(Father, OR for overweight = 1.67; 95% CI: 0.991.62; OR for obesity = 2.53; 95% CI: 2.013.65; mother, OR for overweight = 1.21; 95% CI: 0.931.84; OR for obesity = 1.86; 95% CI: 1.352.29.) In: Nelson Textbook of Pediatrics. Kim H.Y., Kwon S., Lee J.S., Choi Y.S., Chung H.R., Kwak T.K., Park J., Kang M.H. Keywords: Not all forms of precocious puberty are dangerous. Analysis of the Relationship between Nutritional Status and Bone Age and Sexual Development in Children and Adolescents. Obesity & Precocious Puberty in Males Symptom Checker: Possible causes include Hypothalamic Lesion. In central precocious puberty, the puberty process starts too soon. 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. Management and outcome of central precocious puberty. Other searches included Essential Evidence Plus, the Cochrane Database of Systematic Reviews, and the U.S. Preventive Services Task Force website. Obesity has been linked . causes of precocious puberty, childhood obesity and environmental hormones Health and Wellness About Precocious Puberty Recently, fatty food and diets have increased childhood obesity, and the number of precocious puberty patients has increased due to the environment in which children and adolescents are easily exposed to environmental hormones. This site needs JavaScript to work properly. The data are presented as the mean standard deviation or numbers (%). When both children and parents judged that the body type was fatty or very fatty, the adjusted odds ratio (OR) was significantly higher (children, OR for fatty = 1.60; 95% confidence interval (CI): 0.982.52; OR for very fatty = 2.13; 95% CI: 1.442.88; parents, OR for fatty = 2.04; 95% CI: 1.012.49; OR for very fatty = 2.21; 95% CI: 1.563.23), and this tendency was similar for satisfaction of body shape. [Epidemiologic study on current pubertal development in Chinese school-aged children]. Mice and people with certain genetic mutations in this region experienced later sexual development. A study published in Italy in February showed that 328 girls were referred to five clinics across the country during a seven month period in 2020, compared with 140 during the same period in 2019. 2002 Nov;110(5):897-902. doi: 10.1542/peds.110.5.897. What kind of tumors cause precocious puberty? Pediatrics 2008;121(Suppl 3):S218S230.10.1542/peds.2007-1813G 2012;22:84-100. doi: 10.1159/000334304. All authors have read and agreed to the published version of the manuscript. The scores for each factor were significantly lower in the obese group than in the normal and overweight groups. And during the pandemic, pediatric endocrinologists from across the world noticed that referrals were increasing for earlier puberty in girls. 2013. The NQ scores, which reflect a comprehensive evaluation of childrens nutrition status and eating habits, are shown in Table 4. These values are similar to previous reports indicating that the incidence of precocious puberty is more than 10 times higher in females than in male children and that early puberty was more common in obese children [19,20]. However, although many studies have focused on the relationship between obesity or dietary habits and precocious puberty, relatively few studies have examined the dietary habits of patients with precocious puberty and their families. Growth patterns, such as constitutional delay, may be familial. Obesity has been linked to earlier periods in girls since the 1970s. The clinician should inquire about the onset and progression of body odor, acne, breast or testicular development, and pubic and axillary hair. The ePub format uses eBook readers, which have several "ease of reading" features Physicians must identify which findings are suitable for surveillance over time and which suggest treatable underlying pathology. 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. In central precocious puberty, the HPG axis is activated, resulting in early but normal development, symmetric progression of secondary sexual characteristics, and increasing growth velocity.6,9,32 Central precocious puberty is approximately 10-fold more common in girls than in boys.33 Although usually idiopathic in girls, it can be incited by head trauma, neoplasm, radiation, or genetic conditions.5,6,9 Pathologic causes of central precocious puberty are more common in boys.5,6,9, Peripheral precocious puberty occurs when hormonal influences originating outside of the HPG axis produce incomplete, atypically sequenced or rapid pubertal progression.5,6,9 Quickly progressing or significant hyperandrogenic findings may warrant workup for congenital adrenal hyperplasia or an androgen-secreting tumor. The fathers BMI showed a significant correlation with the childs BMI (. When this hormone reaches the pituitary gland a small bean-shaped gland at the base of your brain it leads to the production of more hormones in the ovaries for females (estrogen) and the testicles for males (testosterone). It occurs more frequently in girls than boys, and most cases of precocious puberty in girls are idiopathic. It may be caused by tumors or growths on the ovaries, adrenal glands, pituitary gland, or brain. All rights reserved. Boo M.N., Cho S.K., Park K. Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient. The site is secure. In central precocious puberty, the brain releases GnRH at a younger-than-normal age and starts the process. The median ages of breast, pubic hair and testicle development decreased with BMI increase and median ages of thelarche and testicular development rather than pubarche were earlier in children with central obesity. Anthropometric status and biochemical data according to obesity status. Its just happened too quickly.. After calculating the BMI values of the father and mother based on their anthropometric information, the parents were also classified using the BMI (normal: 18.522.9 kg/m2; overweight: 23.0 and 24.9 kg/m2; obesity: 25.0 kg/m2). Only children and caregivers who agreed to participate in the study were included as subjects. https://www.uptodate.com/contents/search. The comparisons of body cognition and parents health status are shown in Table 3 and Figure 1. Multivariate logistic regressions of an association between various factors and obesity status. -, Golub MS, Collman GW, Foster PM, et al. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. already built in. Secondary sexual characteristics in children with cerebral palsy and moderate to severe motor impairment: a cross-sectional survey. Treatment for precocious puberty typically includes medication to delay further development. . Patient information: See related handout on early and delayed puberty. That did not go over too well, he recalled. Health Conditions. In children with central precocious puberty, Gn-RH will cause other hormone levels to increase. What causes precocious puberty? Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. 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. Participants: Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce. Rarely, certain conditions, such as infections, hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. A survey was conducted including 249 children and their caregivers who had consented to the use of their medical records. p-Value determined by analysis of 2 test (categorical variables). In rare cases, central precocious puberty may be caused by: Estrogen or testosterone in your child's body causes this type of precocious puberty. eTable A includes the differential diagnosis of isolated pubertal changes and true precocious puberty. Elevated estradiol levels in the setting of low LH may suggest an estrogen-secreting tumor.6 Hypothyroidism and exogenous steroid use should be excluded. Other causes may include central nervous system problems, family history of the disease, or certain rare genetic syndromes. eCollection 2022. BMJ Open. It may comprise of central or gonadotropin-dependent. 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). For decades, medical textbooks have defined the stages of puberty using the so-called Tanner Scale, which was based on close observations between 1949 and 1971 of about 700 girls and boys who had lived in an orphanage in England. They were blindsided, she said. Precocious or early puberty has been linked to possible problems, including stunted growth, emotional-social problems like increased risks of depression and substance abuse. 1, normal group; 2, overweight group; 3, obesity group. 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. A similar pattern, though less extreme, has been observed in boys. This study was conducted by multistage and stratified cluster random sampling. Yong Hee Hong, Yeon Ju Woo, [], and Hee-Sook Lim. A single copy of these materials may be reprinted for noncommercial personal use only. Precocious puberty is onset of sexual maturation before the average age. 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. a There existed significant differences between the normal and obesity groups. Those five factors are then further divided into questions on datary intake and behavior: balance (5 questions: intake frequency of whole grains, fruits, white milk, eggs, and legumes); diversity (3 questions: intake frequency of colorful vegetables, kimchi, and diverse side dishes); moderation (5 questions: intake frequency of fast foods, sweet foods, instant noodles, eating at night, and street foods), regularity (3 questions: meal regularity, eating breakfast, and exercise); practice (3 questions: hand washing, chewing well, and checking nutrition labels) [18]. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Correlation between childrens body mass index (BMI) z-score and parents BMI.
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