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1.
Clin Endocrinol (Oxf) ; 97(1): 91-99, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35436365

RESUMO

OBJECTIVE: Induction of puberty with exogenous oestrogen results in considerable variability in final uterine and breast volumes. We set out to quantify the variability of these two outcome measures with a view to establishing monitoring methods that could be used to individualise treatment protocols. DESIGN: A prospective observational study. PARTICIPANTS: Sixteen participants with pubertal delay and primary amenorrhoea, due to hypogonadism were recruited from paediatric gynaecology and endocrinology clinics at University College London Hospital. A standardised protocol of transdermal 17ß oestradiol (17ßE) was used (Evorel™), with a starting dose of 12.5 mcg increasing to 25 mcg (patch changed twice weekly) after 4 months. Follow up was every 2 months for a total of 8 months. MEASUREMENTS: Uterine dimensions using ultrasound, oestradiol concentrations and breast development assessed by both Tanner staging and 3D photographic imaging. RESULTS: After 8 months of treatment, the changes in oestradiol concentrations (0-174 pmol), uterine volume growth (4.4-16.4 ml) and breast volume (1.76-140.1 ml) varied greatly between individuals. Of uterine parameters, transverse uterine diameter was most closely associated with serum oestradiol levels at 8 months (beta standardised coefficient = 0.80, p = .001). Change in breast volume was associated with age of treatment initiation (beta standardised coefficient 0.55 p = .04). CONCLUSIONS: We demonstrate variation in response to exogenous oestrogen, emphasising the necessity for individualised dose titration. In the absence of sensitive oestradiol assays, uterine transverse measurements may be used as a surrogate marker of oestrogen sensitivity to guide early dose adjustment. 3D breast imaging may provide a quantitative assessment of breast development to complement Tanner breast staging.


Assuntos
Puberdade Precoce , Útero , Criança , Estradiol , Estrogênios , Feminino , Humanos , Puberdade/fisiologia , Útero/diagnóstico por imagem
2.
Ital J Pediatr ; 48(1): 45, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331309

RESUMO

BACKGROUND: Constitutional delay of growth and puberty (CDGP) is classified as the most frequent cause of delayed puberty (DP). Finding out the etiology of DP during first evaluation may be a challenge. In details, pediatricians often cannot differentiate CDGP from permanent hypogonadotropic hypogonadism (PHH), with definitive diagnosis of PHH awaiting lack of puberty by age 18 yr. Neverthless, the ability in providing a precise and tempestive diagnosis has important clinical consequences. MAIN TEXT: A growth failure in adolescents with CDGP may occur until the onset of puberty; after that the growth rate increases with rapidity. Bone age is typically delayed. CDGP is generally a diagnosis of exclusion. Nevertheless, other causes of DP must be evaluated. A family history including timing of puberty in the mother and in the father as well as physical examination may givee information on the cause of DP. Patients with transient delay in hypothalamic-pituitary-gonadal axis maturation due to associated conditions, such as celiac disease, inflammatory bowel diseases, kidney insufficiency and anorexia nervosa, may experience a functional hypogonadotropic hypogonadism. PHH revealing testosterone or estradiol low serum values and reduced FSH and LH levels may be connected to abnormalities in the central nervous system. So, magnetic resonance imaging is required in order to exclude either morphological alterations or neoplasia. If the adolescent with CDGP meets psychological difficulties, treatment is recommended. CONCLUSION: Even if CDGP is considered a variant of normal growth rather than a disease, short stature and retarded sexual development may led to psychological problems, sometimes associated to a poor academic performance. A prompt and precise diagnosis has an important clinical outcome. Aim of this mini-review is throwing light on management of patients with CDGP, emphasizing the adolescent diagnosis and trying to answer all questions from paediatricians.


Assuntos
Hipogonadismo , Síndrome de Klinefelter , Puberdade Tardia , Adolescente , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/terapia , Humanos , Hipogonadismo/complicações , Hipogonadismo/diagnóstico , Hipogonadismo/terapia , Síndrome de Klinefelter/complicações , Puberdade/fisiologia , Puberdade Tardia/diagnóstico , Puberdade Tardia/etiologia , Puberdade Tardia/terapia
3.
Trends Endocrinol Metab ; 33(5): 359-370, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35331614

RESUMO

Normal growth pattern variations [i.e., constitutional advancement and constitutional delay of growth and puberty (CAGP and CDGP)] are the mirror image of each other and are associated with early puberty (EP) and delayed puberty (DP), respectively. Differences between CAGP and CDGP relate not only to auxological characteristics (height, weight) but also to insulin-like growth factor-1 (IGF-1). IGF-1 levels in CAGP are above average whereas in CDGP they are below average, suggesting a role for IGF-1 in the induction of these growth patterns. Herein, we provide data suggesting that early activation of the growth hormone (GH)/IGF-1 axis induces the growth pattern of CAGP. Moreover, we suggest that IGF-1 is a decisive factor for the release of the gonadotropin-releasing hormone (GnRH) inhibition brake that occurs in prepuberty. It is therefore crucial for puberty onset.


