The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition
The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition
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DOI：
10.1530/eje-12-0191
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发表时间：
2013-02-01
影响因子：
5.8
通讯作者：
Juul, Anders
中科院分区：
文献类型：
--
作者：
Mouritsen, Annette;Aksglaede, Lise;Juul, Anders
背景：青春期的开始通常由女孩的乳房发育和男孩的睾丸生长来定义。阴毛初长被定义为阴毛的生长，被认为是青春期过渡的标志。阴毛初露之前，肾上腺雄激素、DHEA 和 Delta 4-雄烯二酮 (Adione) 的产生逐渐增加，这一过程称为肾上腺初现。 目的：研究青春期过渡的自然过程以及与肾上腺初现、身体脂肪和线性生长的关系。设计和方法：对 179 名具有较高社会经济背景的健康儿童（89 名女孩）进行纵向研究，每 6 个月进行一次检查，持续 5 年。测量了阴毛阶段、乳房阶段、生殖器阶段、睾丸体积 (TV)、身高、体重和四个皮褶。结果：在女孩中，乳房初发育 (B2+) 时的中位年龄（第 25 个百分位和第 75 个百分位数）为 10.1 岁 (9.3-10.9)。在男孩中，获得电视 >3 毫升的中位年龄为 11.5 岁 (10.9-12.0)。女孩的阴毛初露 (PH2+) 中位年龄为 10.9 岁 (10.3-11.4)，男孩为 11.6 岁 (10.8-12.4)。只有 6.8% (4/59) 的女孩和 24.6% (15/61) 的男孩长出阴毛，这是青春期的第一个孤立迹象。血清 DHEAS 和 Adione 随着年龄的增长而增加，尽管 Adione 的增加在女孩中最为明显。没有观察到乳房发育/睾丸生长过早与体脂增加（BMI 和四个皮褶之和）之间存在关联。结论：丹麦儿童很少将阴毛初露作为青春期的第一个迹象。未发现青春期开始年龄与身体成分之间存在关联。随着青春期的开始，Adione（而非 DHEAS）的循环水平增加，尽管个体间差异较大。欧洲内分泌学杂志168 129-136
Background: Pubertal onset is usually defined by breast development in girls and testicular growth in boys. Pubarche is defined as the attainment of pubic hair and is considered as a sign of pubertal transition. Pubarche is preceded by a gradual increase in production of adrenal androgens, DHEA and Delta 4-androstenedione (Adione), a process termed adrenarche.Objective: To study the natural course of pubertal transition and the associations with adrenarche, body fat, and linear growth.Design and methods: A longitudinal study of 179 healthy children (89 girls) with higher socioeconomic background examined every 6 months for 5 years. Pubic hair stage, breast stage, genital stage, testicular volume (TV), height, weight, and four skinfolds were measured.Results: In girls, median age (25th and 75th percentiles) at thelarche (B2+) was 10.1 years (9.3-10.9). In boys, median age at attaining a TV >3 ml was 11.5 years (10.9-12.0). Median age at pubarche (PH2+) was 10.9 years (10.3-11.4) in girls and 11.6 years (10.8-12.4) in boys. Only 6.8% (4/59) of the girls and 24.6% (15/61) of the boys developed pubic hair as the first isolated sign of puberty. Serum DHEAS and Adione increased with age, although the increase in Adione was most pronounced in girls. No associations between early age at thelarche/testicular growth and increased body fat (BMI and sum of four skinfolds) were observed.Conclusion: Danish children rarely experience pubarche as the first sign of puberty. No associations between age at pubertal onset and body composition were found. Circulating levels of Adione, but not DHEAS, increased with the onset of puberty, although with large interindividual variability. European Journal of Endocrinology 168 129-136