Downloads
Abstract
Background: Central precocious puberty (CPP) is characterized by the early onset of secondary sexual characteristics before the age of 8 in girls and 9 in boys. It impacts the psychological, social, and health aspects of children, particularly their final height (FH). This study aims to describe the characteristics of CPP in girls and investigate factors related to the predicted FH in girls with CPP.
Methods: This cross-sectional descriptive study was conducted on girls diagnosed with CPP at Hue University of Medicine and Pharmacy Hospital from January 2023 to April 2024.
Results: The average age at diagnosis was 7,71 years. The primary reason for consultation was breast enlargement (86,8%). Height for age ≤ 2SD was observed in 84,2% of cases. The rates of overweight and obesity were 31,6% and 10,5%, respectively. All subjects had breast development of B2 or higher, mainly at stage B3 (68,4%). Pubic hair development was at stage P1 in 78,9% of cases. The average uterine height was 36,06 mm, with 57,9% having a uterine height > 34 mm. Basal serum LH levels > 0,3 IU/ml were found in 57.9% of cases. Bone age exceeded chronological age in 71.1% of cases, the average bone age is 9,24 ± 1,53 years old. The average predicted FH was -0,88 ± 1,29 SD, with 21,1% showing a reduced predicted FH. The group of children with height at diagnosis ≥ 2SD had a higher predicted FH than the group of children with height < 2SD (p<0,05). The group of children with peak LH/FSH ratio > 0.66 had a lower predicted FH than the group of children with peak LH/FSH ratio ≤ 0.66 (p<0.05). There is a moderate positive correlation between predicted FH and height Z score at diagnosis (r = 0,556; p<0,01), between predicted FH and target height (r = 0,459; p<0,01). There is a moderate negative correlation between predicted FH and bone age (r = -0,376; p<0,05), between predicted FH and difference in bone age - chronological age (r = -0,391; p<0,05).
Conclusion: Girls with CPP typically show symptoms between the ages of 6-8, with common clinical and subclinical manifestations such as breast enlargement, pubic hair development, increased levels of sex hormones, uterine height > 34 mm, and advanced bone age. Predicting FH is crucial for timely intervention. There is a relationship between predicted FH and height Z score at diagnosis, target height, peak LH/FSH ratio, bone age and difference in bone age - chronological age.
References
Tinggaard J, Mieritz MG, Sørensen K, Mouritsen A, Hagen CP, Aksglaede L, et al., The physiology and timing of male puberty. Current opinion in endocrinology, diabetes and obesity, 2012;19(3):197-203.
Carel J-C, Eugster EA, Rogol A, Ghizzoni L, Palmert MR, Group motE-LGACC, Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics, 2009;123(4):e752-e762.
De Silva NK, Tschirhart J, Puberty-defining normal and understanding abnormal. Current Treatment Options in Pediatrics, 2016;2:121-130.
Abreu AP, Kaiser UB, Pubertal development and regulation. The lancet Diabetes & endocrinology, 2016;4(3):254-264.
Aguirre RS, Eugster EA, Central precocious puberty: From genetics to treatment. Best Practice & Research Clinical Endocrinology & Metabolism, 2018;32(4):343-354.
Lee M-H, Kim SH, Oh M, Lee K-W, Park M-J, Age at menarche in Korean adolescents: trends and influencing factors. Reproductive health, 2016;13:1-7.
Lê Ngọc D, Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị dậy thì sớm trung ương. 2018.
Latronico AC, Brito VN, Carel J-C, Causes, diagnosis, and treatment of central precocious puberty. The lancet Diabetes & endocrinology, 2016;4(3):265-274.
Dong Y, Dai L, Dong Y, Wang N, Zhang J, Liu C, et al., Analysis of risk factors of precocious puberty in children. BMC Pediatrics, 2023;23(1):456.
Liu Y, Yu T, Li X, Pan D, Lai X, Chen Y, et al., Prevalence of precocious puberty among Chinese children: a school population-based study. Endocrine, 2021;72:573-581.
Carel J-C, Léger J, Precocious Puberty. 2008;358(22):2366-2377.
Greulich WW, Pyle SI, Radiographic atlas of skeletal development of the hand and wrist. The American Journal of the Medical Sciences, 1959;238(3):393.
Chi NTD, Yên HTT, Một số đặc điểm lâm sàng, cận lâm sàng dậy thì sớm vô căn ở trẻ gái. Vietnam Journal of Diabetes and Endocrinology, 2020(38):81-88.
Yến PT, Hiệp NM, Sơn NV, Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị dậy thì sớm trung ương vô căn ở trẻ gái tại Bệnh viện sản nhi Bắc Ninh.. TNU Journal of Science and Technology, 2019;207(14):237-241.
Đặng VC, Trần HD, Nguyễn ĐL, Đặc điểm lâm sàng, cận lâm sàng của 81 trẻ gái dậy thì sớm trung ương tại Bệnh viện Trẻ em Hải Phòng năm 2018-2019= Clinical and Paraclinical Features of 81 Girls with Central Precocious Puberty at Hai Phong Children’s Hospital in 2018-2019. 2021.
Nguyên NHĐ, Yên HTT, Chi NTD, Đặc điểm lâm sàng, cận lâm sàng và các chỉ số siêu âm tử cung buồng trứng trong dậy thì sớm ở trẻ gái. Vietnam Journal of Diabetes and Endocrinology, 2020(41):118-124.
Thành NĐ, Hương NTT, Đặc điểm phát triển thể chất ở trẻ bị dậy thì sớm trung ương tại Bệnh viện đa khoa Xanh Pôn. Tạp chí Y học Việt Nam, 2024;536(1).
Huỳnh TCL, Huỳnh TVQ, Đặc điểm các trường hợp dậy thì sớm trung ương đã hoàn tất điều trị với đồng vận GnRH tại Bệnh viện Nhi đồng 2 từ năm 2011 đến năm 2021. 2022.
Knific T, Lazarevič M, Žibert J, Obolnar N, Aleksovska N, Šuput Omladič J, et al., Final adult height in children with central precocious puberty–a retrospective study. Frontiers in endocrinology, 2022;13:1008474.
Shi L, Jiang Z, Zhang L, Childhood obesity and central precocious puberty. Frontiers in Endocrinology, 2022;13.
Tanner J, Landt K, Cameron N, Carter B, Patel J, Prediction of adult height from height and bone age in childhood. A new system of equations (TW Mark II) based on a sample including very tall and very short children. Archives of disease in childhood, 1983;58(10):767-776.
Lee HS, Yoon JS, Park KJ, Hwang JS, Increased final adult height by gonadotropin-releasing hormone agonist in girls with idiopathic central precocious puberty. PLOS ONE, 2018;13(8):e0201906.
Onat P, Erdeve Ş S, Çetinkaya S, Aycan Z, Effect of gonadotropin-releasing hormone analog treatment on final height in girls aged 6-10 years with central precocious and early puberty. Turk Pediatri Ars, 2020;55(4):361-369.
Adan L, Chemaitilly W, Trivin C, Brauner R, Factors predicting adult height in girls with idiopathic central precocious puberty: implications for treatment*. Clinical Endocrinology, 2002;56(3):297-302.
| Published | 20-10-2024 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 16 No. 7 (2024) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.16.7.5 | |
| Keywords | dậy thì sớm trung ương, tuổi xương, chiều cao cuối dự báo |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.