Assuntos
Hormônio do Crescimento Humano , Fator de Crescimento Insulin-Like I , Hormônio do Crescimento , Humanos , Puberdade/fisiologia
4.
Arch Iran Med ; 25(1): 64-70, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-35128913

RESUMO

Mini puberty is the important period of infancy life that can have a serious impact on sexual development in both sexes. In the infants born very preterm and with extremely low birth weight, mini puberty changes including changes in clinical, hormonal, and imaging data are severe and long lasting, especially in girls. It can be called "exaggerated mini puberty". In this study, a 6-month preterm infant with bronchopulmonary dysplasia presented with periodic vaginal bleeding, Tanner stage 3 breast development, and Tanner stage 2 pubic hair. We did follow up clinical and para-clinical evaluations for the infant during one year and compared the obtained data with those of similar published articles. During one year of monitoring, the case gradually grew to the normal pre-pubertal state, without any hormonal suppressive treatment. Exaggerated mini puberty is a temporary physiologic state in very low birth weight (VLBW) preterm infants that does not require any extra hormonal and surgical interventions.


Assuntos
Recém-Nascido Prematuro , Puberdade , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Masculino , Puberdade/fisiologia , Hemorragia Uterina
5.
Eat Behav ; 45: 101602, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35219033

RESUMO

INTRODUCTION: Early pubertal timing increases risk for disordered eating (DE) in females, but the extent to which associations persist after puberty and are relevant to all types of DE symptoms is unclear. Factors that link pubertal timing and DE also remain unknown, although leading theories posit that adiposity and body-focused psychosocial factors play a key role. Thus, this study examined pubertal timing effects on several types of DE symptoms in young adult women and evaluated whether body mass index (BMI), pressures for thinness, thin-ideal internalization, and/or history of weight-based teasing account for such associations. METHODS: This study included a racially and ethnically diverse sample of 342 female college students (Mage = 20.44, SD = 3.46). Women retrospectively reported their age at onset of menses, which served as the pubertal timing indicator, and completed self-report questionnaires on DE symptoms, perceived pressures for thinness, thin-ideal internalization, and history of weight-based teasing. BMI was calculated from height/weight measurements. RESULTS: Earlier pubertal timing was associated with body dissatisfaction and binge eating, but not other DE symptoms (dieting, excessive exercise, muscle building) in young adult women. BMI accounted for pubertal timing effects on body dissatisfaction, whereas none of the examined factors explained pubertal timing effects on binge eating. CONCLUSIONS: Earlier pubertal timing may exert long-term effects on only some DE symptoms in women, and the etiologic factors underlying pubertal timing effects on DE outcomes may differ across symptom types.


Assuntos
Insatisfação Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Adulto , Feminino , Humanos , Puberdade/fisiologia , Puberdade/psicologia , Estudos Retrospectivos , Magreza/psicologia , Adulto Jovem
6.
JAMA Netw Open ; 5(2): e2146873, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35119461

