Chen C., Chen Y., Zhang Y., Sun W., Jiang Y., Song Y., Zhu Q., Mei H., Wang X., Liu S., et al. Pearson et al. de Sousa Fortes L., Cipriani F.M., Coelho F.D., Paes S.T., Ferreira M.E. Among the causes of childhood obesity, eating habits and lifestyles are modifiable, and maintaining a balanced diet at home and receiving proper nutrition education are most effective during childhood when eating habits are formed [29]. Definition, etiology, and evaluation of precocious puberty. In children with central precocious puberty, Gn-RH will cause other hormone levels to increase. Subjects anthropometric and biochemical data are shown in Table 1. Because childrens eating behavior is affected by family environmental variables, eating habits that contribute to their parents obesity and disease-inducing behaviors may also be related. Several factors are most likely contributing at once. Pinyerd B., Zipf W.B. Onset of breast and pubic hair development and menses in urban Chinese girls. The demographic characteristics and clinical factors of the subjects are presented as means standard deviation for continuous variables and as frequencies with percentages for categorical variables. The reason for puberty beginning early depends on the type of precocious puberty; in many cases it is not known. In this study, the results regarding body shape awareness and satisfaction showed that childrens dissatisfaction with overweight or obesity was lower than the results reported by Cho et al. BMI, body mass index; AST, aspartate aminotransferase; ALT, alanine aminotransferase. The composition of the family, the number of siblings, the familys economic level by Koreas health insurance criteria (i.e., high, middlehigh, middle, and middlelow), and the parents educational level (i.e., college, high school) were investigated. The https:// ensures that you are connecting to the 2022 Aug 15;19(9):1442-1450. doi: 10.7150/ijms.74335. Precocious puberty is rare and has a clear female predominance. When the factors that make up the scale were considered separately, the score for moderation was the lowest overall, at 45.9 3.7, and was regularly the highest at 66.8 5.6 points. DAVID A. KLEIN, MD, MPH, JILL E. EMERICK, MD, JILLIAN E. SYLVESTER, MD, AND KAREN S. VOGT, MD. Clipboard, Search History, and several other advanced features are temporarily unavailable. . And in 2021, researchers from Britain found that leptin, a hormone released by fat cells that limits hunger, acted on a part of the brain that also regulated sexual development. Elevated estradiol levels in the setting of low LH may suggest an estrogen-secreting tumor.6 Hypothyroidism and exogenous steroid use should be excluded. Rhie Y.J., Lee K.H. The views expressed in this publication are those of the authors and do not reflect the official policy or position of the Departments of the Army, Navy, or Air Force; the Department of Defense; or the U.S. government. Clin. As a result of analyzing the responses and matching the rates of parents and childrens body shape awareness and satisfaction, disagreement in body perception rates was significantly higher in the obese group (p = 0.004). " Idiopathic" precocious puberty is the commonest cause of GDPP; . Pearson N., Timperio A., Salmon J., Crawford D., Biddle S.J. This form of precocious puberty is called central precocious puberty, or CPP. But lowering the age cutoff remains controversial, with many pediatricians arguing that the risk of a disorder is still large enough to justify extra precautions. The Different Effects of Skeletal Muscle and Fat Mass on Height Increment in Children and Adolescents Aged 6-11 Years: A Cohort Study From China. Mice and people with certain genetic mutations in this region experienced later sexual development. But, there are things you can do to reduce your child's chances of developing precocious puberty, including: Mayo Clinic does not endorse companies or products. Notably, bone age advancement by two standard deviations has low predictive value in differentiating benign pubertal variants from concerning causes of precocious puberty.6,30, Gynecomastia, or estrogen-mediated glandular breast tissue, is common in pubertal boys. Overweight was defined as children with a BMI in the 8594th percentile for age and sex, and obese was classified as those in the 95th percentile and above. Liu Y, Yu T, Li X, Pan D, Lai X, Chen Y, Wang X, Yu X, Fu S, Huang S, Lin C, Liu S. Endocrine. In a 2009 study of nearly 1,000 school-aged girls in Copenhagen, his team found that the average age of breast development had dropped by a year since his earlier study, to a little under 10, with most girls ranging from 7 to 12 years old. ; writingreview and editing, H.