Fertility of Women Treated during Childhood with Triptorelin (Depot Formulation) for Central Precocious Puberty: The PREFER Study.
Hormone research in paediatrics
BACKGROUND:Gonadotropin-releasing hormone analogues (GnRHa) administered as depot formulations are the standard of care for children with central precocious puberty (CPP). Puberty resumes after treatment discontinuation, but little is known concerning fertility in women who have been treated with GnRHa for CPP during childhood. METHODS:The PREFER (PREcocious puberty, FERtility) study prospectively analysed fertility, via a series of questionnaires, in women treated during childhood with triptorelin (depot formulation) for CPP. Co-primary endpoints were the proportion of women wanting a pregnancy any time before study inclusion and during the follow-up period but not pregnant 6 and 12 months after stopping contraception and the waiting time to pregnancy (WTP). RESULTS:A total of 574 women were identified, and 194 women were included in the analysis. Although there were not enough data for primary endpoint assessment, few women (1.7%) reported issues with fertility or were unable to become pregnant despite trying to conceive. Most pregnancies (84.4%, 95% CI [67.2-94.7%]) occurred within 1 year of trying to conceive, in line with the WTP for women without previous CPP. CONCLUSION:The results, based on a limited sample of patients, suggest that CPP treated with triptorelin does not negatively impact women's fertility in adulthood. These results need to be consolidated with a subsequent study performed when these women will have reached their mid-thirties.
10.1159/000513702
Precocious Puberty in Boys: A Study Based on Five Years of Data from a Single Center in Northern China
Ziqin Liu,Xiaohui Li,Xiaobo Chen
Journal of clinical research in pediatric endocrinology
Objective:To evaluate the clinical features and etiology of precocious puberty (PP) in Chinese boys. Methods:In this study, data from boys who were referred for evaluation of PP from 2015 to 2020 at a tertiary hospital in Northern China were retrospectively analyzed. Results:Eighty-two boys were diagnosed with PP from 2015 to 2020. Sixty-two patients (75.6%) were diagnosed with central PP (CPP), and twenty patients (24.4%) were diagnosed with peripheral PP (PPP). In the CPP group, forty-nine cases were classified as idiopathic CPP, and thirteen patients had pathogenic CPP. The top three causes of PPP were congenital adrenal hyperplasia, germ cell tumors and familial male-limited PP. Conclusion:The etiology of PP in males is diverse. The majority of CPP cases in Chinese boys are idiopathic rather than organic.
10.4274/jcrpe.galenos.2021.2021.0033
Which parameters predict the beneficial effect of GnRHa treatment on height in girls with central precocious puberty?
Vuralli Dogus,Gonc Nazli E,Ozon Zeynep Alev,Kandemir Nurgun,Alikasifoglu Ayfer
Clinical endocrinology
OBJECTIVE:Data about GnRHa on adult height in girls with central precocious puberty (CPP) have shown variable results, ranging from improvement of growth prognosis to lack of any benefit. This study was designed to delineate the criteria to decide which girls with idiopathic CPP (iCPP) will have a height benefit from GnRHa treatment. DESIGN:Retrospective PATIENTS: 102 girls with iCPP who had reached final height (FH) were included. MEASUREMENTS:Auxological, hormonal and radiological findings at treatment onset, and FHs were extracted from records. RESULTS:Most important factor affecting height gain was chronological age (CA) at treatment onset. All the girls treated ≤6.4 years of age achieved a height gain of ≥1SDS, while none of the girls treated ≥8.3 years of age made the target. 75.6% of patients who started GnRHa between the ages of 6.4 and 8.3 years had a height gain of ≥1SDS. Most important factors affecting height gain in those treated 6.4-8.3 years were advanced bone age (BA), basal estradiol (E ) and pubertal stage (r : 0.906; P < .001). All individuals with BA advancement of ≥2.6 years or E of ≥32.6 pg/ml or pubertal stage of ≥3 had significant height gain, and none of the cases with BA advancement of <2 years or E of <21.5 pg/ml or pubertal stage of <2 had a height gain of ≥1SDS. CONCLUSIONS:Treatment with GnRHa is unquestionably beneficial to improve FH in girls with iCPP when initiated ≤6.4 years of age. GnRHa treatment after 8.3 years of age may not improve FH. Girls between the ages of 6.4 and 8.3 years at presentation can have a better height gain if BA (≥2.6 years over CA) and pubertal findings (pubertal stage ≥3 or E ≥32.6 pg/ml) are well-advanced.