RESUMO

Importance: Earlier pubertal onset may be associated with an increased risk of chronic diseases. However, the extent to which growth in the first 5 years of life-an important developmental life stage that lays the foundation for later health outcomes-is associated with pubertal onset remains understudied. Objective: To assess whether changes in weight, length or height, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) during the first 5 years of life are associated with earlier pubertal onset. Design, Setting, and Participants: This cohort study used data from 36 cohorts participating in the Environmental Influences on Child Health Outcomes program from January 1, 1986, to December 31, 2015. Participant inclusion required at least 1 anthropometric measure in the first 5 years of life and at least 1 measure of pubertal onset. Data were analyzed from January 1 to June 30, 2021. Exposures: Standardized velocities of weight, length or height, and BMI gain in early infancy (0-0.5 years), late infancy (0.5-2 years), and early childhood (2-5 years). Main Outcomes and Measures: Markers of pubertal onset for boys and girls, including age at peak height velocity (APHV), time to puberty score greater than 1, time to Tanner pubic hair stage greater than 1, and time to menarche. Multivariable regression models were used to estimate mean differences in APHV by growth periods. Results: Of 7495 children included in the study, 3772 (50.3%) were girls, 4505 (60.1%) were White individuals, and 6307 (84.1%) were born during or after the year 2000. Girls had a younger APHV (10.8 vs 12.9 years) than boys. In boys, faster weight gain (per 1-SD increase) in early infancy (ß, -0.08 years; 95% CI, -0.10 to -0.06), late infancy (ß, -0.10 years; 95% CI, -0.12 to -0.08), and early childhood (ß, -0.07 years; 95% CI, -0.08 to -0.05) was associated with younger APHV after adjusting for the child's birth year, race, and Hispanic ethnicity as well as maternal age at delivery; educational level during pregnancy; annual household income during pregnancy; prenatal cigarette smoking; whether the mother was nulliparous; whether the mother had gestational diabetes, hypertension, or preeclampsia; mode of delivery; prepregnancy BMI; gestational weight gain; and gestational age at delivery. Similar associations were observed for length or height and BMI gains during the same age periods. In girls, faster gains (per 1-SD increase) in weight (ß, -0.03 years; 95% CI, -0.05 to -0.01) and height (ß, -0.02 years; 95% CI, -0.04 to 0.00) in early childhood were associated with younger APHV. Faster BMI gain in late infancy was associated with earlier time to menarche, whereas faster BMI gain in early childhood was associated with earlier time to Tanner pubic hair stage greater than 1. Conclusions and Relevance: This cohort study found that faster gains in weight, length or height, or BMI in early life were associated with earlier pubertal onset. The results suggest that children who experience faster early growth should be monitored closely for earlier onset of puberty and referred as appropriate for supportive services.


Assuntos
Idade de Início , Desenvolvimento Infantil , Puberdade/fisiologia , Adolescente , Antropometria , Criança , Feminino , Humanos , Masculino , Estados Unidos
7.
PLoS One ; 17(1): e0262816, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35077489

RESUMO

BACKGROUND: The majority children living with HIV infection now survive into adulthood because of effective antiretroviral therapy (ART), but few data exist on their growth during adolescent years. This study investigated growth patterns and evaluated factors associated with suboptimal growth in adolescents with perinatally-acquired HIV infection. METHODS: This retrospective cohort study included HIV-infected adolescents, aged 13 to 18 years, with at least 5 years of ART follow-up at a large HIV clinic in the Gauteng Province, South Africa. Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ) and body mass index (BMI)-for-age Z-scores were calculated using World Health Organization (WHO) growth standards. Growth velocity graphs were generated utilising the mean height change calculated at 6-monthly intervals, using all available data after ART initiation, to calculate the annual change. Other collected data included WHO HIV disease staging, CD4%, HIV viral loads (VLs), ART regimens and tuberculosis co-infection. RESULTS: Included were 288 children with a median age of 6.5 years (IQR 4.2;8.6 years) at ART initiation, and 51.7% were male. At baseline the majority of children had severe disease (92% WHO stages 3&4) and were started on non-nucleoside reverse transcriptase inhibitor-based regimens (79.2%). The median CD4% was 13.5% (IQR 7.9;18.9) and median HIV viral load log 5.0 (IQR 4.4;5.5). Baseline stunting (HAZ <-2) was prevalent (55.9%), with a median HAZ of -2.2 (IQR -3.1;-1.3). The median WAZ was -1.5 (IQR -2.5;-0.8), with 29.2% being underweight-for-age (WAZ <-2). The peak height velocity (PHV) in adolescents with baseline stage 3 disease was higher than for those with stage 4 disease. Being older at ART start (p<0.001) and baseline stunting (p<0.001) were associated with poorer growth, resulting in a lower HAZ at study exit, with boys more significantly affected than girls (p<0.001). CONCLUSIONS: Suboptimal growth in adolescents with perinatally-acquired HIV infection is a significant health concern, especially in children who started ART later in terms of age and who had baseline stunting and is more pronounced in boys than in girls.


