Puberty In Children Research Articles

Childhood adversity, pubertal timing and self-harm: a longitudinal cohort study.

The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm. Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV - males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses. For every additional type of adversity; participants had an average 12-14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00-1.00 for aPHV and RR 1.00, 95% CI 1.00-1.01 for AAM]. A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions.

Substrate Oxidation Is Altered by Obesity During Submaximal Cycling in Prepubertal and Early Pubertal Children: A Quality Study.

To examine substrate oxidation in prepubertal and early pubertal children as a function of body weight, body composition, and sex during an exhaustive cycling test. This study included 320 children in prepubertal and early puberty (Tanner stage 1 or 2; n = 188 males) who completed a minimum of 4 stages (2-5min/stage) of an adapted version of the McMaster exhaustive exercise protocol on an upright cycle ergometer. Substrate utilization, relative to individual VO2peak, was determined using VO2 and VCO2 data, obtained with breath-by-breath gas analysis during exercise. Both peak (mg/kg lean body mass·min) and submaximal lipid oxidation (mg/kg lean body mass·min) were highest (P < .01) in children with healthy weight (HW), then overweight, and lowest in obese (OB). Both females with HW (compared with males with HW) and females with OB (compared with males with OB) had higher (P < .01) peak and submaximal lipid oxidation. In children with OB, fat-free mass correlated positively (P < .01) with submaximal lipid oxidation (r = .50). In contrast, in children with HW and overweight, fat-free mass correlated positively (P < .01) with carbohydrate oxidation (r = .52 and r = .47, respectively). Obesity during childhood may alter substrate oxidation during exercise. These results may have implications in the implementation of exercise programs in prepubertal or early puberty to control adiposity.

Participation in organized sports activities and evaluation of self-esteem among children in puberty

Participation in organized sports activities and evaluation of self-esteem among children in puberty

RELATIONSHIP BETWEEN FRIENDSHIP QUALITY AND ANXIETY IN FACING PHYSICAL CHANGES DURING PUBERTY IN FEMALE STUDENTS OF ELEMENTARY SCHOOL

Background: Friends have the most influence in an individual's life. Friendship contains specific elements, such as trust, openness, sharing of ups and downs, and learning to deal with conflict. Puberty children try to have friends to share their feelings with others. Because with good friendship will reduce minimize the anxiety they experience at puberty (Wulandari, Kustriyani, &amp; Fiyannti, 2018).Objectives: The Purpose of this study to determine the relationship between friendship quality and anxiety facing the physical changes of puberty in female students at SDIT Bakti Insani Sleman Yogyakarta.Methods: This study was a quantitative research with survey method, with a total sampling of 47 respondents. Research instruments with questionnaires, the questionnaire was adopted from Marvienda (2007), researchers used a measuring instrument in the form of a friendship quality scale and anxiety scale of female students during puberty. Data analysis using person product moment.Results: The result showed respondents age 100% at the early adolescent stage, 74.5% respondents had not yet menarche, 25.5% had menarche, the average value of friendship quality was 84.89 and the average anxiety value was 63.91. The results showed that there was no relationship between the quality of friendship with anxiety facing physical changes during puberty in female students at SDIT Bakti Insani Sleman Yogyakarta (r = -.38, p-value = .802).Conclusion: This study found that the majority of respondents were in their early teens and only a small proportion had experienced menarche. The average value of high friendship quality shows that the quality of friendship is also high and the average value of anxiety in the medium shows moderate anxiety. The implications of this study are as input or consideration in preparing adolescent reproductive health starting from the beginning of puberty at school. Keywords: Quality of Friendship, Anxiety, Puberty, Physical Changes

Growth and Puberty in Children with Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBD) are gastrointestinal tract pathologies of unknown etiology; they have an alternating trend, with active and silent phases. IBD are classified in two main forms: ulcerative colitis (UC) and Crohn’s disease (CD). Both have chronic and recurrent course, gastrointestinal symptoms, and extraintestinal manifestations. The altered immune response role seems to be important both in UC and CD. In the majority of cases, CD begins with abdominal pain, diarrhea, decrease in appetite, and weight loss; there can be also perianal fistulas, rhagades, and perianal recurrent abscesses. In addition, retarded growth and delayed puberty can precede the development of the disease or can even be predominant at onset. Growth retardation is found in 40% of IBD patients, but the underlying mechanism of this and other extra-intestinal manifestations are partially known: the main hypotheses are represented by malnutrition and inflammatory response during the active phase of the disease. The increased level of pro-inflammatory cytokines can influence growth, but also the onset of puberty and its progression. In addition, it could be essential to clarify the role and the possible effects of all the currently used treatments concerning growth failure and delayed puberty.

