• 제목/요약/키워드: puberty

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성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가 (Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type)

  • 김정인;권원현;문기춘;이인원
    • 핵의학기술
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    • 제20권2호
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    • pp.54-61
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    • 2016
  • 1. 목적 성조숙증은 2차성징의 발달이 여아에서는 8세 이전 남아에선 9세 이전에 조기 2차성징이 출현하는 증상으로 골단의 조기 폐쇄를 일으켜 결국 최종 성인 신장의 감소를 가져오는 질환이다. 본 연구는 성조숙증으로 내원한 여아들의 GnRH(Gonado-tropin-releasing Hormone) 자극검사 결과와 의무기록을 후향 분석하여 진단별 차이를 알아보고자 하였다. 2. 방법 2015년 2월부터 2015년 12월까지 분당서울대병원 소아청소년 내분비내과를 내원한 여아 118명을 대상으로 하였다. 의무기록을 후향 분석하여 대상 환아들은 진성 성조숙증(true precocious puberty) 57명, 조기사춘기(early puberty) 39명, 유방 조기발육군(premature thelarche) 22명을 진단별로 분류하였다. 진단 당시의 신장, 체중, Tanner stage, 골연령, 역연령, 부모의 키, GnRH 검사에서 LH, FSH와 E2 (Estradiol) Basal 값도 함께 조사하였다. 성선 자극호르몬 결과값 LH (Basal,30min,45min,60min) FSH(Basal,30min,60min)을 비교하여 각 그룹별 LH, FSH Peak치 분포도와 LH 최고치/LH 기저치 비율에 대한 평균${\pm}$표준편차와 LH 최고치/FSH 최고치 비율에 대한 평균${\pm}$표준편차를 비교하여 각 3그룹 간 유의확률(P-value) 값을 구하였다. 골연령의 측정은 Greulich-Pyle법(왼쪽 수근골 X선 사진을 촬영하여 골성숙도를 평가하는 방법- 6개월 단위의 표준손목사진을 보고 비교해서 골연령을 유추하는 방식)을 이용한 소아 청소년 내분비내과 교수가 직접 판독한 결과로 사용하였고 GnRH 검사는 합성 LHRH 100 ug을 정맥 주사하여 LH는 Basal, 30분, 45분,60분 후에 채혈된 결과값과 FSH는 Basal, 30분, 60분후에 채혈된 결과값을 조사하였다. 3. 결과 진성성조숙증그룹의 평균 키는$131{\pm}14.85$, 평균체중은 $8.80{\pm}4.93$, 평균역연령은 $7.1{\pm}0.81$, 평균 골연령은 $9.9{\pm}0.9$, 조기사춘기 그룹의 평균키는 $134{\pm}5.10$, 평균체중은 $28.50{\pm}4.43$, 평균역연령은 $8.05{\pm}0.03$, 평균 골연령은 $10.0{\pm}0.62$, 유방조기발육군의 평균 키는 $129{\pm}6,01$ 평균체중은 $28.65{\pm}5.98$, 평균역연령은 $7.02{\pm}0.58$ 평균 골연령은 $8.04{\pm}1.29$로 세 그룹간에 키와 체중 비교 시 유의한 차이가 없었고 역연령(P < 0.0001), 골연령( P< 0.0001), 골연령과 역연령과의 차이(P < 0.0002 )에서는 그룹간 유의한 차이가 있었다. 각 그룹별 LH, FSH Peak치 분포도 비교시 진성성조숙증 그룹은 LH 30분-82.5%, 45분-12.3%, 60분-5.3%, FSH 30분-8.8%, 60분-91.2%로 높은 Peak치를 보였고 조기사춘기 그룹은 LH 30분-79.5%, 45분-17.9%, 60분-2.6%, FSH 30분-7.7%, 60분 -92.32%로 높은 Peak치를 나타내었다. 유방조기 발육군 그룹에서는 LH 30분-30%, 45분-59%, 60분-9.09%, FSH 30분 -0%, 60분-100%로 Peak치를 나타내었다. LH Peak/LH basal ratio 비교시 진성성조숙증 그룹은 $19.09{\pm}17.15$, 조기사춘기 그룹은 $15.23{\pm}10.88$ 유방조기 발육군 그룹은 $4.93{\pm}4.36$으로 3 그룹간 유의한 차이를 보였다(P < 0.0001). LH Peak/FSH Peak ratio 비교시 진성성조숙증 그룹은 $1.222{\pm}0.77$, 조기사춘기 그룹은 $1.34{\pm}1.23$ 유방조기 발육군 그룹은 $0.3{\pm}0.09$로 3 그룹간 유의한 차이(P < 0.0001)를 보였다. 4. 결론 여아들의 진성성조숙증을 진단하기 위한 GnRH Test 검사는 자극 후 30분과 60분 사이에 LH 최고치가 기저치에 비해 2~3배 이상 증가 되어 있거나 또는 5~10 IU/L 이상 증가되었을 때 유용한 판정 자료로 이용 될 수 있는 핵의학 연속검사라고 사료되어진다.