Assuntos
Desenvolvimento do Adolescente , Infecções por HIV/congênito , Puberdade/fisiologia , Adolescente , Fármacos Anti-HIV/uso terapêutico , Estatura , Índice de Massa Corporal , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Estudos Retrospectivos , África do Sul/epidemiologia
9.
Nutrients ; 14(2)2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-35057456

RESUMO

Dietary fat and fat quality have been inconsistently associated with puberty timing. The aim of this study was to investigate the prospective associations of dietary fat, saturated fatty acid (SFA), polyunsaturated fatty acid (PUFA), and monounsaturated fatty acid (MUFA) with puberty timing. Using longitudinal data from China Health and Nutrition Survey (CHNS) and Southwest China Childhood Nutrition and Growth (SCCNG) Study, we analyzed dietary data, anthropometric measurements, and potential confounders. Dietary intakes were assessed by 3-day 24-h recalls. Age at Tanner stage 2 for breast/genital development (B2/G2) and age at menarche/voice break (M/VB) were used as puberty development markers. Cox proportional hazard regression models were used to estimate the relevance of dietary intake of total fat, SFA, PUFA, and MUFA on puberty timing. Among 3425 girls and 2495 boys, children with higher intakes of total fat and PUFA were more likely to reach their B2/G2 or M/VB at an earlier age. Associations were not attenuated on additional adjustment for childhood dietary protein intake. However, higher intakes of SFA or MUFA were not independently associated with puberty development. A higher intake of dietary fat and PUFA in prepuberty was associated with earlier puberty timing, which was independent of dietary protein intake.


Assuntos
Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Puberdade/fisiologia , Adolescente , Fatores Etários , Criança , China , Ingestão de Alimentos , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Insaturados/administração & dosagem , Feminino , Humanos , Estudos Longitudinais , Masculino , Menarca/fisiologia , Inquéritos Nutricionais , Modelos de Riscos Proporcionais , Estatísticas não Paramétricas
10.
Pediatr Diabetes ; 23(2): 194-202, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34877761

RESUMO

OBJECTIVE: The measurement of glycated hemoglobin (HbA1c) represents one way to detect type 1 and 2 diabetes in children at an early stage. However, to date, variations in HbA1c levels are not fully understood, even in healthy children. With this in mind, the present study aimed to establish HbA1c reference values in healthy children and to investigate the influence of various independent variables. STUDY DESIGN AND METHODS: Two thousand four hundred fifty-five healthy children and adolescents aged between 0.5 and 18 years participated in the population-based cohort study LIFE Child, Germany. Age- and gender-dependent percentiles were estimated, enabling HbA1c values to be converted into standard deviation scores (SDS). Logistic regression models were applied to assess associations between HbA1c-SDS (as outcome) and age, gender, BMI, birth weight, physical activity, pubertal status, and socioeconomic status (SES; as explanatory variables). RESULTS: The mean HbA1c value was 31.79 mmol/mol or 5.06% (SD = 3.3 mmol/mol, SD = 0.3%). Positive associations with HbA1c values were identified for age (b = 0.09, p < 0.001), gender (b = 0.25, p = 0.007), and BMI-SDS (b = 0.06, p < 0.001). In addition, obesity was related to higher HbA1c values (b = 0.29, p < 0.001). Compared to prepuberty, the pubertal and postpubertal stages were associated with higher HbA1c levels. Furthermore, higher SES was associated with higher HbA1c-SDS (b = 0.01, p = 0.04). CONCLUSION: The present study established HbA1c reference values based on a large sample of healthy German children and adolescents. Age, gender, SES, pubertal stage, and BMI were found to be associated with higher HbA1c levels.


Assuntos
Fatores Etários , Índice de Massa Corporal , Hemoglobina A Glicada/análise , Puberdade/metabolismo , Fatores Sexuais , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Correlação de Dados , Feminino , Alemanha , Voluntários Saudáveis , Humanos , Lactente , Masculino , Puberdade/fisiologia
11.
Chronobiol Int ; 39(3): 409-420, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34814789

