Childhood Obesity and Sexual Maturation

描述（由申请人提供）：这项修订后的赠款申请是项目R 01 HD 38356美国儿童性成熟的竞争延续，这是一项关于性成熟和体重，身高和BMI的横断面研究。竞争性的更新建议分析从出生到20岁的长期系列数据收集在287名男孩和269名女孩在费尔斯纵向研究。女孩的乳房发育（乳房发育）通常先于阴毛的出现（肾上腺发育），而男孩的生殖器发育（性腺发育）通常先于肾上腺发育。在每种性别中，都有一个交替的途径，其中女孩的肾上腺发育先于乳房发育，男孩的性腺发育先于肾上腺发育。具体的目的是检查，纵向，（i）出生体重和身体成分的影响，对两个青春期的途径和（ii）在男孩和女孩的成熟率的影响，同期和随后的身体脂肪，脂肪分布，瘦体重，血压，骨量，血脂谱和胰岛素抵抗。这些参数是重要的，因为它们与心血管疾病，2型糖尿病和骨质疏松症的关系。这种应用依赖于这样的想法，即身体组成与青春期和青少年生长的事件密切相关的促性腺激素轴，促生长激素轴，肾上腺雄激素，瘦素和胰岛素之间的相互作用。Fels数据集中这些因素的纵向建模将产生对青春期过程的机械见解，也将有助于预测那些在以后的生活中最有可能患代谢综合征的儿童。在Fels纵向研究中，我们收集了成熟和身体组成指标，瘦素，胰岛素，IGF-1，DHEAS和性腺类固醇以及心血管疾病，2型糖尿病和骨质疏松症的危险因素的长期系列数据。这些数据提供了一个独特的机会，研究身体成分和性成熟之间的关系，在男孩和女孩。Fels参与者在出生时就被招募到研究中，并且不根据与任何特定身体组成或临床状况相关的因素进行选择。从拟议的研究中揭示的关系和得出的推论应反映出生体重和身体成分对性成熟自然史的影响，以及脂肪和脂肪分布的发展，瘦体重，骨矿物质含量和生命后期疾病的相关风险因素。

DESCRIPTION (provided by applicant): This revised grant application is a competing continuation of the project R01HD38356 Sexual Maturity in US Children which is a cross-sectional study of sexual maturation and body weight, height, and BMI. The competing renewal proposes to analyze long-term serial data collected from birth to 20 years of age in 287 boys and 269 girls in the Fels Longitudinal Study. In girls breast development (thelarche) usually precedes the appearance of pubic hair (adrenarche), and in boys genital development (gonadarche) usually precedes adrenarche. In each sex there is an alternate pathway in which adrenarche precedes thelarche in girls or gonadarche in boys. The specific aims are to examine, longitudinally, (i) the impact of birth weight and body composition on the two pubertal pathways and (ii) the effects of rate of maturation in boys and girls on contemporaneous and subsequent body fat, fat distribution, lean body mass, blood pressure, bone mass, lipid profiles, and insulin resistance. These parameters are important in view of their relationship to cardiovascular disease, type 2 diabetes, and osteoporosis later in life. This application rests on the idea that body composition is related to the events of puberty and adolescent growth by closely intertwined interactions between the gonadotropic axis, the somatotropic axis, adrenal androgens, leptin, and insulin. Longitudinal modeling of these factors in the Fels data set will yield mechanistic insights into the pubertal process and will also aid in predicting those children who are most at risk for components of the metabolic syndrome later in life. In the Fels Longitudinal Study we have collected long-term serial data for indicators of maturation and body composition, and leptin, insulin, IGF-1, DHEAS, and gonadal steroids as well as risk factors for cardiovascular disease, type 2 diabetes, and osteoporosis. These data provide a unique opportunity to study the relationships between body composition and sexual maturation in boys and girls. The Fels participants are enrolled into the study at birth and are not selected in regard to factors associated with any particular body composition or clinical condition. The relationships revealed and the inferences drawn from the proposed study should reflect the impact of birth weight and body composition on the natural history of sexual maturation and the development of fat and fat distribution, lean body mass, bone mineral content and related risk factors for disease later in life.