10.1111/cen.14420
Central nervous system imaging in girls with central precocious puberty: when is necessary?
Archives of endocrinology and metabolism
OBJECTIVE:The determinants of an increased risk of an organic pathology underlying central precocious puberty (CPP) in girls remain contentious. The present study aimed to determine the clinical and hormonal findings that can be used to differentiate organic and idiopathic CPP in girls as a screening method so that only those considered likely to have organic CPP undergo cranial magnetic resonance imaging (MRI). METHODS:The medical records of 286 girls that received GnRH agonist (GnRHa) therapy for CPP were retrospectively evaluated. Chronological and bone age, height, pubertal stage, and basal/stimulated gonadotropin and estradiol (E) levels, as well as cranial MRI findings at the time CPP was diagnosed were recorded. Clinical and hormonal parameters that can be used to differentiate between girls with organic and idiopathic CPP were identified using ROC curves. RESULTS:Organic CPP was noted in 6.3% of the participants. Puberty started before age 6 years in 88.9% of the girls with organic CPP. Mean E and peak luteinizing hormone (LH) levels were higher in the girls with organic CPP than in those with idiopathic CPP that were matched for pubertal stage, as follows: early stage puberty (Tanner 2 and 3): E: 62.4 ± 19.8 pg/mL 29.1 ± 9.5 pg/mL; peak LH: 16.8 ± 3.2 IU/L 12.2 ± 3.7 IU/L; advanced stage puberty (Tanner 4): mean E: 87.6 ± 3.4 pg/mL 64.6 ± 21.2 pg/mL; peak LH: 20.8 ± 0.4 IU/L 16.6 ± 5.8 IU/L (P < 0.001 for all). Thresholds for differentiating organic and idiopathic CPP in girls with early-stage puberty were 38.1 pg/mL for E (100% sensitivity and 80.4% specificity) and 13.6 IU/L for peak LH (100% sensitivity and 66.4% specificity). CONCLUSION:Pubertal symptoms and signs generally begin before age 6 years and hormone levels are much higher than expected for pubertal stage in girls with organic CPP. Based on the present findings, cranial MRI is recommended for girls aged < 6 years, as the risk of diagnosing an organic pathology is highest in this age group. Hormone levels higher than expected for pubertal stage might be another indication for cranial MRI, regardless of patient age. Cranial MRI should be performed in girls with early-stage puberty, and an E level > 38 pg/mL and/or a peak LH level > 13.6 IU/L.
10.20945/2359-3997000000259
Association between the onset age of puberty and parental height.
Limony Yehuda,Koziel Slawomir,Friger Michael
PloS one
BACKGROUND:The onset age of physiological puberty is greatly variable. This variability has been attributed to environmental factors and to genetic factors although a very little is explained by genome-wide associations studies. Previously, we reported the existence of an association between the onset age of puberty and final height. It is known that final height is associated with parental height (specifically, with the "target height"). We hypothesized that the variability of the onset age of puberty contributes to the attainment of a final height which is similar to the target height. We hypothesized that whenever a child's height-percentile differs from the target height percentile (we called this difference the "height gap"), the onset of puberty is advanced or delayed so that they are closer or even equal at the end of pubertal growth. The association between height gap and onset age of puberty was investigated in the reported study. METHODS:The study is an observational retrospective study on growth during puberty in 170 Israeli (60 girls) and 335 Polish children (162 girls). Anthropometric measurements were analyzed by multivariable linear regression with the onset age of the pubertal growth spurt (PGS) as the dependent variable, and two independent variables "height gap" and body mass index (BMI)-both standardized. RESULTS:The adjusted coefficient of determination (adj R2) between the onset age of the PGS and the two independent variables was 0.69 (Israeli girls), 0.50 (Israeli boys, BMI excluded), 0.25 (Polish girls) and 0.13 (Polish boys). A prediction model for the onset age of puberty is presented. CONCLUSIONS:The association between the "height gap" and the onset age of puberty suggests that the variability of this age is part of the targeted process of statural growth. The proposed model may explain idiopathic cases of precocious and delayed puberty.
10.1371/journal.pone.0211334
Central Precocious Puberty and Response to GnRHa Therapy in Children with Cerebral Palsy and Moderate to Severe Motor Impairment: Data from a Longitudinal, Case-Control, Multicentre, Italian Study.