Pubertal timing and adult fracture risk in men: A population-based cohort study

Background Puberty is a critical period for bone mass accrual, and late puberty in boys is associated with reduced bone mass in adult men. The role of variations in pubertal timing within the normal range for adult fracture risk in men is, however, unknown. We, therefore, assessed the association between age at peak height velocity (PHV), an objective measure of pubertal timing, and fracture risk in adult men. Methods and findings In the BMI Epidemiology Study Gothenburg, 31,971 Swedish men born between January 1, 1945, and December 31, 1961, with detailed growth data (height and weight) available from centrally archived school healthcare records and the conscription register were followed until December 31, 2016. Age at PHV was calculated according to a modified infancy–childhood–puberty model, and fracture information was retrieved from the Swedish National Patient Register. The mean ± SD age at PHV was 14.1 ± 1.1 years. In total, 5,872 men (18.4%) sustained at least 1 fracture after 20 years of age and 5,731 men (17.9%) sustained a non-vertebral fracture after 20 years of age during a mean ± SD follow-up of 37.3 ± 11.7 years. Cox proportional hazards models adjusted for birth year and country of origin revealed that age at PHV was associated with the risk of any fracture and non-vertebral fracture. Participants with age at PHV in the highest tertile (after 14.5 years of age) were at greater risk of any fracture (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08–1.22, P < 0.001) and non-vertebral fracture (HR 1.16, 95% CI 1.09–1.24, P < 0.001) compared with those with age at PHV in the lowest tertile (at 13.6 years of age or younger). Additional adjustments for birthweight, childhood BMI, adult educational level, and young adult height did not attenuate the associations between age at PHV and adult fracture risk. Limitations of this study include the inability to adjust for important risk factors for fracture, inadequate power to assess the relation between pubertal timing and specific fracture types, and the limited generalizability to other populations. Conclusions In this study, we observed that late pubertal timing was associated with increased adult fracture risk in men. These findings suggest that information on pubertal timing might aid in the identification of those men at greatest risk of fracture.

Premature Adrenarche in Children with Prader-Willi Syndrome Treated with Recombinant Human Growth Hormone Seems to Not Influence the Course of Central Puberty and the Efficacy and Safety of the Therapy.

Puberty in children with Prader-Willi syndrome (PWS) is usually delayed and/or incomplete but in some patients premature/early adrenarche is observed. We assessed the premature adrenarche (PA) in PWS patients during the recombinant human growth hormone (rhGH) therapy and influence of PA on the course of central puberty (CP), rhGH efficacy and safety, and patients’ metabolic state. Forty-nine PWS patients were treated with rhGH, 11 presented with PA (group 1) and 14 had normal course of adrenarche (group 2). PA was observed in 22.5% of the PWS children treated with rhGH. The mean time between the rhGH start and the adrenarche, the rhGH dose, the growth velocity and the insulin-like growth factor 1 SD (IGF1 SD) during the treatment, as well as the time of CP, final height SD and BMI SD were similar in both groups. There were also no significant differences in the metabolic assessment—the oral glucose tolerance test (OGTT) and lipid profile results. PA may be a part of the clinical picture of PWS, apart from hypogonadotrophic hypogonadism and it seems to have no influence on CP in PWS patients. The rhGH efficacy and safety were comparable in the patients with PA and the normal course of adrenarche.

Characteristics of true precocious puberty in children over last three years

Characteristics of true precocious puberty in children over last three years

The prevalence rate of true precocious puberty in children by region of the Republic of Uzbekistan (as of December 1, 2018)

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

Physical deviation and precocious puberty among school-aged children in Leshan City: an investigative study.

