Efficacy and safety of human chorionic gonadotropin combined with human menopausal gonadotropin and a gonadotropin-releasing hormone pump for male adolescents with congenital hypogonadotropic hypogonadism.

BACKGROUND: Compared to adult studies, studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism (CHH) are limited and no universal treatment regimen is available. The aim of this study was to evaluate the feasibility of human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) therapy for treating male adolescents with CHH. METHODS: Male adolescent CHH patients were treated with hCG/hMG (n = 20) or a gonadotropin-releasing hormone (GnRH) pump (n = 21). The treatment was divided into a study phase (0-3 months) and a follow-up phase (3-12 months). The testicular volume (TV), penile length (PL), penis diameter (PD), and sex hormone levels were compared between the two groups. The TV and other indicators between the groups were analyzed using a t-test (equal variance) or a rank sum test (unequal variance). RESULTS: Before treatment, there was no statistical difference between the two groups in terms of the biochemistry, hormones, and other demographic indicators. After 3 months of treatment, the TV of the hCG/hMG and GnRH groups increased to 5.1 ±â€Š2.3 mL and 4.1 ±â€Š1.8 mL, respectively; however, the difference was not statistically significant (P > 0.05, t = 1.394). The PL reached 6.9 ±â€Š1.8 cm and 5.1 ±â€Š1.6 cm (P < 0.05, t = 3.083), the PD reached 2.4 ±â€Š0.5 cm and 2.0 ±â€Š0.6 cm (P < 0.05, t = 2.224), respectively, in the two groups. At the end of 6 months of treatment, biomarkers were in normal range in the two groups. Compared with the GnRH group, the testosterone (T) level and growth of PL and PD were significantly greater in the hCG/hMG group (all P < 0.05). While the TV of both groups increased, the difference was not statistically significant (P > 0.05, t = 0.314). After 9 to 12 months of treatment, the T level was higher in the hCG/hMG group. Other parameters did not exhibit a statistical difference. CONCLUSIONS: The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH. The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy. Furthermore, results from the extended time-period showed positive outcomes at the 1-year mark; however, the long-term effectiveness, strengths, and weaknesses of the hCG/hMG regimen require further research. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02880280; https://clinicaltrials.gov/ct2/show/NCT02880280.

Final adult height of children with idiopathic short stature: a multicenter study on GH therapy alone started during peri-puberty.

BACKGROUND: To evaluate the efficacy of GH in improving FAH in ISS children in a multicenter study. METHODS: A real-world observation was carried out. Children with ISS in seven hospitals in China were enrolled. The height gains standard deviation score and the height gain over the target height were evaluated. RESULTS: There were 344 ISS patients (217 boys and 127 girls). The baseline average age of boys and girls was 12.7 and 11.7 years, with bone age of 11.7 and 10.1 years, respectively. The baseline height SDS of boys and girls was - 3.07 and - 2.74, and the FAH SDS was - 1.91 and - 1.38, respectively. Compared with the baseline height SDS, the FAH SDS was significantly increased in both boys and girls (both P = 0.0000). The FAH SDS was the highest (gain by 1.54 SD) in the ≥2y treatment course group. Two hundred eighteen patients (218/344, 63.4%) had a FAH SDS > - 2 SD. Among these patients, girls in the 1-2y treatment course group and ≥ 2y group had a FAH SDS higher than TH SDS. Even in the control group, a spontaneous catch-up growth of 1.16 SD was observed. A multivariate linear regression model was used to analyze the results, with FAH SDS as the dependent variable. It was found that the treatment course and baseline height SDS in the boys' model were statistically significant (P < 0.05), whereas the baseline height SDS and baseline bone age significantly affected the girls' FAH SDS (P < 0.05). CONCLUSIONS: Both girls and boys of ISS improved FAH by GH therapy even if treatments begin over 10 years old and majority of them reached TH. Some peri-puberty ISS will have a spontaneous height gain. We recommend the course of GH treatment more than 2 years for girls, and longer courses for boys.

Population-based frequency of surfactant dysfunction mutations in a native Chinese cohort.