Bruzzi Patrizia,Messina Maria Francesca,Bartoli Alessandra,Predieri Barbara,Lucaccioni Laura,Madeo Simona Filomena,Verrotti Alberto,De Luca Filippo,Iughetti Lorenzo
International journal of endocrinology
BACKGROUND:Children affected by neurodevelopmental disability could experience early pubertal changes at least 20 times more than the general population. Limited data about central precocious puberty (CPP) among children affected by cerebral palsy (CP) are available. METHODS:This is a longitudinal, observational, retrospective, case-control study involving 22 children affected by CPP and CP (group A), 22 paired with CP but without CPP (group B), and 22 children with CPP without CP. Auxological, biochemical, and instrumental data were collected at diagnosis of CPP and at 2 follow-up visits. RESULTS:No differences were detected between groups A (at baseline) and B. At diagnosis of CPP, height SDS adjusted for target height (H-TH SDS) was significantly reduced in A than in C (-0.63 ± 1.94 versus 1.56 ± 1.38), while basal LH and oestradiol levels were significantly elevated in A than in C. During follow-up, despite an effective treatment, growth impairment deteriorated in A than in C (Δ H-SDS from diagnosis of CPP to last follow-up: -0.49 ± 0.91 versus 0.21 ± 0.33, = 0.023). CONCLUSIONS:Diagnosis of CPP could be partially mislead in CP due to growth failure that got worse during follow-up despite therapy. CPP in CP seems to progress rapidly along time supporting the hypothesis of a more intense activation of hypothalamic-pituitary-gonadal-axis in these patients.
10.1155/2017/4807163
Effects of pomegranate extract in supplementing gonadotropin-releasing hormone therapy on idiopathic central precocious puberty in Chinese girls: a randomized, placebo-controlled, double-blind clinical trial.
Liu Jinsheng,Tang Jiulai
Food & function
Central precocious puberty (CPP) without organic abnormality is called idiopathic CPP (ICPP). The objective of this trial was to evaluate the effects of pomegranate extract in supplementing gonadotropin-releasing hormone (GnRH) analog therapy on ICPP-affected girls in the Chinese population. 286 girls, diagnosed with ICPP were initially enrolled into this trial, and among them 225 eligible patients were randomized to receive a combinational GnRH analog treatment supplemented with either a placebo or pomegranate extract on a daily basis for a period of 3 months. Their demographics, secondary sexual characteristics and hormone profiles were analyzed at baseline and end of trial. After 3 months of treatment, demographic profiles including bone age, growth velocity and height standard deviation score for bone age, and secondary sexual characteristics including uterus and ovary volume, as well as serum hormone profiles including estradiol, peak luteinizing hormone and insulin-like growth factor 1 were all significantly improved in girls receiving a combinational treatment of both GnRH analog and pomegranate extract. Daily consumption of pomegranate extract was able to supplement and improve the treatment outcomes of the GnRH analog therapy for ICPP in Chinese girls.
10.1039/c6fo01616b
Association between Dietary Patterns and Precocious Puberty in Children: A Population-Based Study.
Chen Chang,Chen Yao,Zhang Yunting,Sun Wanqi,Jiang Yanrui,Song Yuanjin,Zhu Qi,Mei Hao,Wang Xiumin,Liu Shijian,Jiang Fan
International journal of endocrinology
OBJECTIVE:The aim of the present study was to investigate the association between dietary patterns and precocious puberty among Shanghai children. METHODS:A cross-sectional study was conducted among Shanghai children by multistage stratified cluster random sampling in June 2014. Diet was assessed using a simplified food frequency questionnaire (FFQ). Height, weight, and Tanner stages of breast development, pubic hair growth, and testicular volume were carefully measured. Exploratory factor analysis was used to identify dietary patterns, and logistic regression analysis was used to assess the association between dietary patterns and precocious puberty. RESULTS:Three distinct dietary patterns, "traditional diet," "unhealthy diet," and "protein diet," were established. Neither the "traditional diet" pattern nor the "protein diet" pattern showed any association with precocious puberty, taking gender, BMI, and adjustment factors into consideration. The "unhealthy diet" pattern was significantly positively associated with precocious puberty in both boys (OR = 1.24, 95% CI = 1.02-1.51) and girls (OR = 1.31, 95% CI = 1.10-1.56). The relationship remained positive only for girls (OR = 1.25, 95% CI = 1.04-1.49) after adjustment for age and BMI but statistically nonsignificant after further adjustment for socioeconomic factors in both boys and girls. CONCLUSIONS:Dietary patterns were found to be related to precocious puberty among Shanghai children.
