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Puberte Prekoks ve Obezite İlişkisinin Değerlendirilmesi

Year 2022, Volume: 12 Issue: 4, 659 - 663, 28.12.2022
https://doi.org/10.31832/smj.1204475

Abstract

Amaç: Benzer yaşam koşullarına rağmen ergenlik zamanlamasındaki belirgin değişiklik, ergenlik başlangıcında çok sayıda faktörün etkili olduğunu gösterir. Ergenlik başlama yaşını genetik ve çevresel faktörler, stres, sosyoekonomik durum, metabolik hız ve vücut yağ oranı gibi birçok faktör etkiler. Son çalışmalar, ergenlik yaşının daha erkene kaydığını göstermiştir. Çocukluk çağı obezitesinin artan prevalansı buna katkı sağladığı varsayılmaktadır. Bu nedenle puberte prekoks nedeni ile takip edilen hastalarda obezite ve fazla ağırlık sıklığını belirlemek, obezite kemik yaşı, boy yaşı ilişkisini değerlendirmek ve obezite ile hormon profili ilişkisini incelemek amacıyla bu çalışmayı planladık.
Araçlar ve Yöntem: Sakarya Eğitim ve Araştırma Hastanesi Çocuk Endokrinoloji polikliniğinde Ekim 2018 ile Ekim 2021 tarihleri arasında takip edilen idiopatik puberte prekoks tanılı 206 hastanın dosyaları retrospektif olarak tarandı. Hastaların dosyalarından antropometrik verileri (yaş, cins, boy, kilo, vücut kitle indeksi, puberte evresi), kemik yaşı, boy yaşı, kilo yaşı kaydedildi. Hastalar vücut kitle indeksine (VKİ) göre normal kilolu, fazla ağırlıklı ve obez olarak gruplandırıldı.
Bulgular: Hastaların %97.6’sı (201 hasta) kız, %2.4’ü (5 hasta) erkekti. Hastaların 131’i (%63.6) normal kiloda, 40’ı (%19.4) fazla ağırlıklı, 35’i (%17) obezdi. Gruplar arasında (normal kilo, fazla ağırlıklı ve obez), kilo yaşı, VKİ persentili, boy yaşı, kemik yaşı ve kemik yaşı standart deviasyon skoru (SDS) değerleri arasında anlamlı fark saptandı (sırasıyla p=<0.001, p=< 0.00, p=0.015, p =0.026, p=0.035). Hastaların mevcut puberte evresi hastaların takvim yaşından ziyade kemik yaşı ve kilo yaşı ile daha korele idi.
Sonuç: Puberte prekoks hastalarında fazla ağırlık ve obezite sıklığı artmıştır. Obezite puberte prekoks için kolaylaştırıcı bir risk faktörü gibi görünmektedir. Puberte başlangıcında kemik yaşı ve kilo yaşı daha belirleyicidir. Erken ergenliği olan kızlarda etiyolojik neden ararken ya da tedaviye karar verirken obezite dikkate alınmalıdır.