RESUMO

Puberty onset is tightly regulated by a broad spectrum of neuroendocrine signals and peripheral stimuli which coordinate the hypothalamic-pituitary-gonadal (HPG) axis activation. Numerous studies suggest that light stimulation influences HPG axis function; however, the effect of blindness on puberty timing remains controversial. Given that menarche is a suitable marker for sexual development initiation, the evaluation of the age at which blind girls attain it allows to indirectly assess the effect of light-dark cycle disruption on pubertal development. The present investigation aimed to review the evidence regarding menarcheal age drift in visually impaired girls, as well as to discuss the findings based on the existing hypotheses of the physiological mechanisms linking the light-dark cycle and photic sensitivity loss to the onset of puberty. Eleven studies were retrieved from a literature search conducted in PubMed, Scopus, ScienceDirect, SpringerLink, and Google Scholar databases. Eight studies concluded that light perception impairment is related to a moderately earlier age at menarche. Moreover, the evidence gathered in this review suggests a positive association between the degree of light perception loss and precocious menarcheal onset; yet, no conclusive outcomes were found regarding menarche advancement in acquired versus congenital blindness. We encourage further research aiming to elucidate the physiological mechanism underlying photosensitive regulation and blindness effect on the neuroendocrine pathways involved in human sexual maturation.


Assuntos
Menarca , Fotoperíodo , Cegueira , Ritmo Circadiano , Feminino , Humanos , Menarca/fisiologia , Puberdade/fisiologia
12.
Am J Epidemiol ; 191(1): 7-16, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33831178

RESUMO

Secular trends in earlier initiation of puberty have been observed in recent decades. One risk factor appears to be increases in adiposity, as measured by body mass index. This trend is particularly notable among Latino populations, who have higher rates of overweight/obesity compared with non-Latino White youth. Previous research has focused primarily on White girls, resulting in data gaps regarding male puberty and among potentially high-risk populations. Using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, we examined body mass index at age 5 years (2005-2006) and multiple markers of pubertal onset, assessed repeatedly and longitudinally at 7 in-person visits, starting at age 9 and continuing through age 14 (2009-2015), among 336 Mexican Americans in Salinas, California. We observed no associations among boys, but found significantly earlier thelarche in overweight (HR = 1.7, 95% CI: 1.1, 2.7) and obese girls (HR = 1.5, 95% CI: 1.0, 2.4), menarche in overweight girls (HR = 1.6; CI: 1.0, 2.4), and pubarche in obese girls (HR = 1.9; CI: 1.2, 3.0), compared with normal-weight girls. This study examined an understudied population and included key covariates, such as birth weight and early adverse events, which are typically omitted in studies.


Assuntos
Americanos Mexicanos/estatística & dados numéricos , Obesidade Pediátrica/etnologia , Puberdade/fisiologia , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Menarca/fisiologia , Circunferência da Cintura
13.
Mol Psychiatry ; 27(1): 606-623, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34117365

RESUMO

Suicide is the second leading cause of death among adolescents. While clinicians and researchers have begun to recognize the importance of considering multidimensional factors in understanding risk for suicidal thoughts and behaviors (STBs) during this developmental period, the role of puberty has been largely ignored. In this review, we contend that the hormonal events that occur during puberty have significant effects on the organization and development of brain systems implicated in the regulation of social stressors, including amygdala, hippocampus, striatum, medial prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Guided by previous experimental work in adults, we also propose that the influence of pubertal hormones and social stressors on neural systems related to risk for STBs is especially critical to consider in adolescents with a neurobiological sensitivity to hormonal changes. Furthermore, facets of the pubertal transition, such as pubertal timing, warrant deeper investigation and may help us gain a more comprehensive understanding of sex differences in the neurobiological and psychosocial mechanisms underlying adolescent STBs. Ultimately, advancing our understanding of the pubertal processes that contribute to suicide risk will improve early detection and facilitate the development of more effective, sex-specific, psychiatric interventions for adolescents.


Assuntos
Ideação Suicida , Suicídio , Adolescente , Adulto , Feminino , Giro do Cíngulo , Humanos , Masculino , Puberdade/fisiologia , Fatores de Risco
14.
Sci Rep ; 11(1): 23297, 2021 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-34857814