ObjectiveWe investigated physical deviation and precocious puberty among school-aged children in Leshan City, to provide a theoretical basis for the management of precocious puberty in children.MethodsWe selected 12 primary schools of Leshan City using a cluster random sampling method and conducted physical examinations among healthy students aged 4 12 years. A total of 11,000 students were recruited (5502 boys and 5498 girls). We measured body mass index (BMI), and participants were tested for precocious puberty according to the Tanner stages and standard maps. Nutritional status was also evaluated.ResultsObese and overweight children accounted for a high proportion of participants; the prevalence of underweight was the lowest. The prevalence of obesity among boys was higher than that in girls. Precocious puberty was mainly observed in girls, particularly those age 7 years old. The prevalence of precocious puberty among overweight and obese children was higher than that in children with normal weight.ConclusionWe identified a significant sex difference in precocious puberty among children in Leshan City. Overweight and obesity may be associated with precocious puberty.

HUBUNGAN PENGETAHUAN IBU TENTANG KESEHATAN REPRODUKSI REMAJA DENGAN UPAYA MEMPERSIAPKAN MASA PUBERTAS PADA ANAK DI SD NEGERI 20 PEKANBARU

Adolescence is a period of rapid growth and development both physically, psychologically and intellectually. The special nature of adolescents has a great sense of curiosity, likes adventure and challenges and tends to dare to bear the risk of his actions without being preceded by careful consideration. Mothers who have a major role and share in the period of seeing the development of their children to be able to undergo puberty, because mothers who pay more attention and follow the development of each of their children. This study uses quantitative research with analytical methods and cross sectional research design, namely research to see the relationship between independent and dependent variables. The purpose of the study is to determine the relationship of maternal knowledge about adolescent reproductive health with efforts to prepare for puberty in children at SD Negeri 20 Pekanbaru. The results of the study are there is a relationship between maternal knowledge about adolescent reproductive health with efforts to prepare for puberty in children in SD Negeri 20 Pekanbaru with a P value = 0.027.

Does Renal Function Remain Stable after Puberty in Children who underwent Ureteral Reimplantation due to Ureterovesical Junction Obstruction?

Ureteric reimplantation due to ureterovesical junction (UVJ) obstruction enjoys high success in the short term. However, renal function after reimplantation must accommodate the numerous changes in the pediatric urinary tract that occur along with child development that may theoretically cause an occult loss of renal function. The purpose of this study was to evaluate whether improved renal function after ureter reimplantation for antenatal diagnosed UVJ obstruction remains stable after puberty. Twenty-one children who underwent open reimplantation using Politano-Leadbetter technique were followed until they completed puberty. Mean age at surgery was 14.3 months (range: 3-60 months). Five (23.8%) of 21 children had right hydronephrosis, 13 (61.9%) had left hydronephrosis, and 3 (14.3%) had bilateral hydronephrosis. The Society for Fetal Urology (SFU) level of the hydronephrosis was 3 (47.6%) in 10 children and 4 (52.4%) in remaining 11. Fourteen (66.6%) patients had poor renal function upon surgery and the remaining seven (33.4%) patients had moderate renal function. The mean renal function upon operation was 28 ± 4.3 (mean ± standard deviation [SD]). Reimplantation led to the increase in the RRF in the short-term period from 28 ± 4.3% prior to the surgery to 36.4 ± 5% (p < 0.001) in all patients and remains stable 35 ± 5% after puberty in all the reviewed patients. Our data demonstrate for the first time that successful ureteral reimplantation following antenatal diagnosis of UVJ obstruction is associated with an improvement in renal function, not only during short- and midterm follow-up but also allows preserving the renal function throughout the puberty period.

Clinical experience of growth hormone replacement for pediatric intracranial germ cell tumor.