Project Number

71522473-050.01.04-64758-440

References

  • 1. Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009;123:e752-e762.
  • 2. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2017;14:1266.
  • 3. Zukauskaite S, Lasiene D, Lašas L, Urbonaite B, Hindmarsh P. Onset of breast and pubic hair development in 1231 preadolescent Lithuanian school girls. Arch Dis Child 2005;90:932-936.
  • 4. Garibaldi RL, Chemaitelly W. Disorders of pubertal development. In: Kliegman R, St Geme J, editors. Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. pp.2899-2912
  • 5. Aksglaede L, Olsen LW, Sørensen TI, Juul A. Forty years trends in timing of pubertal growth spurt in 157,000 Danish school children. PLoS One. 2008;3:e2728.
  • 6. Howard SR, de Roux N, Leger J, Carel JC, Dunkel L. Puberty and its disorders. In: Brook’s Clinical Pediatric Endocrinology. Dattani MT, Brook CGD editors. 7th ed. Wiley-Blackwell; 2019. pp. 235-289
  • 7. Aksglaede L, Juul A, Olsen LW, Sørensen TI. Age at puberty and the emerging obesity epidemic. PLoS One. 2009;4:e8450.
  • 8. Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics. 2002;110:903-910.
  • 9. Shalitin S, Phillip M. Role of obesity and leptin in the pubertal process and pubertal growth-a review. Int J Obes Relat Metab Disord. 2003;27:869-874.
  • 10. Zurita-Cruz JN, Villasís-Keever MA, Damasio-Santana L, Manuel-Apolinar L, Nishimura-Meguro E, Rivera-Hernández AJ, et al. Relatıonshıp Between Serum Leptın Levels And Weıght Gaın In Gırls Wıth Central Precocıous Puberty At 1-Year Follow-Up. Endocr Pract 2017;23:519-525.
  • 11. Günöz H. Büyüme bozuklukları. In: Çocuk endokrinolojisi. Cinaz P, Darendeliler F, Akıncı A, Özkan B, Dündar BN, Abacı A, Akçay T, editörler. Nobel Tıp Kitapevleri; 2014. pp. 31-76
  • 12. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303.
  • 13. https://bonexpert.com/ahp/ Accessed on: 02 November, 2022.
  • 14. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, Baş F. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015 Dec;7:280-93.
  • 15. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman-Giddens ME. Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001;108(2):347-353
  • 16. Adair LS, Gordon-Larsen P. Maturational timing and overweight prevalence in US adolescent girls. Am J Public Health. 2001;91:642-644.
  • 16. He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49:244-251.
  • 17. Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty?. Lancet Child Adolesc Health. 2019;3(1):44-54.
  • 18. Liu M, Cao B, Luo Q, et al. The critical BMI hypothesis for puberty initiation and the gender prevalence difference: Evidence from an epidemiological survey in Beijing, China. Front Endocrinol (Lausanne). 2022;13:1009133.
  • 19. He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49:244-251.
  • 20. Atay Z, Turan S, Guran T, Furman A, Bereket A. Puberty and influencing factors in schoolgirls living in Istanbul: end of the secular trend?. Pediatrics. 2011;128:e40-e45.
  • 21. Semiz S, Kurt F, Kurt DT, Zencir M, Sevinç O. Pubertal development of Turkish children. J Pediatr Endocrinol Metab. 2008;21:951-961.
  • 22. “Türkiye Çocukluk Çağı (İlkokul 2. Sınıf Öğrencileri) Şişmanlık Araştırması - COSI-TUR 2016” Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Milli Eğitim Bakanlığı, Dünya Sağlık Örgütü Avrupa Bölge Ofisi, Sağlık Bakanlığı Yayın No: 1080, Ankara 2017. Accessed on: 02 November, 2022. https://hsgm.saglik.gov.tr/depo/haberler/turkiye-cocukluk-cagi-sismanlik/COSI-TUR-2016-Kitap.pdf

Evaluation of the Association between Precocious Puberty and Obesity

Year 2022, Volume: 12 Issue: 4, 659 - 663, 28.12.2022
https://doi.org/10.31832/smj.1204475

Abstract

Objective: The marked variation in the timing of puberty despite similar living conditions shows that many factors are effective in determining the onset of puberty. Many factors, such as genetic and environmental factors, stress, socioeconomic status, metabolic rate, and body fat ratio, affect the age of puberty onset. Recent studies have shown that the age of puberty onset has shifted to earlier ages. The increasing prevalence of childhood obesity is deemed to contribute this change. Therefore, we planned the present study to determine the rates of obesity and overweight, to evaluate the association between obesity, bone age, and height age, and to examine the association between obesity and hormone profile.
Materials and Methods: The medical records of 206 patients diagnosed with idiopathic precocious puberty who were being followed up at the Pediatric Endocrinology outpatient clinic of Sakarya Training and Research Hospital between October 2018 and October 2021 were retrospectively reviewed. Anthropometric data (age, gender, height, weight, body mass index, and puberty stage), bone age, height age, and weight age of the patients were recorded from the medical records. Patients were grouped as normal weight, overweight, and obese by body mass index (BMI).
Results: Of the included patients, 97.6% (201 patients) were female and 2.4% (5 patients) were male. One hundred and thirty-one patients (63.6%) had normal weight, 40 (19.4%) were overweight and 35 (17%) had obesity. Significant differences were found between the groups (normal weight, overweight and obese) in terms of weight age, BMI percentile, height age, bone age, and bone age standard deviation score (SDS) (p = <0.001, p = < 0.00, p = 0.015, p = 0.026, and p = 0.035, respectively). The current puberty stages of the patients were more correlated with bone age and weight age than with chronological age.
Conclusion: The overweight and obesity rates are increased in patients with precocious puberty. Obesity appears to be a facilitating factor for precocious puberty. Bone age and weight age are more determinants for the onset of puberty.
Obesity should be considered when searching for the etiological reason or deciding on treatment in girls with precocious puberty.