RESUMO

Accumulating evidence indicates that gut microbiota may regulate sex-hormone levels in the host, with effects on reproductive health. Very little is known about the development of intestinal microbiota during puberty in humans. To assess the connection between pubertal timing and fecal microbiota, and to assess how fecal microbiota develop during puberty in comparison with adult microbiota, we utilized a Finnish allergy-prevention-trial cohort (Flora). Data collected at 13-year follow-up were compared with adult data from a different Finnish cohort. Among the 13-year-old participants we collected questionnaire information, growth data from school-health-system records and fecal samples from 148 participants. Reference adult fecal samples were received from the Health and Early Life Microbiota (HELMi) cohort (n = 840). Fecal microbiota were analyzed using 16S rRNA gene amplicon sequencing; the data were correlated with pubertal timing and compared with data on adult microbiota. Probiotic intervention in the allergy-prevention-trial cohort was considered as a confounding factor only. The main outcome was composition of the microbiota in relation to pubertal timing (time to/from peak growth velocity) in both sexes separately, and similarity to adult microbiota. In girls, fecal microbiota became more adult-like with pubertal progression (p = 0.009). No such development was observed in boys (p = 0.9). Both sexes showed a trend towards increasing relative abundance of estrogen-metabolizing Clostridia and decreasing Bacteroidia with pubertal development, but this was statistically significant in girls only (p = 0.03). In girls, pubertal timing was associated positively with exposure to cephalosporins prior to the age of 10. Our data support the hypothesis that gut microbiota, particularly members of Ruminococcaceae, may affect pubertal timing, possibly via regulating host sex-hormone levels.Trial registration The registration number for the allergy-prevention-trial cohort: ClinicalTrials.gov, NCT00298337, registered 1 March 2006-Retrospectively registered, https://clinicaltrials.gov/show/NCT00298337 . The adult-comparison cohort (HELMi) is NCT03996304.


Assuntos
Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal/microbiologia , Puberdade/fisiologia , Caracteres Sexuais , Adolescente , Clostridiaceae , Estudos de Coortes , Estrogênios/metabolismo , Fezes/microbiologia , Feminino , Finlândia , Humanos , Masculino , Ruminococcus , Inquéritos e Questionários
15.
Nutrients ; 13(12)2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34960039

RESUMO

Obesity and cardiometabolic risk have been associated with vitamin D levels even in children. The objective of the present study was to evaluate the association between insulin resistance (IR), cardiometabolic risk factors, and vitamin D in children from prepubertal to pubertal stages. A total of 76 children from the PUBMEP study, aged 4-12 years at baseline, were included. Children were evaluated in prepubertal and pubertal stages. Anthropometric measurements and selected cardiometabolic risk biomarkers, such as plasma glucose, blood lipids, insulin, adiponectin, leptin, and blood pressure, and serum 25-hydroxyvitamin D (25(OH)D) were determined. Children were categorized by obesity degree and IR status combined before and after puberty. Paired t-test and multivariate linear regression analyses were conducted. During puberty, the increase in triacylglycerols, insulin, and HOMA-IR and the decrease in QUICKI were significantly associated with the reduction in 25(OH)D (B = -0.274, p = 0.032; B = -0.219, p = 0.019; B = -0.250, p = 0.013; B = 1.574, p = 0.013, respectively) after adjustment by BMI-z, sex, and pubertal stage. Otherwise, prepubertal non-IR children with overweight/obesity that became IR during puberty showed a significant decrease in 25(OH)D and HDL-c, and an increase in waist circumference and triacylglycerol concentrations (p < 0.05 for all) over time. These results suggest that changes in IR seem to be associated with an effect on 25(OH)D levels during puberty, especially in children with overweight.


Assuntos
Fatores de Risco Cardiometabólico , Resistência à Insulina , Obesidade Pediátrica/metabolismo , Puberdade/fisiologia , Vitamina D/análogos & derivados , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estado Nutricional , Vitamina D/sangue
16.
Nutrients ; 13(11)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34836102

RESUMO

Background: Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. Aims: We aimed to characterize the singularities of follow-up, anthropometric and metabolic evolution of a large cohort of pediatric patients with obesity in a specialized university hospital outpatient obesity unit. Patients and methods: Follow-up duration (up to seven years), attrition rate and anthropometric and metabolic evolution of 1300 children and adolescents with obesity were studied. An individualized analysis was conducted in patients attaining a high level of weight loss (over 1.5 BMI-SDS (standard deviation score) and/or 10% of initial weight; n = 252; 19.4%) as well as in "metabolically healthy" patients (n = 505; 38.8%). Results: Attrition rate was high during the early stages (11.2% prior to and 32.5% right after their initial metabolic evaluation). Mean follow-up time was 1.59 ± 1.60 years (7% of patients fulfilled 7 years). The highest BMI reduction occurred in the first year (-1.11 ± 0.89 SDS, p < 0.001 in 72.5% of patients). At the end of the follow-up, improvements in glucose and lipid metabolism parameters were observed (both p < 0.05), that were highest in patients with the greatest weight reduction (all p < 0.01), independent of the time spent to achieve weight loss. The pubertal growth spurt negatively correlated with obesity severity (r = -0.38; p < 0.01) but patients attaining adult height exceeded their predicted adult height (n = 308, +1.6 ± 5.4 cm; p < 0.001). "Metabolically healthy" patients, but with insulin resistance, had higher blood pressure, glucose, uric acid and triglyceride levels than those without insulin resistance (all p < 0.05). Preservation of the "metabolically healthy" status was associated with BMI improvement. Conclusions: Behavioral management of children with obesity can be effective and does not impair growth but is highly conditioned by high attrition. The best results regarding BMI reduction and metabolic improvement are achieved in the first year of intervention and can be preserved if follow-up is retained.