-S.L. I was interviewed quite a lot about the U.S. puberty boom, as we called it, said Dr. Juul. Medically reviewed by Karen Gill, M.D. All authors have read and agreed to the published version of the manuscript. Overview and treatment of precocious puberty. Parents who are aware of their childrens physical changes also experience anxiety and, as parents, feel the economic difficulties in drug treatment [23,24]. A tumor in the cells that make sperm (germ cells) or in the cells that make testosterone (Leydig cells). If the nutritional elements that the child needs are taken . Compared to boys with healthy weights, boys with obesity had a 2.7 times higher risk of early-onset puberty. Here's what you need to know about this condition and how it's treated. Central precocious puberty was diagnosed when secondary sexual characteristics appeared before the age of 8 years in girls and 9 years in boys, bone age was advanced for the patients chronological age, and the maximum luteinizing hormone level was higher than 5 IU/L in a Gonadotropin-releasing hormone (GnRH) stimulation test [10]. 20th ed. The mean BMI of the fathers was 25.3 3.0 kg/m2 and was highest among fathers of those in the overweight group (p = 0.014). p-Value determined by analysis of variance test (continuous variables) or 2 test (categorical variables). Keywords: In the overweight and obese group, the satisfaction rate was significantly lower (p < 0.001). A lower NQ was significantly affected by the obese status of children, especially diversity, moderation, and practice. Precocious puberty signs and symptoms include development of the following before age 8 in girls and before age 9 in boys. The functionality is limited to basic scrolling. Zhejiang Da Xue Xue Bao Yi Xue Ban. Body weight was measured using an electronic scale and recorded in kilograms. These are poorly understood but do not represent an underlying medical condition. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the association between precocious puberty and general obesity and central obesity. Kim H.Y., Kwon S., Lee J.S., Choi Y.S., Chung H.R., Kwak T.K., Park J., Kang M.H. Several possible causes for the recent rapid increase in the reported incidences of precocious puberty and medical treatment for it have been proposed, including increases in childhood obesity, opportunities to exposure to sexual stimulation through TV and the Internet, environmental hormones caused by environmental pollution, and parental focus on child development [3,4]. Initial workup should include measurements of serum FSH, LH, testosterone in boys or estradiol in girls, and bone age radiography (eTable B, Figure 27,8,25,44,45). Evid Based Complement Alternat Med. Puberty-timing is everything! Puberty usually occurs in girls between the ages of 10 and 14, while in boys it generally occurs later, between the ages of 12 and 16. . Studies in the decades since have confirmed, in dozens of countries, that the age of puberty in girls has dropped by about three months per decade since the 1970s. Association between Dietary Habits and Parental Health with Obesity among Children with Precocious Puberty, Multidisciplinary Digital Publishing Institute (MDPI). Clinical practice. In girls with initial pubertal changes, absence of menarche by 15 years of age is also concerning. From the various blood tests performed, four parameters (i.e., AST, ALT, serum glucose, total cholesterol) were collected and analyzed in this study. First, it is not possible to generalize the results of this study, as it was conducted with a limited audience in a single institution. PMC Search dates: October 1, 2016, to May 21, 2017. The definition of precocious puberty and the role of obesity in the age of onset have also been areas of debate since the Lawson Wilkins Society recommended a lowering of the age of onset of precocious puberty in US girls. If puberty begins younger than those cutoffs, doctors are supposed to screen the child for a rare hormonal disorder called central precocious puberty, which can spur puberty as early as infancy. Li X, Zhang X, Shen Z, Chen Z, Wang H, Zhang X. Int J Med Sci. That lack of data has led many scientists to be skeptical of the theory, said Dr. Hauser, who recently reported on how endocrine disrupters affect puberty in boys. Girls achieve peak height velocity during sexual maturity ratings 2 and 3 (mean: 8.3 cm per year, age 11 or 12 years) and boys during sexual maturity ratings 3 and 4 (mean: 9.5 cm per year, age 13 or 14 years). Wilcoxons rank-sum test was used for comparing the continuous variables, and the 2 test or Fishers exact test were used for comparing the categorical variables as appropriate. 2022 Jun 30;13:892005. doi: 10.3389/fendo.2022.892005. What causes precocious puberty? HHS Vulnerability Disclosure, Help 1, normal group; 2, overweight group; 3, obesity group. Pathogenesis and epidemiology of precocious puberty. Unable to load your collection due to an error, Unable to load your delegates due to an error. Earlier pubertal development was positively associated with obesity and central obesity in Chinese children. Selecting items of a food behavior checklist for the development of Nutrition Quotient (NQ) for children. A large population-based cross-sectional study using multistage, stratified cluster random sampling. Obesity: Excess weight and obesity is linked to early onset of menstruation in girls and early puberty in boys. Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. Any dysmorphic features or caf au lait spots may suggest Turner or McCune-Albright syndrome.47,9,27. Biro F.M., Khoury P., Morrison J.A. Accessibility Central obesity was defined by sex-specific waist-to-height ratio (WHtR) cut-offs (WHtR 0.48 for boys, WHtR 0.46 for girls). Central precocious puberty (CPP) is caused by abnormality in the hypothalamus-pituitary-gonadal axis. The brain starts the process with the production of a hormone called gonadotropin-releasing hormone (GnRH). Mol Cell Endocrinol 2010;324:4550.10.1016/j.mce.2010.01.026 The following are more likely causes according to Dr. Fine: Obesity Rising obesity rates in the U.S. are likely linked to early puberty in girls. Evaluation for chronic disease; hyperprolactinemia; testicular or adrenal neoplasm; use of prescription, recreational, or performance-enhancing drugs; or hypogonadism (e.g., Klinefelter syndrome) should be initiated if symptoms persist for 18 to 24 months or the patient has no pubertal changes.31, Precocious puberty can be characterized by the pathologic location. Cho H.H., Yoon Y.M., Moon S.H. Partsch C.J., Heger S., Sippell W.G. In central precocious puberty, the brain releases GnRH at a younger-than-normal age and starts the process. Obesity has been linked . Does self-esteem affect body dissatisfaction levels in female adolescents? Table 316,9 and Table 415,7,8 summarize history and physical examination findings in the evaluation of early and delayed puberty. Prevalence of precocious puberty among Chinese children: a school population-based study. a There existed a significant difference between the normal and obesity groups. Seven districts were randomly chosen, 26 general primary schools were randomly sampled. Design: But experts say it can be a result of hormone disorders or brain abnormalities. Investigating the relationship between precocious puberty and obesity: a cross-sectional study in Shanghai, China. Lee K.A. Researchers note that the earlier age of puberty seems to go along with the rise of obesity in the U.S. The NQ total scores were categorized into five grades based on points out of 100, and nutritional status was divided into five grades: the highest (NQ 80.9), higher (73.8 NQ < 80.9), medium (56.5 NQ < 73.8), lower (47.6 NQ <56.5), and the lowest grade (NQ < 47.6) [12]. More careful observation and management of healthy dietary habits for children with precocious puberty are needed, especially considering the poor NQ results among obese members of this group. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. p-Value determined by analysis of variance test (continuous variables) or 2 test (categorical variables). Its just happened too quickly.. Clinical expression of precocious puberty in girls. The results show that obese children with precocious puberty were more vulnerable to negative lifestyle, family environment, and self-esteem effects than their normal-weight peers. Dunger D.B., Ahmed M.L., Ong K.K. One reason for the rapid increase in precocious puberty is the consumption of high-calorie, high-fat foods; these habits are also closely related with childhood obesity. eTable A includes the differential diagnosis of isolated pubertal changes and true precocious puberty. Rarely, puberty occurs early because the glands that make sex hormones, the ovaries in girls and the testes in boys, start working on their own, earlier than normal. Analysis of the correlation between the childrens BMI z-scores and parents BMI revealed significant positive correlations for both mothers (r = 0.199, p = 0.006) and fathers (r = 0.298, p < 0.001). In girls, dull pink vaginal mucosa suggests estrogen exposure; virilization (e.g., clitoromegaly) should be excluded.47,9,27, The thyroid, abdomen, and neurologic system should be examined for evidence of thyroid or gastrointestinal disease or intracranial pathology. For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. Karimy M., Armoon B., Fayazi N., Koohestani H.R. Anthropometric status and biochemical data according to obesity status. Korea Centers for Disease Control & Prevention Standard Development Diagram of Child and Adolescent. Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity. You might have seen that some reusable food container brands have labels that say "BPA-free." This is generally younger than eight years in females, and younger than nine years in males (1). An ALT level was significantly higher in the obesity group than in the normal group (p = 0.005), but both groups remained in the normal range. An LH level of more than 0.3 mIU per mL (0.3 IU per L) is the most reliable laboratory finding for central precocious puberty; however, in patients with lower values and high clinical suspicion, a gonadotropin-releasing hormone analogue stimulation test may be warranted.6,34 In cases of diagnostic uncertainty, pelvic ultrasonography can evaluate for increased uterine and ovarian volume expected for age, which may indicate central precocious puberty or a tumor.6, The appropriate timing for neuroimaging to identify central nervous system lesions (e.g., hypothalamic hamartoma, malignancy) in children with precocious puberty is controversial. and Y.H.H. We aimed to investigate the relationship between precocious puberty and obesity as well as central obesity. It may comprise of central or gonadotropin-dependent. Its unclear whether the trend was caused by increased stress, a more sedentary lifestyle or parents being in close enough quarters with their children to notice early changes. 