BACKGROUND: Rare mutations in surfactant-associated genes contribute to neonatal respiratory distress syndrome. The frequency of mutations in these genes in the Chinese population is unknown. METHODS: We obtained blood spots from the Guangxi Neonatal Screening Center in Nanning, China that included Han (n=443) and Zhuang (n=313) ethnic groups. We resequenced all exons of the surfactant proteins-B (SFTPB), -C (SFTPC), and the ATP-binding cassette member A3 (ABCA3) genes and compared the frequencies of 5 common and all rare variants. RESULTS: We found minor differences in the frequencies of the common variants in the Han and Zhuang cohorts. We did not find any rare mutations in SFTPB or SFTPC, but we found three ABCA3 mutations in the Han [minor allele frequency (MAF)=0.003] and 7 in the Zhuang (MAF=0.011) cohorts (P=0.10). The ABCA3 mutations were unique to each cohort; five were novel. The collapsed carrier rate of rare ABCA3 mutations in the Han and Zhuang populations combined was 1.3%, which is significantly lower than that in the United States (P<0.001). CONCLUSION: The population-based frequency of mutations in ABCA3 in south China newborns is significantly lower than that in United States. The contribution of these rare ABCA3 mutations to disease burden in the south China population is still unknown.

Possible role of birth weight on general and central obesity in Chinese children and adolescents: a cross-sectional study.

PURPOSE: According to the developmental origins of health and disease theory, fetal nutrition is associated with obesity and chronic diseases in children and adults. However, previous findings regarding the association between birth weight and childhood obesity have been inconsistent. The aim of the present study was to investigate the relationship between birth weight and childhood obesity in China. METHODS: The 16,580 subjects (8477 boys and 8103 girls) aged 7-17 years, who participated in this study were recruited from a cross-sectional study in six cities in China. Epidemiological data, including birth information, were collected through face-to-face interviews, and anthropometric indices were measured by trained physicians. Overweight and obese cases were defined using sex-specific and age-specific 85th and 95th percentile body mass index (BMI) cutoffs for Han children and adolescents. Central obesity was defined using sex-specific waist-to-height ratio (WHtR) cutoffs (WHtR ≥0.48 in boys and WHtR ≥0.46 for girls). RESULTS: The overall rate of overweight status and obesity was 20.3% in the Chinese children and adolescents and that of central obesity was 18.9%. Subjects were stratified into eight groups according to weight at birth. J-shaped relationships were observed between birth weight and BMI for age Z-score and WHtR. After adjusting for confounders such as gender, gestational age, parental factors, and dietary factors, the risk of overweight and obese status was still higher in the children with higher birth weights than in children with birth weights of 3000-3499 g (3500-3999 g: odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.02-1.28; 4000-4499 g: OR = 1.39, 95% CI = 1.19-1.63; and 4500-4999 g: OR = 1.36, 95% CI = 1.06-1.76). Moderately high birth weight also increased the risk of central obesity. Relative to the children with normal birth weights (3000-3499 g), the adjusted OR and 95% CI were 1.33 (1.13-1.56) in children with birth weights of 4000-4499 g. Children with very low birth weight (lower than 1500 g) had the highest risk of central obesity. The adjusted OR was 2.30 (95% CI: 1.03-5.14) relative to children with birth weights of 3000-3499 g. CONCLUSIONS: Birth weight was associated with obesity in Chinese children and adolescents. J-shaped relationships were observed between birth weight and BMI and WHtR in childhood, and very low birth weight was associated with a mild increase in the risk of central obesity in Chinese children and adolescents.

Genetic variations in SEC16B, MC4R, MAP2K5 and KCTD15 were associated with childhood obesity and interacted with dietary behaviors in Chinese school-age population.

Both genetic predisposition and lifestyle factors are associated with the risk for obesity. Multiple obesity loci have been identified using genome-wide association studies mainly in European populations. The aims of this study were to examine the associations of these loci with obesity and gene×dietary behavior interactions among Chinese children and adolescents. Nineteen candidate SNPs were genotyped using Sequenom technology in the Chinese children (N=2977, 853 obese and 2124 controls, aged 7-17). Dietary behaviors were assessed using self-administered questionnaires. After adjusting for age, sex and multiple testing, MC4R rs17782313, SEC16B rs543874, MAP2K5 rs2241423 and KCTD15 rs11084753 were associated with obesity and obesity-related traits (all P<0.005), with odd ratios ranging from 1.22 to 2.15. Dose-response association was significant between genetic risk score, which was calculated by summing the risk alleles, and the risk of obesity (P<0.001). Multiplicative interaction was found between rs543874 and salt preference on obesity with an OR of 4.40 (95% CI, 1.12-17.30). Additive interactions with salt preference were found in rs17782313 and rs11084753. Our findings indicated that rs17782313, rs543874, rs2241423 and rs11084753 were associated with the risk for children obesity in China, and interaction of genetic variants with diet behaviors on obesity.