Intracranial germ cell tumors (IGCTs) account for 8-15% of brain tumors in children in Eastern Asia and typically occur at the age of puberty. Recently, adjuvant therapy has been modified to ameliorate post-treatment complications such as cognitive dysfunction, in patients with IGCT. However, endocrine problems remain to be resolved. There is reluctance to use growth hormone (GH) at an early stage after treatment for IGCT because of the risk of tumor recurrence; however, GH replacement must be administered before the onset of puberty in children with short stature. There is little guidance on this issue due to a lack of literature on the risks of GH replacement therapy in patients with IGCT. This study aimed to evaluate the safety of GH replacement. In this retrospective study, 6 patients with IGCT who were under the age of 18years when they started GH replacement therapy were reviewed. Histopathological analysis and/or analysis of tumor markers was used to confirm a diagnosis. All six cases who underwent GH replacement therapy showed no recurrence. GH replacement therapy was administered in 5 patients for short stature and all achieved a height within ± 2.0 standard deviation. GH replacement for children with IGCT was safe in our case series. Placental alkaline phosphatase levels in cerebrospinal fluid can be used to facilitate the decision on when to initiate GH replacement.

Male precocious puberty described in literature of the Spanish Golden Age.

Aristotle was the first author who described the existence of abnormalities in the timing of human puberty. In the classic Greek-Roman period, Pliny the Elder and Phlegon of Tralles described the first individual cases of precocious puberty in children. During the Middle Ages, precocious puberty in the male (but not in the female) was ignored. We present what is, to our knowledge, the first full description in European literature of male precocious puberty and its consequences in an adult. This case is included in a book of the miscellaneous genre of Spanish Renaissance literature (Jardin de Flores Curiosas) written by Antonio de Torquemada in the sixteenth century.

Adipokines: A gear shift in puberty.

SummaryIn this review, we discuss the role of adipokines in the onset of puberty in children with obesity during adrenarche and gonadarche and provide a clear and detailed overview of the biological processes of two major players, leptin and adiponectin. Adipokines, especially leptin and adiponectin, seem to induce an early onset of puberty in girls and boys with obesity by affecting the hypothalamic‐pituitary‐gonadal (HPG) axis. Moreover, adipokines and their receptors are expressed in the gonads, suggesting a role in sexual maturation and reproduction. All in all, adipokines may be a clue in understanding mechanisms underlying the onset of puberty in childhood obesity and puberty onset variability.

Estrogen can promote the expression of genes related to precocious puberty in GT1-7 mouse hypothalamic GnRH neuronal cell line via activating G protein-coupled estrogen receptor.

The G protein-coupled estrogen receptor (GPER) was proved to be a new type of estrogen receptor (ER). It is unknown that whether estrogen can regulate the secretion of gonadotrophin releasing hormone (GnRH) in GT1-7 cells through the mechanism with the involvement of GPER. The GnRH, estradiol (17β-estradiol, E2) and GPER in peripheral blood of precocious puberty children were detected by ELISA and RT-qPCR assays. After E2 treatment, the levels of GPER and GnRH in GT1-7 cells were detected. Following G1 treatment, cell proliferation was examined using a CCK-8 assay. The levels of GnRH, KISS1, GPR54, nNOS, c-FOS in GT1-7 cells were assessed following GT1-7 cells were induced by E2 combined with G1 or G15. GnRH, E2 and GPER were significantly increased in precocious puberty children. After E2 treatment, GT1-7 cells expressed more GnRH and GPER was markedly elevated and reached a peak at 8 h. The KISS1, GPR54 and nNOS in GT1-7 cells were significantly increased with G1 induction, but were significantly decreased with G15 induction compared with E2 induction alone. Collectively, GPER cannot promote the release of GnRH via affecting the proliferation of GT1-7 cells, but it may regulate GnRH through KISS1/GPR54 pathway, which provides novel ideas for precocious puberty children treatment.

Saliva diagnostics of sex hormones and subgingival microflora in children in puberty

During puberty there are increased levels of sex hormones, which can affect the oral environment. At this period, there is a peak prevalence of periodontal pathology believed to be related to alteration in the subgingival microflora. This study investigated the interaction between sex hormones isolated in the saliva, and the subgingival microflora in children undergoing puberty. The study included 60 children aged 10–14 years who were monitored: 30 without gingivitis (up to 25% Papillary Bleeding Index—PBI) and good oral hygiene, and 30 children with plaque-induced gingivitis (over 50% PBI). All patients were registered with a periodontal status using a medical card developed for this purpose. For the study of sex hormones (oestradiol, progesterone and testosterone), samples of unstimulated saliva were taken under fasting condition in the morning and were tested by using labelled immunological analysis and liquid chromatography with mass spectrometry [LC-MS (MS(QQQ)]. Gingival sulcus from six teeth was taken with paper pins to test nine control strains (pooled sample) by real-time polymerase chain reaction (PCR). The results showed that, when comparing children with gingivitis with healthy children, only the oestradiol hormone had elevated values. In the children with gingivitis, the composition of the subgingival microflora was much more varied and complex, with a tendency to increase the species diversity of microorganisms from the red complex. The oestradiol levels in saliva correlated with the total number of subgingival microorganisms, as well as with some species of microorganisms, Capnocytophaga gingivalis, Peptostreptococcus micros, Treponema denticola and Tannerella forsythia.