10.1155/2018/4528704
Prevalence and clinical characteristics of isolated forms of central precocious puberty: a cohort study at a single academic center.
Harbulot Carole,Lessim Soucounda,Simon Dominique,Martinerie Laetitia,Storey Caroline,Ecosse Emmanuel,De Roux Nicolas,Carel Jean-Claude,Léger Juliane
European journal of endocrinology
Objective:Isolated central precocious puberty (CPP) includes sporadic, familial and adoption-related forms, and the characterization of its etiology is challenging. This study investigated the prevalence and clinical characteristics of isolated CPP. Design and methods:This observational cohort study included all patients (n = 395) with CPP included in the database of a single academic pediatric care center over a period of 11.5 years. Results:In total, 332 of the 395 patients (84%) had isolated forms of CPP; the proportion of male patients was lower in this group than for non-isolated CPP (4 vs 33%, P < 0.0001). These patients had sporadic (n = 228, 68.5%), familial (n = 82, 25%) or adoption-related (n = 22, 6.5%) forms. Clinical characteristics at diagnosis were similar between groups, but girls with sporadic CPP were older at referral than those with familial or adoption-related CPP (P < 0.02), and birth weight SDS was lower in adopted patients than in those from the sporadic and familial groups (P < 0.01). In the 72 families containing patients with familial forms, both recessive and dominant transmissions were observed between first-degree relatives. Potential maternal or paternal transmission was identified in two-thirds of the studied families, in similar proportions. An autosomal dominant mode of transmission with low penetrance was suggested by the high proportion of affected parents (33 of the 72 families, 46%). Clinical presentation was similar whatever the mode of inheritance. Conclusion:These findings highlight the need for careful monitoring of the various forms of CPP. Future studies should explore pathophysiological mechanisms, particularly for familial forms.
10.1530/EJE-20-0862
Central precocious puberty in a girl with LEGIUS syndrome: an accidental association?
Orlandi Valentina,Cavarzere Paolo,Palma Laura,Gaudino Rossella,Antoniazzi Franco
Italian journal of pediatrics
BACKGROUND:Central precocious puberty is a condition characterized by precocious activation of the hypothalamic-pituitary-gonadal axis. It may be idiopathic or secondary to organic causes, including syndromes such as Neurofibromatosis type 1 (NF1). CASE PRESENTATION:We presented a girl of 6 years and 10 months with almost 11 café-au-lait skin macules, without other clinical or radiological signs typical of NF1, and with a central precocious puberty. Genetic analysis evidenced the new variant NM-152594.2:c.304delAp. (Thr102Argfs*19) in SPRED1 gene, which allowed to diagnose Legius syndrome. CONCLUSIONS:We report for the first time a case of central precocious puberty in a girl with Legius syndrome. The presence of central precocious puberty in a child with characteristic café-au-lait macules should suggest pediatricians to perform genetic analysis in order to reach a definitive diagnosis. Further studies on timing of puberty in patients with RASopathies are needed to better elucidate if this clinical association is casual or secondary to their clinical condition.
10.1186/s13052-021-01004-9
Higher poultry consumption was associated with an earlier age at menarche.
Acta paediatrica (Oslo, Norway : 1992)
AIM:To examine the association between meat consumption and earlier age of menarche among schoolgirls in Shanghai. METHODS:The study randomly selected 1981 schoolgirls aged 6-18 years in Shanghai using a two-stage random sampling design. Information on meat intake was collected using a semi-quantitative food frequency questionnaire. Menarche age, household income, physical activity and other covariates were obtained by standardised questionnaires. Logistic regression was used to analyse the association between intake of meat and earlier age of menarche. Earlier age of menarche was defined as first menstruation before 12 years of age. RESULTS:Among the 986 girls who had experienced menarche, 518/986 (52.5%) had earlier age of menarche. After adjusting for body mass index, age, physical activity, sleep, household income and parental education, consumption of poultry was positively associated with risk of earlier age of menarche (P-trend = .03). Girls who never consumed poultry had a lower risk of earlier age of menarche (odds ratio [OR]: 0.61, 95% confidence interval [CI]: 0.39-0.96). Neither the consumption of pork, beef, lamb, processed meat nor total meat consumption was associated with menarche age. CONCLUSION:Higher consumption of poultry was associated with an earlier age at menarche.
