Value of basal luteinizing hormone level combined with uterine volume measurement in the early diagnosis of central precocious puberty in girls with different Tanner stages / 中国当代儿科杂志

OBJECTIVES@#To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages.@*METHODS@#A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP.@*RESULTS@#For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group (P<0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone (P<0.001), but with no significant difference compared with that of basal LH level measurement alone (P>0.05).@*CONCLUSIONS@#Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.

Early Infliximab Yields Superior Long-Term Effects on Linear Growth in Pediatric Crohn's Disease Patients

BACKGROUND/AIMS: Information regarding the efficacy of early infliximab treatment in pediatric patients with Crohn's disease (CD) is limited. We aimed to evaluate the impact of early combined immunosuppression on linear growth in pediatric patients with CD by performing step-up comparisons. METHODS: This retrospective study included pediatric patients with moderate-to-severe CD, who received a combination therapy with infliximab and azathioprine for at least 3 years and sustained corticosteroid-free remission without loss of response. The z-scores of the growth indicators obtained at the time of diagnosis and annually for 3 years thereafter were compared between the two groups. RESULTS: The early combined immunosuppression group displayed significantly increased linear growth 3 years after diagnosis (p=0.026). A significant difference was also observed in the linear growth 3 years after diagnosis between subgroups of Tanner stages 1–2 (p=0.016). CONCLUSIONS: The early introduction of biologics should be considered to improve linear growth in pediatric patients with CD.

Comparison of the hormonal responses to exhaustive incremental exercise in adolescent and young adult males / Comparação das respostas hormonais ao exercício incremental até exaustão em adolescentes e adultos jovens do sexo masculino

OBJECTIVE: Evaluate hormonal responses to incremental-stage exercise (EX) test to exhaustion in adolescents. SUBJECTS AND METHODS: Adolescents were tested at 16 years of age in Tanner Stage 4 (TS4) and at 17 years of age in Tanner Stage 5 (TS5) (n = 6). Adults were tested at 21 ± 1 y. (X ± SD) (n = 4) and served as controls. Blood samples were taken at rest, at the end of each EX stage. RESULTS: Main effects for EX in cortisol (p < 0.01, increasing with each EX stage) and for subject group for testosterone (T) occurred (p < 0.01; TS4 < TS5, adults). Interaction effect of group by EX stage occurred for GH (p < 0.05). GH increased in response to EX in all groups, however, the magnitude of increase was significantly less for TS5 and adults than TS4. CONCLUSIONS: Differences in T and GH responses for TS4 than those for TS5 and adults reflect the differing maturation levels of the endocrine system between Tanner Stages. TS5 adolescents are more similar to young adults in hormonal responses to EX than are TS4 adolescents.

OBJETIVO: Avaliar as respostas hormonais ao teste de exercício em estágios incrementais (EX) até exaustão. SUJEITOS E MÉTODOS: Foram examinados adolescentes com 16 anos de idade e índice Tanner 4 (TS4) e com 17 anos de idade e índice Tanner Stage 5 (TS5) (n = 6), e adultos com 21 ± 1 anos de idade. (X ± SD) (n = 4), estes últimos compondo o grupo controle. As amostras de sangue foram retiradas no repouso e ao final de cada estágio EX. RESULTADOS: Os principais efeitos observados no EX ocorreram no cortisol (p < 0,01, aumentou com a elevação do estágio EX) e no grupo de testosterona (p < 0,01; TS4 < TS5, adultos). Houve efeito de interação entre grupos e por estágio de EX no grupo de hormônio de crescimento (p < 0,05). O hormônio de crescimento aumentou em todos os grupos em resposta ao EX, no entanto, a magnitude dos aumentos observados foi significativamente menor em TS5 e nos adultos do que em TS4. CONCLUSÕES: As diferenças verificadas nas respostas dos grupos de testosterona e hormônio de crescimento em TS4 em relação ao TS5 e adultos refletem os diferentes níveis de maturação do sistema endócrino entre os estágios do índice de Tanner. Os adolescentes no TS5 se assimilam mais aos jovens adultos do que aos adolescentes TS4, quanto a suas respostas hormonais ao EX.

Ghrelin Levels During Puberty: Relationship with Anthropometric Measures and Other Hormones / 대한소아내분비학회지

PURPOSE: Puberty is a rapid changing periods of body composition and endocrine system. Already leptin was known to be closely related to body composition and was known to change according to Tanner stage. Ghrelin, a natural GH secretagogue, was also known to be related with weight change, fat utilization, insulin secretion, and influenced by sex steroid. But the relationship between ghrelin and other parameter according to pubertal development is not established yet. METHODS: Cross-sectional study of 101 peripubertal children (54 males and 47 females) aged 8.5 to 17.0 years. We examined body composition (free fat mass, fat mass, % body fat) by bioelectric impendence measurements. Total ghrelin, leptin, insulin was measured by radioimmunoassay (RIA). Relationship between ghrelin, leptin, insulin and body composition data was analysed according to Tanner stage controlling gender using SPSS ver 11.0. RESULTS: Ghrelin concentration is only correlated with Tanner stage (r=-0.21, P<0.05) and GIR (r=0.29, P<0.01). When we divided subjects by sex, even though there was no difference of ghrelin level between both sex, only male is correlated with Tanner stage (r=-0.28, P<0.05) and GIR (r=0.36, P<0.01). There was no difference of ghrelin level between each Tanner stage and no correlation was observed with other body composition and endocrine parameter including leptin. CONCLUSION: These data suggest that Ghrelin levels decrease during puberty at least in boys as pubertal development proceeds but it is minimal. During puberty, ghrelin levels are stable. Ghrelin may have no relationship with other pubertal change. The relation of ghrelin and insulin sensitivity need to be further investigated.

Changes and Their Correlations of Body Compositions and Serum Leptin Concentrations according to the Progression of Tanner Stage in Healthy Children and Adolescents / 대한소아내분비학회지

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.

Changes and Their Correlations of Body Compositions and Serum Leptin Concentrations according to the Progression of Tanner Stage in Healthy Children and Adolescents / 대한소아내분비학회지

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.