Assuntos
Assistência ao Convalescente/estatística & dados numéricos , Tratamento Conservador/estatística & dados numéricos , Manejo da Obesidade/métodos , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/terapia , Adolescente , Antropometria , Índice de Massa Corporal , Criança , Feminino , Seguimentos , Humanos , Perda de Seguimento , Masculino , Puberdade/fisiologia , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
17.
Nature ; 599(7885): 436-441, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34732894

RESUMO

The state of somatic energy stores in metazoans is communicated to the brain, which regulates key aspects of behaviour, growth, nutrient partitioning and development1. The central melanocortin system acts through melanocortin 4 receptor (MC4R) to control appetite, food intake and energy expenditure2. Here we present evidence that MC3R regulates the timing of sexual maturation, the rate of linear growth and the accrual of lean mass, which are all energy-sensitive processes. We found that humans who carry loss-of-function mutations in MC3R, including a rare homozygote individual, have a later onset of puberty. Consistent with previous findings in mice, they also had reduced linear growth, lean mass and circulating levels of IGF1. Mice lacking Mc3r had delayed sexual maturation and an insensitivity of reproductive cycle length to nutritional perturbation. The expression of Mc3r is enriched in hypothalamic neurons that control reproduction and growth, and expression increases during postnatal development in a manner that is consistent with a role in the regulation of sexual maturation. These findings suggest a bifurcating model of nutrient sensing by the central melanocortin pathway with signalling through MC4R controlling the acquisition and retention of calories, whereas signalling through MC3R primarily regulates the disposition of calories into growth, lean mass and the timing of sexual maturation.


Assuntos
Desenvolvimento Infantil/fisiologia , Estado Nutricional/fisiologia , Puberdade/fisiologia , Receptor Tipo 3 de Melanocortina/metabolismo , Maturidade Sexual/fisiologia , Adolescente , Idoso de 80 Anos ou mais , Animais , Criança , Ciclo Estral/genética , Ciclo Estral/fisiologia , Feminino , Homozigoto , Humanos , Hipotálamo/citologia , Hipotálamo/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Melanocortinas/metabolismo , Menarca/genética , Menarca/fisiologia , Camundongos , Fenótipo , Puberdade/genética , Receptor Tipo 3 de Melanocortina/deficiência , Receptor Tipo 3 de Melanocortina/genética , Maturidade Sexual/genética , Fatores de Tempo , Ganho de Peso
18.
PLoS One ; 16(11): e0260137, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793547

RESUMO

OBJECTIVE: Growth-based determination of pubertal onset timing would be cheap and practical. We aimed to determine this timing based on pubertal growth markers. Secondary aims were to estimate the differences in growth between cohorts and identify the role of overweight in onset timing. DESIGN: This multicohort study includes data from three Finnish cohorts-the Type 1 Diabetes Prediction and Prevention (DIPP, N = 2,825) Study, the Special Turku Coronary Risk Factor Intervention Project (STRIP, N = 711), and the Boy cohort (N = 66). Children were monitored for growth and Tanner staging (except in DIPP). METHODS: The growth data were analyzed using a Super-Imposition by Translation And Rotation growth curve model, and pubertal onset analyses were run using a time-to-pubertal onset model. RESULTS: The time-to-pubertal onset model used age at peak height velocity (aPHV), peak height velocity (PHV), and overweight status as covariates, with interaction between aPHV and overweight status for girls, and succeeded in determining the onset timing. Cross-validation showed a good agreement (71.0% for girls, 77.0% for boys) between the observed and predicted onset timings. Children in STRIP were taller overall (girls: 1.7 [95% CI: 0.9, 2.5] cm, boys: 1.0 [0.3, 2.2] cm) and had higher PHV values (girls: 0.13 [0.02, 0.25] cm/year, boys: 0.35 [0.21, 0.49] cm/year) than those in DIPP. Boys in the Boy cohort were taller (2.3 [0.3, 4.2] cm) compared with DIPP. Overweight girls showed pubertal onset at 1.0 [0.7, 1.4] year earlier compared with other girls. In boys, there was no such difference. CONCLUSIONS: The novel modeling approach provides an opportunity to evaluate the Tanner breast/genital stage-based pubertal onset timing in cohort studies including longitudinal data on growth but lacking pubertal follow-up.