[Prevalence of hypertension and relationship between hypertension and obesity in children and adolescents in Nanning of Guangxi Province].

OBJECTIVE: To investigate the prevalence of hypertension and the relationship between hypertension and obesity in children and adolescents aged 6-18 years in Nanning, Guangxi Province, China. METHODS: A stratified cluster random sampling method was adopted in Nanning to select 7 893 children and adolescents aged 6-18 years as research subjects. Questionnaire surveys were conducted, and blood pressure, height, weight, and other indicators of growth and development were measured. RESULTS: An increasing trend with age for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed. Detection rates of hypertension, high SBP (HSBP) and high DBP (HDBP) were 6.58%, 4.02% and 3.81%, respectively. The detection rates of hypertension and HSBP in boys were significantly higher than in girls (P<0.05). The detection rates of hypertension in normal, overweight and obesity groups were 3.87%, 9.84% and 19.23%, respectively. The obesity group showed the highest detection rates for hypertension, HSBP and HDBP, followed by the overweight group and normal group. Compared with that in the normal group, the odds ratios (95% CI) for hypertension in the overweight and obesity groups were 2.71 (1.69-5.96) and 5.91 (3.46-7.63), respectively. Blood pressure showed a positive correlation with age, height, weight and BMI (P<0.01). CONCLUSIONS: The present study provides with the current information and characteristics of blood pressure of children and adolescents aged 6-18 years in Nanning, Guangxi. Blood pressure is correlated with gender, age, height, weight and BMI. Obesity is positively correlated with the prevalence of hypertension and the risk of hypertension increases with body weight.

[Analysis of chromosomal abnormalities and a report of eight new karyotypes among children in genetic counseling].

OBJECTIVE: To study the relationship between abnormal karyotypes and clinical phenotypes among children in genetic counseling in Guangxi Zhuang Autonomous Region, China. METHODS: We studied 601 children who visited Guangxi Zhuang Autonomous Region Women and Children Care Hospital for genetic counseling between January 2009 and July 2012. Blood samples were cultured routinely for karyotype analysis with G banding as well as clinical analysis. RESULTS: Out of 601 patients, 329 (54.7%) had chromosomal abnormalities, and 8 new abnormal human karyotypes were found. Among 329 children with abnormal karyotypes, 317 (96.4%) had an abnormal number of chromosomes, and 12 (3.6%) had abnormal chromosomal structure. Abnormal karyotypes were clinically manifested by Down's syndrome (74.5%), growth retardation (10.9%), and mental retardation (3.0%). CONCLUSIONS: Eight rare abnormal karyotypes were found in the study, providing new resources for the genetic studies and etiological analysis of growth retardation, mental retardation, gonadal dysgenesis, and multiple congenital anomalies in children.

[Cytogenetic analysis of 105 new human abnormal karyotypes].

To analyze the genetic effect of the abnormal chromosome karyotype, we summarized and studied the clinical data of the new abnormal karyotypes diagnosed at the Guangxi Zhuang Autonomous Region Women and Children Care Hospital from January 2009 to July 2012. The samples were cultured routinely for the karyotype analysis using G banding and C banding. Chromosomal aberrations were named according to the International System for Human Cytogenetic Nomenclature (ISCN 2009). Among tested samples, 105 new human abnormal karyotypes were identified (86 reciprocal translocation, 10 chromosomal inversion, six derivative chromosome, one duplication, one isochromosome, one partial trisomy and monosomy). The results suggest that chromosomal abnormalities were a major cause of miscarriage, infertility, congenital abnormalities, mental retardation and amenorrhea in humans.

[Analysis of clinical manifestations and genetic mutations in a child with Laron syndrome].

OBJECTIVE: To analyze clinical manifestations and gene mutations in a child with severe short stature, explore its molecular mechanism and further clarify the diagnostic procedure for short stature. METHOD: We observed clinical characteristics of a patient with short stature and did diagnostic examinations, assessed the function of GH-IGF-1 axis, and surveyed its family members.Genomic DNA was extracted from peripheral blood, GHR, IGFALS, STAT5b and GH1 gene were amplified by PCR for sequencing, including exons and splicing areas. RESULT: The patient presented symmetrical short stature (height -8.2 SDS) and facial features, and other congenital abnormalities.It displayed non-growth hormone deficiency. The baseline value of GH was 21 µg/L, and the peak was 57.9 µg/L. The value of IGF-1 was less than 25 µg/L, and the IGFBP-3 less than 50 µg/L. And IGF-1 generation test showed no response. There was no similar patients in the family members.Sequencing of GHR in the patient revealed a homozygous point mutation (c.Ivs6+1G>A), and her father and mother had the same heterozygous mutation. The same mutation was not identified for her sister.No other candidate gene was found. CONCLUSION: As the result of combined clinical characteristics and lab examinations, as well as gene detection, the case was diagnosed with Laron syndrome and GHR gene mutation is the molecular mechanism.We should explicit the etiological diagnosis for short stature, and avoid missed diagnosis and misdiagnosis.