1 Model: adjusted for age, sex, current family composition, numbers of siblings, economic level, and education level. already built in. Chan School of Public Health and a co-author of the analysis. -, Rubin C, Maisonet M, Kieszak S, et al. Copyright 2017 by the American Academy of Family Physicians. An analysis of childrens body satisfaction revealed that the proportion who were satisfied or very satisfied was 46.2%, but satisfaction was significantly lower in the overweight group (p < 0.001). eCollection 2022. 2022 Aug 25;2022:8325756. doi: 10.1155/2022/8325756. [25]. Reexamination of the age limit for defining when puberty is precocious in girls in the United States: implications for evaluation and treatment. The numbers revealed that, on average, girls in the mid-1990s had started to develop breasts typically the first sign of puberty around age 10, more than a year earlier than previously recorded. And I said, its not happening in Denmark.. This study was approved by the Institutional Review Board of Soonchunhyang University, Bucheon Hospital (IRB number 2017-07-004). Abstract Precocious puberty is defined as pubertal development occurring more than 2.5 standard deviations earlier than the average age. But, unlike doctors in the United States, he did not think obesity was to blame: The body mass index of the Danish children in the 2009 cohort was no different than it had been in the 1990s. This study was the first to analyze NQs for children with precocious puberty, and there are many limitations to comparing them with NQs of general children in the previous study. Among patients with true precocious puberty, or full activation of the hypothalamic-pituitary-gonadal axis, most girls have an idiopathic etiology, whereas it is commonly due to identifiable pathology on imaging in boys. Dr. Juul has become one of the most vocal proponents of an alternate theory: that chemical exposures are to blame. She wondered whether girls with early breast development were more likely to be sexually abused, but she could not find any data keeping track of puberty onset in girls in the United States. Obesity is reported to be closely relevant to early sexual development but the relationship between sexual precocity and obesity or central obesity is still inconsistent, especially in boys. Obese girls with confirmed thelarche should be evaluated for gonadotropin-dependent, central precocious puberty (CPP) to determine if further investigation or treatment is warranted. In: Ferri's Clinical Advisor 2019. Multiple caf au lait spots and fibrous dysplasia of bones are concerning for McCune-Albright syndrome or neurofibromatosis.5,6,9, The initial workup should include measurement of serum FSH, LH, and testosterone in boys or estradiol in girls; thyroid function testing; and bone age radiography (eTable B, Figure 15,6,9). Body image recognition and parents health status according to obesity status. And then we thought, Is this a real phenomenon? Dr. Juul said. bucks county playhouse thanatophoric dysplasia causes smiths crisps uk contact why is food security important for sustainability? Estrogen is involved in the growth and development of female sexual characteristics. In particular, children show a positive attitude toward good eating habits and can change their behavior by learning and acquiring nutrition-related knowledge. Declining age of puberty of school girls in southern Thailand. Its causes are heterogeneous, with alterations of the central nervous system being of special interest, and with environmental factors also playing a role in some cases. doi: 10.1136/bmjopen-2016-014004corr1. They also analyzed BMI as a continuous . Epub 2021 Feb 2. Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. 2002 Nov;110(5):897-902. doi: 10.1542/peds.110.5.897. In contrast to the many monogenic causes associated with hypogonadotropic hypogonadism, only four monogenic causes of central precocious puberty (CPP) have been described. Neurobiological mechanisms underlying kisspeptin activation of gonadotropin-releasing hormone (GnRH) neurons at puberty. Others, like Dr. Herman-Giddens, say that the changes are a sign of a legitimate public health problem and should not be accepted as normal. You may notice problems with May lead to precocious puberty? < /a > What is precocious puberty obesity and/or precocious and! 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