0·033). Carriers of the (TTTA)₁₃ repeat allele were significantly younger at pubertal onset and had higher levels of oestrogen than noncarriers of the (TTTA)₁₃ repeat allele. Although nine polymorphisms were detected in exons of the CYP19A1 gene, no clinical significance was observed. In this study, carriers of a higher repeat (TTTA)₁₃ polymorphism in intron 4 of the CYP19A1 gene had higher levels of oestrogen. Those carrying the (TTTA)₁₃ repeat allele may have a higher risk of developing CPP.