[Study on physique index set for Chinese children and adolescents].

OBJECTIVE: To provide data as age-gender dependent mean, standard deviation and percentile on height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist hip ratio (WHR), waist to height ratio (WHtR) among 7-16 year-olds Chinese children and adolescents, towards setting up diagnostic criteria on metabolic syndrome for them. METHODS: A representative sample involving 22,197 children and adolescence aged 7 to 16 years were randomly surveyed and they were from 6 representative geographical areas, including Beijing, Tianjin, Hangzhou, Shanghai, Chongqing and Nanning. A total of 21 858 had available data, with male/female ratio as: 11,460/10,398. Using the standard methods, we measured height, weight, WC, HC, BMI, WHtR and other data in all age groups. Physique indexes among different geographic regions (North, Mid-west and East) were compared. RESULTS: (1) Both male and female showed an increasing trend of height, weight, waist circumference, hip circumference and BMI along with the increase of age. WHR of girls decreased gradually from 0.84 to 0.76 went from 7 to 16 years old while WHR of boys changed from 0.87 to 0.81 accordingly. (2) WHtR was rarely affected by age. It fluctuated between 0.42-0.43 in all girls and 0.44-0.45 in boys less than 11 years. WHtR of boys older than 12 years showed a slight decline from 0.45 to 0.42 of WHtR. (3) The average height, weight, BMI of children and adolescents from the northern regions (Beijing, Tianjin) were significantly higher than that of the mid-western (Chongqing, Nanning) and the eastern regions (Shanghai, Hangzhou) (P<0.001), while those from the mid-western region were slightly higher than that of the eastern region (P<0.05) in each of the age group. CONCLUSION: Reference values and percentile curves for WC and WHtR of Chinese children and adolescents were provided. For the assessment of central obesity. WHtR had the advantages of relative stability and small degree of variation and rarely affected by age and gender, when compared with WC, and could be used as an simple index to reflect the central obesity of children and adolescents.

[Survey on the levels of lipids in school-aged children of Beijing, Tianjin, Hangzhou, Shanghai, Chongqing and Nanning cities].

OBJECTIVE: To investigate the lipid levels of Han ethnicity Chinese children at school-age, to provide objective data for the formulation of prevention and management strategy regarding dyslipidemia among children and adolescents. METHODS: 20 191 children (with 10 669 boys and 9522 girls) aged 7 to 16 years old from 6 representative geographical areas, including Beijing, Tianjin, Hangzhou, Shanghai, Chongqing and Nanning, were surveyed in a randomly selected clustered sample in China. Data on fasting blood triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were measured. Non-high-density lipoprotein cholesterol (non-HDL-C) levels were calculated with data collection, entry, and collation were under the same criteria. RESULTS: (1) In the 7 - 16 year-old group, TG (P(95)) fluctuated between 1.26 mmol/L and 1.88 mmol/L, while TC (P(95)) was between 4.80 mmol/L and 5.46 mmol/L. LDL-C (P(95)) was between 2.67 mmol/L and 3.27 mmol/L while non-HDL-C (P(95)) was between 3.36 mmol/L and 3.91 mmol/L, suggesting that age did not seem to be an affecting factor for the lipid level (P > 0.05). The level of HDL-C (P(5)) fluctuated between 1.08 mmol/L and 0.83 mmol/L, and the dependability analysis on HDL-C and age showed statistically significant difference (P < 0.01, r = -0.274). (2) In the 7 - 9 year-old group, the levels of TG, TC, LDL-C and non-HDL-C of boys were lower but the HDL-C level was higher than in girls. However, in the 10-16 year-old group, the levels of five lipids of boys were all lower than in girls, with all the differences statistically significant (P < 0.05). (3) The levels of TG, TC, LDL-C and non-HDL-C in the obese group were significantly higher than those in non-obesity group, as HDL-C was significantly lower than in non-obese group (P < 0.01). Incidence rates of single and multiple dyslipidemia in obese group were significantly higher than in non-obese group (P < 0.01). (4) Grouped by region, the abnormal rates of TG were descending, with the ranking as North (10.4%), Midwest (9.7%) and East (8.3%), while the abnormal rates of TC were descending with the ranking as Midwest (6.0%), North (5.2%) and East (4.8%). The abnormal rates of LDL-C were descending as the ranking of North (3.1%), East (2.6%) and Midwest (0.9%), with the abnormal rates of non-HDL-C were descending as Midwest (6.5%), North (4.2%) and East (3.6%). The abnormal rates of HDL-C were descending as Midwess (14.2%), North (5.7%) and East (5.5%). All the differences in the above-said items were statistically significant (P < 0.05). (5) According to the standards of hyperlipidemia formulated by the American Academy of Pediatrics, the incidence rates of abnormal TG, TC, LDL-C, non-HDL-C, HDL-C were 9.4%, 5.4%, 2.2%, 4.8%, 8.6% respectively. CONCLUSION: (1) Levels of lipids were affected by many factors, but age was not one of them in children and adolescents. However, HDL-C was declining along with the increase of age, to some extent. (2) Girls had a relatively protective tendency through the increasing HDL-C level when they entered the puberty years. (3) Lipids levels in non-obese group were significantly better than the obese group. (4) The lipids levels of children and adolescents in the Eastern region of the country were better than that in the northern and mid-western areas.

