Update in the etiology and treatment of sexual precocity

사춘기 조숙증의 원인 및 치료의 최신지견

  • Park, Mi Jung (Department of Pediatrics, College of Medicine, Inje University)
  • 박미정 (인제대학교 의과대학 소아과학교실)
  • Received : 2006.06.10
  • Accepted : 2006.06.12
  • Published : 2006.07.15

Abstract

The pubertal activation of gonadotrophin releasing hormone(GnRH) requires coordinated changes in excitatory or inhibitory amino acids, growth factors, and a group of transcriptional regulators. The age of onset of puberty is progressing to younger age. Factors affecting early puberty include genetic traits, nutrition(body fat) and exposure to endocrine disrupting chemicals. In rapidly progressing central precocious puberty, gonadotrophin releasing hormone(GnRH) agonists(GnRHa) appear to increase final height if treated early stage. Further large scaled long-term follow-up study of the effects of GnRHa on final height is needed.

Keywords

References

  1. Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP. The timing of normal puberty and the age limits of sexual precocity : variations around the world, secular trends, and changes after migration. Endocr Rev 2003;24:668-93 https://doi.org/10.1210/er.2002-0019
  2. Ebling FJ. The neuroendocrine timing of puberty. Reproduction 2005;129:675-83 https://doi.org/10.1530/rep.1.00367
  3. Seminara SB, Messager S, Chatzidaki EE, Thresher RR, Acierno JS, Shagoury JK, et al. The GPR54 gene as a regulator of puberty. New Engl J Med 2003;349:1614-27 https://doi.org/10.1056/NEJMoa035322
  4. Shahab M, Mastronardi C, Seminara SB, Crowley WF, Ojeda SR, Plant TM. Increased hypothalamic GPR54 signaling : a potential mechanism for initiation of puberty in primates. Proc Natl Acad Sci USA 2005;102:2129-34 https://doi.org/10.1073/pnas.0409822102
  5. Ojeda SR, Lomniczi A, Mastronardi C, Heger S, Roth C, Parent AS et al, The neuroendocrine regulation of puberty : is the time ripe for a systems biology approach? Endocrinology 2006;147:1166-74 https://doi.org/10.1210/en.2005-1136
  6. Sun SS, Schubert CM, Chumlea WC, Roche AF, Kulin HE, Lee PA, et al. National estimates of the timing of sexual maturation and racial differences among US children. Pediatrics 2002;110:911-9 https://doi.org/10.1542/peds.110.5.911
  7. Park MJ, Lee IS, Shin EK, Joung HJ, Cho SI. The timing of sexual maturation and secular trends of menarchial age in Korean adolescents. Korean J Pediatr 2006;49:610-6 https://doi.org/10.3345/kjp.2006.49.6.610
  8. Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, Koch GG, et al. Secondary sexual characteristics and menses in young girls seen in office practice : a study from the Pediatric Research in Office Settings network. Pediatrics 1997;99:505-12 https://doi.org/10.1542/peds.99.4.505
  9. Kaplowitz PB and Oberfield SE. Reexamination of the age limit for defining when puberty is precocious in girls in the United States : implications for evaluation and treatment. drug and therapeutics and executive committees of the Lawson Wilkins Pediatric Endocrine Society. Pediatrics 1999;104:936-41 https://doi.org/10.1542/peds.104.4.936
  10. Pescovitz OH, Hench KD, Barnes KM, Loriaux DL, Cutler GB Jr. Premature thelarche and central precocious puberty : the relationship between clinical presentation and the gonadotropin response to luteinizing hormone-releasing hormone. J Clin Endocrinol Metab 1988;67:474-9 https://doi.org/10.1210/jcem-67-3-474
  11. 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: 347-53 https://doi.org/10.1542/peds.108.2.347
  12. Dunger DB, Ahmed ML, Ong KK. Effects of obesity on growth and puberty. Best Pract Res Clin Endocrinol Metab 2005;19:375-90 https://doi.org/10.1016/j.beem.2005.04.005
  13. Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys and girls. Pediatrics 2002;110:903-9 https://doi.org/10.1542/peds.110.5.903
  14. Shalitin S, Phillip M. Role of obesity and leptin in the pubertal process and pubertal growth. Int J Obes Relat Metab Disord 2003;27:869-74 https://doi.org/10.1038/sj.ijo.0802328
  15. Hond ED, Schoeters G. Endocrine disrupters and human puberty. Int J Androl 2006;29:264-71 https://doi.org/10.1111/j.1365-2605.2005.00561.x
