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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Early puberty-menarche after precocious pubarche: relation to prenatal growth.
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Early puberty-menarche after precocious pubarche: relation to prenatal growth.

机译：性早熟后的青春期初潮：与产前生长的关系。

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OBJECTIVE: Girls with precocious pubarche (PP; pubic hair at <8 years of age) as a result of an early or amplified adrenarche (high dehydroepiandrosterone-sulfate [DHEAS]) tend to be hyperinsulinemic, in particular when born with low birth weight (LBW). The objective of this study was to assess the interrelationship among prenatal growth, PP, the timing of puberty-menarche, and adult stature. METHODS: We studied 187 PP girls longitudinally: (1) at birth, (2) in prepuberty, (3) at onset of puberty, (4) at menarche, and (5) on reaching adult stature. This PP cohort was divided into subgroups of higher birth weight (>0 SD), intermediate birth weight (0 to -2 SD), and lower birth weight (less than -2 SD). RESULTS: At the time of PP diagnosis, age, bone age, and BMI were similar across birth weight subgroups; circulating sex hormone-binding globulin and body height were reduced in PP girls with lower birth weight, and these remained so throughout pubertal development. Onset of puberty occurred earlier in PPgirls with lower birth weight; so did menarche. Adult height differed by an average of 6.5 cm (approximately 1 SD) between the upper and lower birth weight subgroups; this difference was essentially achieved before puberty and even before PP. Menarche before age 12.0 years was twofold more prevalent in PP girls than in control subjects. Among PP girls, age at menarche was advanced by 8 to 10 months in lower versus higher birth weight girls. Menarche before age 12.0 years was threefold more prevalent among LBW-PP girls than in control subjects (approximately 75% vs approximately 25%). CONCLUSIONS: The link between prenatal growth restraint and early menarche is herewith extended to PP girls. In particular LBW-PP girls may become a target group for interventions directed toward normalization of pubertal onset and progression.
机译：目的：由于早期或扩大的肾上腺（高脱氢表雄酮硫酸盐[DHEAS]）而导致性早熟（PP;阴毛<8岁）的女孩倾向于高胰岛素血症，尤其是出生时体重低（ LBW）。这项研究的目的是评估产前生长，PP，青春期初潮的时间和成人身高之间的相互关系。方法：我们纵向研究了187名PP女婴：（1）出生时，（2）青春期前，（3）青春期开始，（4）初潮时，（5）达到成年身材。此PP队列分为高出生体重（> 0 SD），中出生体重（0至-2 SD）和低出生体重（小于-2 SD）的子组。结果：在进行PP诊断时，出生体重亚组的年龄，骨龄和BMI相似。出生体重较低的PP女童的循环性激素结合球蛋白和身高降低，并且在整个青春期发育过程中一直保持这种状态。出生体重较低的PPgirls青春期发病较早。初潮也是如此。上，下出生体重分组之间的成年人身高平均相差6.5厘米（约1个标准差）。这种差异本质上是在青春期甚至PP前就已经达到。 12.0岁之前的月经初潮在PP女孩中的发生率是对照对象中的两倍。在PP女婴中，初出生体重较低的女孩与初出生体重较高的女孩相比，初潮年龄提高了8至10个月。在LBW-PP女孩中，12.0岁之前的月经初潮比对照组的患病率高三倍（大约75％对大约25％）。结论：产前生长受限和初潮早期之间的联系由此延伸至PP女孩。特别是LBW-PP女孩可能成为针对青春期发作和进展正常化的干预措施的目标人群。

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