Supporting Institution

NO

Project Number

71522473-050.01.04-64758-440

References

  • 1. Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics. 2009;123:e752-e762.
  • 2. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between Obesity and Puberty Timing: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2017;14:1266.
  • 3. Zukauskaite S, Lasiene D, Lašas L, Urbonaite B, Hindmarsh P. Onset of breast and pubic hair development in 1231 preadolescent Lithuanian school girls. Arch Dis Child 2005;90:932-936.
  • 4. Garibaldi RL, Chemaitelly W. Disorders of pubertal development. In: Kliegman R, St Geme J, editors. Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. pp.2899-2912
  • 5. Aksglaede L, Olsen LW, Sørensen TI, Juul A. Forty years trends in timing of pubertal growth spurt in 157,000 Danish school children. PLoS One. 2008;3:e2728.
  • 6. Howard SR, de Roux N, Leger J, Carel JC, Dunkel L. Puberty and its disorders. In: Brook’s Clinical Pediatric Endocrinology. Dattani MT, Brook CGD editors. 7th ed. Wiley-Blackwell; 2019. pp. 235-289
  • 7. Aksglaede L, Juul A, Olsen LW, Sørensen TI. Age at puberty and the emerging obesity epidemic. PLoS One. 2009;4:e8450.
  • 8. Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics. 2002;110:903-910.
  • 9. Shalitin S, Phillip M. Role of obesity and leptin in the pubertal process and pubertal growth-a review. Int J Obes Relat Metab Disord. 2003;27:869-874.
  • 10. Zurita-Cruz JN, Villasís-Keever MA, Damasio-Santana L, Manuel-Apolinar L, Nishimura-Meguro E, Rivera-Hernández AJ, et al. Relatıonshıp Between Serum Leptın Levels And Weıght Gaın In Gırls Wıth Central Precocıous Puberty At 1-Year Follow-Up. Endocr Pract 2017;23:519-525.
  • 11. Günöz H. Büyüme bozuklukları. In: Çocuk endokrinolojisi. Cinaz P, Darendeliler F, Akıncı A, Özkan B, Dündar BN, Abacı A, Akçay T, editörler. Nobel Tıp Kitapevleri; 2014. pp. 31-76
  • 12. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303.
  • 13. https://bonexpert.com/ahp/ Accessed on: 02 November, 2022.
  • 14. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, Baş F. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015 Dec;7:280-93.
  • 15. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman-Giddens ME. Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001;108(2):347-353
  • 16. Adair LS, Gordon-Larsen P. Maturational timing and overweight prevalence in US adolescent girls. Am J Public Health. 2001;91:642-644.
  • 16. He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49:244-251.
  • 17. Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty?. Lancet Child Adolesc Health. 2019;3(1):44-54.
  • 18. Liu M, Cao B, Luo Q, et al. The critical BMI hypothesis for puberty initiation and the gender prevalence difference: Evidence from an epidemiological survey in Beijing, China. Front Endocrinol (Lausanne). 2022;13:1009133.
  • 19. He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49:244-251.
  • 20. Atay Z, Turan S, Guran T, Furman A, Bereket A. Puberty and influencing factors in schoolgirls living in Istanbul: end of the secular trend?. Pediatrics. 2011;128:e40-e45.
  • 21. Semiz S, Kurt F, Kurt DT, Zencir M, Sevinç O. Pubertal development of Turkish children. J Pediatr Endocrinol Metab. 2008;21:951-961.
  • 22. “Türkiye Çocukluk Çağı (İlkokul 2. Sınıf Öğrencileri) Şişmanlık Araştırması - COSI-TUR 2016” Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Milli Eğitim Bakanlığı, Dünya Sağlık Örgütü Avrupa Bölge Ofisi, Sağlık Bakanlığı Yayın No: 1080, Ankara 2017. Accessed on: 02 November, 2022. https://hsgm.saglik.gov.tr/depo/haberler/turkiye-cocukluk-cagi-sismanlik/COSI-TUR-2016-Kitap.pdf
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Recep Polat 0000-0002-3786-0739

Project Number 71522473-050.01.04-64758-440
Publication Date December 28, 2022
Submission Date November 15, 2022
Published in Issue Year 2022 Volume: 12 Issue: 4

Cite

AMA Polat R. Evaluation of the Association between Precocious Puberty and Obesity. Sakarya Tıp Dergisi. December 2022;12(4):659-663. doi:10.31832/smj.1204475

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