10.1111/apa.15554
Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis.
Eckert-Lind Camilla,Busch Alexander S,Petersen Jørgen H,Biro Frank M,Butler Gary,Bräuner Elvira V,Juul Anders
JAMA pediatrics
Importance:The initial clinical sign of pubertal onset in girls is breast gland development (thelarche). Although numerous studies have used recalled age at menarche (first menstruation) to assess secular trends of pubertal timing, no systematic review has been conducted of secular trends of thelarche. Objectives:To systematically evaluate published data on pubertal timing based on age at thelarche and evaluate the change in pubertal onset in healthy girls around the world. Data Sources:A systematic literature search was performed in PubMed and Embase of all original peer-reviewed articles published in English before June 20, 2019. Study Selection:Included studies used clinical assessment of breast development in healthy girls and used adequate statistical methods, including the reporting of SEs or CIs. The quality of the articles was evaluated by assessing study design, potential sources of bias, main characteristics of the study population, and methods of statistical analysis. Data Extraction and Synthesis:In accordance with PRISMA guidelines, all articles were assessed for eligibility independently by 2 authors. Weighted regression analysis was performed using a random-effects model. Main Outcomes and Measures:Studies examining age at thelarche (development of Tanner breast stage 2) in healthy girls. Results:The literature search resulted in a total of 3602 studies, of which 30 studies fulfilled the eligibility criteria. There was a secular trend in ages at thelarche according to race/ethnicity and geography. Overall, the age at thelarche decreased 0.24 years (95% CI, -0.44 to -0.04) (almost 3 months) per decade from 1977 to 2013 (P = .02). Conclusions and Relevance:The age at thelarche has decreased a mean of almost 3 months per decade from 1977 to 2013. A younger age at pubertal onset may change current diagnostic decision-making. The medical community needs current and relevant data to redefine "precocious puberty," because the traditional definition may be outdated, at least in some regions of the world.
10.1001/jamapediatrics.2019.5881
MKRN3 inhibits the reproductive axis through actions in kisspeptin-expressing neurons.
The Journal of clinical investigation
The identification of loss-of-function mutations in MKRN3 in patients with central precocious puberty in association with the decrease in MKRN3 expression in the medial basal hypothalamus of mice before the initiation of reproductive maturation suggests that MKRN3 is acting as a brake on gonadotropin-releasing hormone (GnRH) secretion during childhood. In the current study, we investigated the mechanism by which MKRN3 prevents premature manifestation of the pubertal process. We showed that, as in mice, MKRN3 expression is high in the hypothalamus of rats and nonhuman primates early in life, decreases as puberty approaches, and is independent of sex steroid hormones. We demonstrated that Mkrn3 is expressed in Kiss1 neurons of the mouse hypothalamic arcuate nucleus and that MKRN3 repressed promoter activity of human KISS1 and TAC3, 2 key stimulators of GnRH secretion. We further showed that MKRN3 has ubiquitinase activity, that this activity is reduced by MKRN3 mutations affecting the RING finger domain, and that these mutations compromised the ability of MKRN3 to repress KISS1 and TAC3 promoter activity. These results indicate that MKRN3 acts to prevent puberty initiation, at least in part, by repressing KISS1 and TAC3 transcription and that this action may involve an MKRN3-directed ubiquitination-mediated mechanism.
10.1172/JCI136564
Association between bisphenol a exposure and idiopathic central precocious puberty (ICPP) among school-aged girls in Shanghai, China.