  16. Blanck HM, Marcus M., Tolbert PE, Rubin C, Henderson AK, Hertzberg VS, et al. Age at menarche and tanner stage in girls exposed in utero and postnatally to polybrominated biphenyl. Epidemiology 2000;11:641-7 https://doi.org/10.1097/00001648-200011000-00005
  17. Colon I, Caro D, Bourdony CJ, Rosario O. Identification of phthalate esters in the serum of young PuertoRican girls with premature breast development. Environ Health Perspect 2000;108:895-900 https://doi.org/10.1289/ehp.00108895
  18. Krstevska-Konstantinova M, Charlier C, Craen M, Du Caju M, Heinrichs C, de Beaufort C, et al. Sexual precocity after immigration from developing countries to Belgium : evidence of previous exposure to organochlorine pesticides. Hum Reprod 2001;16:1020-6 https://doi.org/10.1093/humrep/16.5.1020
  19. Vasiliu O, Muttineni J, Karmaus W. In utero exposure to organochlorines and age at menarche. Hum Reprod 2004;19: 1506-12 https://doi.org/10.1093/humrep/deh292
  20. Maskarinec G, Morimoto Y, Franke AA, Novotny R, Nordt FJ, Stanczyk FZ. Urinary Sex steroid excretion levels during a soy intervention among young girls : A Pilot Study. Nutr Cancer 2005;52:22-8 https://doi.org/10.1207/s15327914nc5201_3
  21. Parent AS, Raiser G, Gerard A, Heger S, Roth C, Mastronardi C. Early onset of puberty : tracking genetic and environmental factors. Horm Res 2005;64:41-7 https://doi.org/10.1159/000087753
  22. Crowley WF, Comite F, Vale W, Rivier J, Loriaux DL, Cutler GB. Therapeutic use of pituitary desensitization with a long-acting l hr agonist : a potential new treatment for idiopathic precocious puberty. J Clin Endocrinol Metab 1981;52:370-2 https://doi.org/10.1210/jcem-52-2-370
  23. Tanaka T, Niimi H, Matsuo N, Fujieda K, Tachibana K, Ohyama K, et al, Results of long-term follow-up after treatment of central precocious puberty with leuprorelin acetate : evaluation of effectiveness of treatment and recovery of gonadal function. The TAP-144-SR Japanese Study Group on Central Precocious Puberty. J Clin Endocrinol Metab 2005;90:1371-6 https://doi.org/10.1210/jc.2004-1863
  24. Carel JC, Lahlou N, Jaramillo O, Montauban V, Teinturier C, Colle M, et al. Treatment of central precocious puberty by subcutaneous injections of leuprorelin 3-month depot (11.25 mg). J Clin Endocrinol Metab 2002;87:4111-6 https://doi.org/10.1210/jc.2001-020243
  25. Rosenfiel RL. Abnormal puberty. In : Sperling MA, editor. Pediatric endocrinology. 2nd ed. Philadelphia : Saunders, 2002:483-90
  26. Walvoord EC, Pescovitz OH, Combined use of growth hormone and gonadotropin-releasing hormone analogues in precocious puberty. Pediatrics 1999;104:1010-4
  27. Brown JJ, Warne GL. Growth in precocious puberty. Indian J Pediatr 2006;73:81-8 https://doi.org/10.1007/BF02758267
  28. Carel JC, Lahlou N, Roger M, Chaussain JL. Precocious puberty and statural growth. Human Reproduction Update 2004;10:135-47 https://doi.org/10.1093/humupd/dmh012
  29. Heger S, Partsch CJ, Sippell WG. Long-term outcome after depot gonadotropin-releasing hormone agonist treatment of central precocious puberty : final height, body proportions, body composition, bone mineral density, and reproductive function. J Clin Endocrinol Metab 1999;84:4583-90 https://doi.org/10.1210/jc.84.12.4583
  30. Arrigo T, Cisternino M, Galluzzi F, Bertelloni S, Pasquino AM, Antoniazzi F, et al. Analysis of the factors affecting auxological response to GnRH agonist treatment and final height outcome in girls with idiopathic central precocious puberty. Eur J Endocrinol 1999;141:140-4 https://doi.org/10.1530/eje.0.1410140
  31. Adan L, Chemaitilly W, Trivin C, Brauner R. Factors predicting adult height in girls with idiopathic central precocious puberty : implications for treatment. Clin Endocrinol 2002;56:297-302 https://doi.org/10.1046/j.1365-2265.2002.01488.x
  32. Klein KO, Barnes KM, Jones JV, Feuillan PP, Cutler GB. Increased final height in precocious puberty after long-term treatment with LHRH agonists : The National Institutes of Health Experience. J Clin Endocrinol Metab 2001;86:4711-6 https://doi.org/10.1210/jc.86.10.4711
  33. Ahn SY, Yoo JH, Shin CH, Yang SW. The effects of gonadotropin releasing hormone agonist on final height and its related factors in patients with true precocious puberty. Korean J Pediatr 2004;47:647-55