[Pulmonary surfactant associated gene variants in mixed ethnic population of Han and Zhuang].

OBJECTIVE: To explore the prevalence of pulmonary surfactant associated pathway genes functional variants in Chinese population. METHOD: Using a cohort of 258 mixed ethnic population of Han and Zhuang, we pooled DNA samples from 146 term male infants and 112 term female infants and then used an Ill umina next generation sequencing platform to perform the complete exonic resequencing in 6 target genes:surfactant protein-B (SFTPB), surfactant protein-C (SFTPC), ATP-binding cassette transporter A3 (ABCA3), lysophospholipid acyltransferase 1 (LPCAT1), choline phosphotransferase 1 (CHPT1), phosphate cytidylyltransferase 1, choline, beta (PCYT1B). Collapsing methods was used to determine the functional allele frequency. RESULT: (1) Altogether, 128 variants were found, including 44 synonymous variants, 66 nonsynonymous variants and 18 insertions-deletions. Of these, 28 variants were predicted to alter protein function. Two of these variants were seen twice, the rest variants were only seen once, for a total of 30 functional alleles; (2) ABCA3 had the most functional variants in both male and female groups with the minor allele frequencies of 0.014 (1.4%) and 0.04 (4%), respectively. The total functional allele frequencies of 6 genes were 0.041 (4.1%) and 0.08 (8%) in the two groups, respectively (P = 0.06). CONCLUSION: (1) Functional variants in pulmonary surfactant associated pathway genes are present in the mixed Han-Zhuang population. (2) ABCA3 contained the most functional variants suggesting that ABCA3 could contribute significantly to neonatal respiratory distress syndrome and other lung disease.

[Relationship between alanine aminotransferase and overweight or obesity in children].

OBJECTIVE: To study the association of alanine aminotransferase (ALT) with overweight or obesity in children. METHODS: A total of 2889 healthy children and 702 overweight or obese children aged from 7 to 18 years who had received a physical examination were enrolled. Height, body weight, waist circumference, and blood pressure were measured, and the biochemical indicators including blood glucose, blood lipids, ALT, and insulin were detected. The insulin resistance index were calculated. RESULTS: The ALT level was significantly higher in boys than in girls. Along with the increase of BMI, the ALT level increased in the normal, overweight, and obese groups in both boys and girls. ALT was correlated with BMI, waist circumference, triglyceride, and insulin resistance index. Among the overweight or obese children, the boys with the increased ALT level had higher BMI, waist circumference, blood pressure, triglyceride, low density lipoprotein and insulin resistance index than the boys with normal ALT level (P<0.05); the girls with the increased ALT level had higher waist circumference, blood pressure and insulin resistance index and lower high density lipoprotein than the girls with normal ALT level (P<0.05). CONCLUSIONS: ALT is correlated with overweight and obesity and metabolic disorders caused by overweight and obesity such as dyslipidemia and insulin resistance.

[Epidemiological study on the association between obesity with metabolic syndrome in obese children and adolescents of Nanning city, Guangxi].