Chen Yao,Wang Yingcan,Ding Guodong,Tian Ying,Zhou Zhijun,Wang Xiumin,Shen Lixiao,Huang Hong
Environment international
BACKGROUND:Bisphenol A (BPA) is a well-known and widely used endocrine disrupter, but data on its association with childhood reproductive development are limited. OBJECTIVES:We investigated the possible relationship between exposure to BPA and idiopathic central precocious puberty (ICPP) in school-aged girls. METHODS:We conducted a 1:1 matched case-control study in Shanghai, China, between July 2011 and September 2012. This study included 136 school-aged (6 to 9 years old) girls diagnosed with ICPP and 136 controls matched for age and body mass index (BMI). We measured the urinary BPA concentrations of all the girls and examined the association with odds of having ICPP. Laboratory examinations including serum estradiol (E2) levels, basal and gonadotropin-releasing hormone (GnRH)-stimulated luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels, bone ages (BA), and uterine and ovarian sizes were conducted in the ICPP girls. RESULTS:Median concentrations of urinary BPA in the ICPP and control groups were 6.35 and 1.17 μg/g creatinine (Cr), respectively (p < 0.001). After adjustment for confounders, compared to those with the lowest concentrations of BPA, the highest concentrations were associated with a 9.08-fold increased odds of having ICPP [odds ratio (OR) = 9.08, (95% confidence interval (CI): 2.83-29.15)]. In the ICPP group, modest negative correlation was present between urinary BPA concentrations (μg/g Cr) and peak FSH levels [β = -0.090 (95% CI: -0.178, -0.003), p = 0.044]. CONCLUSIONS:Our findings suggest that BPA exposure is associated with increased odds of having ICPP in school-aged girls, and the potential mechanism may be attributable to the relatively low FSH levels.
10.1016/j.envint.2018.02.041
Central Ceramide Signaling Mediates Obesity-Induced Precocious Puberty.
Heras Violeta,Castellano Juan Manuel,Fernandois Daniela,Velasco Inmaculada,Rodríguez-Vazquez Elvira,Roa Juan,Vazquez Maria Jesus,Ruiz-Pino Francisco,Rubio Matias,Pineda Rafael,Torres Encarnacion,Avendaño Maria Soledad,Paredes Alfonso,Pinilla Leonor,Belsham Denise,Diéguez Carlos,Gaytán Francisco,Casals Nuria,López Miguel,Tena-Sempere Manuel
Cell metabolism
Childhood obesity, especially in girls, is frequently bound to earlier puberty, which is linked to higher disease burden later in life. The mechanisms underlying this association remain elusive. Here we show that brain ceramides participate in the control of female puberty and contribute to its alteration in early-onset obesity in rats. Postnatal overweight caused earlier puberty and increased hypothalamic ceramide content, while pharmacological activation of ceramide synthesis mimicked the pubertal advancement caused by obesity, specifically in females. Conversely, central blockade of de novo ceramide synthesis delayed puberty and prevented the effects of the puberty-activating signal, kisspeptin. This phenomenon seemingly involves a circuit encompassing the paraventricular nucleus (PVN) and ovarian sympathetic innervation. Early-onset obesity enhanced PVN expression of SPTLC1, a key enzyme for ceramide synthesis, and advanced the maturation of the ovarian noradrenergic system. In turn, obesity-induced pubertal precocity was reversed by virogenetic suppression of SPTLC1 in the PVN. Our data unveil a pathway, linking kisspeptin, PVN ceramides, and sympathetic ovarian innervation, as key for obesity-induced pubertal precocity.
10.1016/j.cmet.2020.10.001
Diet during early life defines testicular lipid content and sperm quality in adulthood.
Crisóstomo Luís,Videira Romeu A,Jarak Ivana,Starčević Kristina,Mašek Tomislav,Rato Luís,Raposo João F,Batterham Rachel L,Oliveira Pedro F,Alves Marco G
American journal of physiology. Endocrinology and metabolism
Childhood obesity is a serious concern associated with ill health later in life. Emerging data suggest that obesity has long-term adverse effects upon male sexual and reproductive health, but few studies have addressed this issue. We hypothesized that exposure to high-fat diet during early life alters testicular lipid content and metabolism, leading to permanent damage to sperm parameters. After weaning ( after birth), 36 male mice were randomly divided into three groups and fed with a different diet regimen for 200 days: a standard chow diet (CTRL), a high-fat diet (HFD) (carbohydrate: 35.7%, protein: 20.5%, and fat: 36.0%), and a high-fat diet for 60 days, then replaced by standard chow (HFD). Biometric and metabolic data were monitored. Animals were then euthanized, and tissues were collected. Epididymal sperm parameters and endocrine parameters were evaluated. Testicular metabolites were extracted and characterized by 1H-NMR and GC-MS. Testicular mitochondrial and antioxidant activity were evaluated. Our results show that mice fed with a high-fat diet, even if only until early adulthood, had lower sperm viability and motility, and higher incidence of head and tail defects. Although diet reversion with weight loss during adulthood prevents the progression of metabolic syndrome, testicular content in fatty acids is irreversibly affected. Excessive fat intake promoted an overaccumulation of proinflammatory n-6 polyunsaturated fatty acids in the testis, which is strongly correlated with negative effects upon sperm quality. Therefore, the adoption of high-fat diets during early life correlates with irreversible changes in testicular lipid content and metabolism, which are related to permanent damage to sperm quality later in life.