Precocious puberty in children - diagnosis, causes and treatment

Precocious puberty in children - diagnosis, causes and treatment

Early pubertal maturation and risk of childhood asthma: A Mendelian randomization and longitudinal study.

Studies on early puberty and incident asthma have reported inconsistent results and are mainly performed in females. In this longitudinal study, we investigated the causal relationship between pubertal maturation and asthma through Mendelian randomization (MR) and explored the joint effect of overweightness and early pubertal maturation on asthma. We used data from the Taiwan Children Health Study with longitudinal follow-ups of 2991 children aged 11-17years. Six puberty-related single-nucleotide polymorphisms (combined into a weighted allelic score) were used to yield genetic instrumental variables for early puberty. Early pubertal maturation was defined as reaching a certain pubertal stage earlier than the median age for that stage. Incident asthma cases were calculated by excluding children with a history of asthma prior to that age. The results of MR analysis revealed that early pubertal maturation was associated with active asthma (OR=1.18; 95% CI: 1.08-1.28); this effect was significant in male children. Early pubertal maturation significantly increased the risk of incident asthma outcomes at 12 and 17years of age in both sexes (hazard ratio=2.15; 95% CI: 1.21-3.84). Taking non-overweight and non-early puberty children as the reference group, we observed a synergistic effect of overweightness and early pubertal maturation on asthma risk (OR=1.08; 95% CI: 1.04-1.11) in children of both sexes. Early screening and intervention for obesity are recommended to prevent future early pubertal onset and asthma occurrence.

Clinical and endocrinological profile of children with precocious puberty at a tertiary care center

Introduction: Puberty is said to be precocious if it appears before chronological age of 8 years in girls and 9 years in boys. Untreated early puberty leads to early sexual maturation with growth and bone age advancement with early fusion, leading to the paradox of tall stature in childhood but short adult final height. Objective: The objective of this study was to study the profile of precocious puberty in children with respect to clinical and endocrinological outcome. Materials and Methods: This was a prospective study of 28 children (23 girls) who presented with precocious puberty in pediatric endocrine outpatient department. Presenting complaints, clinical findings including anthropometry, investigations (biochemical and radiological), treatment, and outcome with follow-up visits (every 3 monthly), were recorded. Results: Age at the presentation was 5.4±2.6 years. Most common presentation in girls was breast development (82.6%) followed by axillary hair development (39.13%), pubic hair development (30.43%), vaginal bleeding (13%), and clitoral hypertrophy (4.3%). History of recent height spurt was reported in 69.57% of girls. Boys presented with pubic hair growth and increased penile length (100%), change in voice (40%), seizures, or behavioral issues including aggressiveness. Etiology varied with the idiopathic cause constituting majority of the cases in girls (43.5%) with other causes being ovarian tumor (4.3%), adrenal adenoma (4.3%), and thelarche variant (4.3%). In boys, hypothalamic hamartoma (60%) was the most common cause followed by sex cord tumors (40%). The mean advancement in bone age on presentation was 3.4 years. Baseline luteinizing hormone (LH) was found to be high in patients with central causes like hypothalamic hamartomas than in children with other cause. Gonadotropin-releasing hormone (GnRH) stimulation test was positive (maximal stimulated LH after aqueous GnRH analog &gt;3 mIU/ml by chemiluminescence immunoassay) in 61.5% of patients. Height velocity post-treatment showed a declining trend as compared to previous records before the onset of treatment and bone age advancement also slowed down. Conclusions: Increasing trend of precocious puberty and its adverse effect on final height and psychological profile of patients mandates the need for early referral and diagnosis and appropriate management.