Assuntos
Previsões/métodos , Puberdade/metabolismo , Puberdade/fisiologia , Adolescente , Idade de Início , Fenômenos Biológicos , Estatura , Mama/crescimento & desenvolvimento , Criança , Estudos de Coortes , Feminino , Finlândia , Genitália/crescimento & desenvolvimento , Crescimento/fisiologia , Humanos , Masculino , Homens , Modelos Teóricos , Sobrepeso , Fatores de Risco , Mulheres
19.
Front Endocrinol (Lausanne) ; 12: 718292, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603203

RESUMO

Objective: Knowledge of the biological parameters of pubertal growth spurt allows verification of secular changes and exploration of the timing of puberty. The aim of the study was to estimate final height, age at peak height velocity (APHV), and peak height velocity PHV (cm/y) in children and adolescents living at moderate altitude in Colombia. Methods: A cross-sectional study was designed in 2.295 schoolchildren from Bogotá (Colombia) with an age range from 5.0 to 18.9 years. Height (cm) was assessed. Preece-Baines model 1 (1PB) was used to make inferences about mathematical and biological parameters. Results: The five mathematical parameters estimated in general have reflected quality in the fit to the model, reflecting a small residual error. Final height was reached in boys at 170.8 ± 0.4 cm and in girls at 157.9 ± 0.2 cm. APHV was estimated at 12.71 ± 0.1 years in boys and 10.4 ± 0.2 years in girls. Girls reached APHV 2.2 years earlier than boys. In relation to PHV (cm/y), boys reached higher growth speed in height (7.4 ± 0.4 cm/y), and in girls it was (7.0 ± 0.2 cm/y). Conclusion: It was determined that final height was reached at 170.8 ± 0.4 cm in boys and 157.9 ± 0.2 cm in girls, and APHV (years) and PHV (cm/ye) were reached relatively early and with average peak velocity similar to Asian and Western populations. A large-scale longitudinal study is needed to confirm these findings.


Assuntos
Desenvolvimento do Adolescente , Altitude , Estatura , Desenvolvimento Infantil , Puberdade/fisiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Prognóstico
20.
Eur Rev Med Pharmacol Sci ; 25(19): 5986-5992, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34661258

RESUMO

OBJECTIVE: Type 2 diabetes mellitus (T2DM) and obesity are alarmingly increasing in children and adolescents. Hence, predictors for early metabolic abnormalities in childhood are urgently needed. We investigated glucose tolerance in children and adolescents with obesity, markers of insulin sensitivity between males and females and the potential association between the parameters measured during an OGTT (glucose, insulin, c-peptide) and prediabetes or stages of puberty. PATIENTS AND METHODS: Glucose tolerance in 89 children and adolescents with excess weight, aged 4-19 years, from Western Greece was studied. A 3-hour OGTT was performed and fasting glucose (FG), fasting insulin (FI), 1/FI, FG/FI, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Quantitative insulin sensitivity check index (QUICKI), ISI Matsuda index and Insulinogenic index (IGI30), were also calculated. RESULTS: No significant differences were observed in glucose values between males and females. Insulin and c-peptide concentrations were higher in the girls at several time points. FG/FI was significantly higher in the boys. Girls with obesity may be at higher risk for future insulin resistance. CONCLUSIONS: Better surveillance of pubertal girls with obesity is crucial and can be achieved using additional information provided by an OGTT, since they appear to be at a higher risk for beta-cell exhaustion. During the OGTT, not only are the baseline and 2-hour glucose and insulin measurements useful for predicting future metabolic risks and development of T2DM in children and adolescents with obesity, but additional time measurements may also be helpful.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/epidemiologia , Resistência à Insulina , Obesidade Pediátrica/epidemiologia , Adolescente , Peptídeo C/sangue , Criança , Pré-Escolar , Feminino , Teste de Tolerância a Glucose , Grécia , Humanos , Insulina/sangue , Masculino , Puberdade/fisiologia , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
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