10.1152/ajpendo.00235.2020
Acupuncture Improving Early Sexual Development of Girls with Peripheral Precocious Puberty: A Prospective Cohort Study.
Evidence-based complementary and alternative medicine : eCAM
OBJECTIVE:To study primarily on the effect of acupuncture on breast Tanner stage, serum sex hormone level, and TCM symptom scores in girls with peripheral precocious puberty (PPP). METHODS:19 eligible patients diagnosed with PPP received acupuncture intervention for 12 weeks, twice a week for 12 weeks, 24 sessions of acupuncture treatment in all, and then follow-up for 12 weeks. The primary outcome was the change in serum luteinizing hormone (LH) level, follicle-stimulating hormone (FSH) level, and breast Tanner stage at 12-week treatment and 12-week follow-up. Serum estradiol (E2) level and TCM symptom scores were also assessed. RESULTS:Nineteen patients with peripheral precocious puberty were treated with acupuncture. After the 12-week acupuncture intervention, the serum LH level, breast Tanner stage, and TCM symptom scores decreased significantly compared with baseline ( < 0.05); the serum FSH and E2 level did not change significantly after the 12-week treatment ( > 0.05). After the 12-week follow-up, breast Tanner stage and TCM symptom scores decreased significantly compared with baseline ( < 0.05), and there was no statistical difference between serum sex hormone (LH, FSH, and E2) level and baseline level ( > 0.05). During the period of acupuncture treatment, no side effects or serious adverse events occurred. CONCLUSIONS:Acupuncture is effective in regulating the hormone level and controlling early development process. It may be a viable alternative to the treatment of peripheral precocious puberty in girls. However, further randomized controlled trials are needed.
10.1155/2020/8091846
[Study of relationship between dietary patterns and precocious puberty of school-age girls in Shenzhen].
Meng F S,Chen D Y,Wu Y,Su Z,Xie H W,Zhou L
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
To explore the daily dietary behaviors of girls under precocious puberty and provide targeted measures for the prevention of precocious puberty. A case control study was conducted in a hospital in Shenzhen between September 2016 and December 2018. Girls with diagnosed precocious puberty were selected as case group. A 1∶1 matching was conducted. The control group was from 26 primary schools in Shenzhen. Dietary survey was conducted in parents, completing a self-administered questionnaire. Frequencies of 12 kinds of food intakes were investigated and dietary patterns were analyzed. Conditional logistic regression was used to analyze the relationship between dietary patterns and precocious puberty. A total of 568 girls were included in the study. Among them, those aged 8-year-old accounted for highest proportion (43.8%). The median of age was same in both case group and control group (8 years-old). There was no significant difference in ethnic group between two groups (>0.05). The medians of height, weight and BMI of case group were 135.0 cm, 30.2 kg and 16.6 kg/m(2), respectively, which were all higher than those of the control group (129.2 cm, 25.0 kg and 15.3 kg/m(2)), the differences were significant (<0.05). There was significant difference in nutritional assessment result between two groups (< 0.05). Three dietary patterns were defined, i.e. balanced pattern, high calorie and fat pattern and high protein diet pattern. The cumulative rate of variance contribution of the three dietary patterns was 0.541 2. The differences in the prevalence of three dietary patterns between two groups were significant ((2)=4.41, (2)=49.24, (2)=39.68, <0.05 respectively). Data from the multivariate regression analysis showed that both balanced dietary pattern (=0.633, 95%: 0.504-0.769) and high protein diet pattern (=0.622, 95%: 0.498-0.776) were protective factors for precocious puberty, while high calorie and fat pattern was risk factors (=1.850, 95%: 1.461-2.342). Balanced dietary pattern was common in school-aged girls. High calorie and fat pattern was risk factor for precocious puberty. Children should be encouraged to develop a balanced dietary habit and increasing the intake of legumes and fish since they are beneficial to normal growth and development.
10.3760/cma.j.cn112338-20190630-00478