Assessment and mechanism of variations in pubertal timing in internationally adopted children:: a developmental hypothesis
Assessment and mechanism of variations in pubertal timing in internationally adopted children:: a developmental hypothesis
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DOI：
10.1530/eje.1.02252
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发表时间：
2006-11-01
影响因子：
5.8
通讯作者：
Bourguignon, J-P
中科院分区：
文献类型：
--
作者：
Domine, F.;Parent, A-S;Bourguignon, J-P
在过去几十年中，为国际收养而移徙的儿童人数增加，在发展过程中造成了环境急剧变化的原始条件。在一些国家，这些受试者的队列显示在青春期开始时经历了全球年龄的增长，性早熟比其他情况下更常见。与寄养国的最新参考资料相比，在相对较小的队列或个体患者中使用定义明确的身体指标对这种早期或早熟发育进行了评估。家庭和青少年对青春期时间的评估可以允许对大量国际采用的主题进行研究。此外，这种类型的评估将青春期的生理变化与青春期心理和社会功能的变化结合起来。导致迁徙儿童青春期提前的病理生理机制尚不清楚，可能涉及几个因素。在本文中，我们假设国际收养移民儿童的性早熟可能代表了一种发育程序性障碍，这种障碍是由交流、社会、营养和激素输入导致的中枢神经系统早期重塑累积异常造成的。有证据表明，这些输入的偏差会导致大脑结构的改变，尤其是在大脑边缘系统。我们讨论了可能与进一步的发育功能障碍的联系，如认知、心理社会和性成熟。根据这一假设，某些形式的特发性性早熟可能是由一种或几种环境编程因素的功能障碍引起的，而其他形式可能主要涉及遗传或家族因素。
During the past decades, children migrating for international adoption have increased in number, creating an original condition of dramatic environmental change during development. In several countries, cohorts of these subjects have been shown to experience a global advancement in age at the onset of puberty, and sexual precocity is seen more frequently than in other conditions. Such early or precocious development has been assessed in relatively small cohorts or individual patients using well-defined physical indicators in comparison with updated references in the foster country. Family and adolescent evaluation of pubertal timing could allow for the study of large series of internationally adopted subjects. Also, this type of assessment integrates the physical changes of puberty with the adolescent changes in psychological and social functioning. The pathophysiological mechanisms leading to advancement of puberty in migrating children are still unclear and possibly involve several factors. In the present paper, we hypothesize that the sexual precocity in children migrating for international adoption could represent a developmentally programmed disorder resulting from cumulative anomalies in early remodeling of the central nervous system by communicational, social, nutritional, and hormonal inputs. There is some evidence that the deviations in those inputs can result in altered brain structure, particularly in the limbic system. We discuss the possible association with further disorders of developmental functions, such as cognitive, psychosocial, and sexual maturation. Along this hypothesis, some forms of idiopathic sexual precocity could result from dysfunction of one or several of the environmental programming factors, while other forms may involve predominantly genetic or familial factors.