OBJECTIVE: To investigate the association between obesity and prevalence of metabolic syndrome (MS) with its associated risk factors, in children and adolescents. METHODS: A stratified random sampling method was used to select 7893 students from 6 to 18 years of age from 14 out of 396 primary and secondary schools in Nanning city. All the students had undergone physical examination and blood tests including the following risk factors related to metabolic syndrome: fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alanine amino shift enzyme (ALT), aspartic acid amine shift enzyme (AST) and fasting insulin (FINS). The homeostasis model assessment insulin resistance index (HOMA-IR) was also measured. RESULTS: (1) The prevalence rate of MS in normal group was 0.57%. In both the overweight and obesity groups, the prevalence rates of MS were 4.53% and 26.80%, respectively. (2) These indices in obesity group were higher than other two groups (P < 0.05). The result of overweight group was higher than normal group (P < 0.05). (3) Waist circumference (OR = 1.087, 95%CI: 1.033 - 1.143), SBP (OR = 1.073, 95%CI: 1.032 - 1.116), FBG (OR = 1.394, 95%CI: 1.568 - 3.423), TG (OR = 3.213, 95%CI: 1.410 - 7.319) and HDL-C (OR = 0.001, 95%CI: 0.000 - 0.012) were detecting indices which had statistically significant with MS in binary logistic regression analysis. CONCLUSION: Metabolic syndrome and obesity were closely related in children and adolescents while its prevalence and risk factors increased with the severity of obesity.

Onset of breast and pubic hair development and menses in urban chinese girls.

OBJECTIVES: To determine the current prevalence and mean ages of onset of pubertal characteristics in healthy urban Chinese girls. METHODS: A cross-sectional study of sexual maturation of healthy Chinese girls was conducted in 9 representative cities of the eastern, western, southern, and northern parts and central region of China between 2003 and 2005. At examination, stages of breast and pubic hair development were rated on girls 3 through 19.83 years of age, and height and weight were also recorded. Data on menses were collected by the status quo method. Probit analysis was used to calculate the median age and 95% confidence interval (CI) for onset of breast and pubic hair development and menarche. RESULTS: Data were analyzed for 20654 apparently healthy girls. At age 8 years, 19.57% of these girls had evidence of breast development. The median ages of onset of Tanner stages 2 and 3 for breast development were 9.20 (95% CI: 9.06-9.32) years and 10.37 (95% CI: 10.28-10.45) years, respectively. The median ages of onset of Tanner stages 2 and 3 for pubic hair development were 11.16 (95% CI: 11.03-11.29) years and 12.40 (95% CI: 12.25-12.55) years, respectively. Menses occurred at 12.27 years (95% CI: 12.16-12.39). CONCLUSIONS: These data suggest that urban Chinese girls are actually experiencing earlier breast development than currently used norms. The up-to-date reference for normal pubertal development in urban Chinese girls needs to be established for the purpose of determining precocious puberty or pubertal delay.

[Impact of gonadotropin-releasing hormone analogs treatment on final height in girls with central precocious puberty].

OBJECTIVE: To study the effects of treatment with gonadotropin-releasing hormone analogs (GnRHa) on final height, weight and pubertal development in girls with central precocious puberty. METHODS: Twenty-six girls with central precocious puberty were treated with GnRHa for an average of 19.2+/- 8.4 months. Pretreatment and posttreatment predicted adult heights (PAH) were evaluated based on the Bayley-Pineau table. The patients, heights and weights were measured monthly. Bone age (BA) was evaluated using Greulich-Plyle. Height standard deviation score for BA [HtSDS (BA)] was measured. After discontinuation of treatment, the patients were followed-up for the observation of height, weight, BA and menstruation. RESULTS: Final height averaged 158.0+/- 4.0 cm in the 26 girls, which was greater than their target height (155.3+/- 4.4 cm; P< 0.01) and consistent with their posttreatment PAH (158.4+/- 5.2 cm). The final height was positively corrrelated with initial height, PAH and HtSDS(BA). There was a positive correlation in the body mass index before and after treatment (r=0.724, P< 0.01). Menarche occurred 13.2+/- 6.1 months after discontinuation of treatment, with a mean menarche age of 12.2+/- 0.7 years. CONCLUSIONS: GnRHa may increase final height in girls with central precocious puberty. Their final heights may be correlated with their initial heights and PAH. The pubertal development after GnRHa treatment in girls with central precocious puberty may be matched with normal children.