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Effect of Soyabean Isoflavones Exposure on Onset of Puberty, Serum Hormone Concentration and Gene Expression in Hypothalamus, Pituitary Gland and Ovary of Female Bama Miniature Pigs

  • Fan, Juexin;Zhang, Bin;Li, Lili;Xiao, Chaowu;Oladele, Oso Abimbola;Jiang, Guoli;Ding, Hao;Wang, Shengping;Xing, Yueteng;Xiao, Dingfu;Yin, Yulong
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권11호
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    • pp.1573-1582
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    • 2015
  • This study was to investigate the effect of soyabean isoflavones (SIF) on onset of puberty, serum hormone concentration, and gene expression in hypothalamus, pituitary and ovary of female Bama miniature pigs. Fifty five, 35-days old pigs were randomly assigned into 5 treatment groups consisting of 11 pigs per treatment. Results showed that dietary supplementation of varying dosage (0, 250, 500, and 1,250 mg/kg) of SIF induced puberty delay of the pigs with the age of puberty of pigs fed basal diet supplemented with 1,250 mg/kg SIF was significantly higher (p<0.05) compared to control. Supplementation of SIF or estradiol valerate (EV) reduced (p<0.05) serum gonadotrophin releasing hormone and luteinizing hormone concentration, but increased follicle-stimulating hormone concentration in pigs at 4 months of age. The expression of KiSS-1 metastasis-suppressor (KISS1), steroidogenic acute regulatory protein (StAR) and 3-beta-hydroxysteroid dehydrogenase/delta-5-delta-4 isomerase ($3{\beta}-HSD$) was reduced (p<0.01) in SIF-supplemented groups. Expression of gonadotropin-releasing hormone receptor in the pituitary of miniature pigs was reduced (p<0.05) compared to the control when exposed to 250, 1,250 mg/kg SIF and EV. Pigs on 250 mg/kg SIF and EV also showed reduced (p<0.05) expression of cytochrome P450 19A1 compared to the control. Our results indicated that dietary supplementation of SIF induced puberty delay, which may be due to down-regulation of key genes that play vital roles in the synthesis of steroid hormones.

Effect of Restricted Feed Intake on Early Reproductive Development in Large White Gilts

  • Gaughan, John B.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권11호
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    • pp.1534-1541
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    • 2001
  • Forty-five Large White gilts were used to study the effect of energy intake from 28 to 176 d of age on body composition and reproductive development. From 28 to 60 d, the gilts were fed ad libitum a 16.6 MJ DE/kg, 24% crude protein and 1.3% total lysine diet. From 61 d of age three dietary treatments were used; 1) ad libitum access to feed (15.6 MJ DE/kg, 21% crude protein and 1.07% total lysine) (H), 2) feed offered at 75% (M) of the previous days intake of H, and 3) feed offered at 60% (L) of the previous days intake of H. ADG from 61 to 176 d of age was (p<0.05) affected by treatment. Although live weight at 176 d of age did not differ (p>0.1) the H gilts had higher (p<0.08) carcass weights than the M or L gilts. Back fat depths were similar (p>0.1) for all treatments at 115 d of age, however by 176 d of age M and H gilts were fatter (p<0.1) than L gilts. The mean lipid deposition (LD) from 115 to 176 d of age for L gilts (78.9 g/d) was less (p<0.05) than for M gilts (143.6 g/d) and H gilts (135.6 g/d). There were no differences between treatments for protein deposition (PD) over the same period. More (p<0.05) H gilts (n=8) attained puberty (first observed estrus) than either M gilts or L gilts (n=4 for both). Follicle numbers were similar (p>0.1) across treatments. For gilts that attained puberty, H gilts had fewer (p<0.05) follicles (13.5) than M gilts (19.7) and L gilts (21.3). For gilts with follicular development, H gilts had the heaviest (458.7 g) reproductive tract weight (RTW). However, for those that attained puberty, L gilts had the heaviest RTW. RTW were lowest for those with no follicular development. Energy restriction had a negative impact on puberty attainment, i.e. it took longer to reach puberty. However, for gilts that attained puberty, the number of follicles was greater for those on r feed intakes. It would appear that rate of fat deposition, but not necessarily the total amount of fat, plays an important role in puberty attainment.

환경 중 수은, 카드뮴 및 피레스로이드계 살충제 노출과 아동의 사춘기 지연 간의 연관성: 제3기 국민환경보건기초조사(2015-2017) (Environmental Exposure to Mercury, Cadmium, and Pyrethroid Pesticide and Its Association with Delayed Puberty in Children: Korean National Environmental Health Survey (KoNEHS) 2015-2017)

  • 이주연;채우리;허다안;문경환
    • 한국환경보건학회지
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    • 제47권3호
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    • pp.245-258
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    • 2021
  • Objectives: In many previous studies, endocrine disruptors (EDCs) have been found to affect delays in puberty. Various EDCs have been reported on, but there have been only limited epidemiologic studies on the effects of exposure to environmental heavy metals and pyrethroid pesticides on puberty delay. Therefore, the aim of this study was to investigate the association of exposure to environmental mercury, cadmium, and pyrethroid pesticides with delayed puberty in children based on national survey data that represents Korean children. Methods: We selected 450 children at the ages of 9-11 years old from the third Korean National Environmental Health Survey (3rd KoNEHS). The relations of urinary Hg, Cd, and 3-PBA with pubertal development were evaluated using multiple logistic regression analyses. Results: Urinary Hg levels were significantly associated with delayed puberty in boys [testicle development: OR=0.41 (95% CI: 0.20, 0.84); genitalia development: OR=0.35 (95% CI: 0.15, 0.81)]. Girls with higher Hg levels were more likely to experience delayed menarche [OR=0.23 (95% CI: 0.06, 0.90)]. We observed a significant 49% reduction in odds for menarche per increasing unit of urinary cadmium levels [OR=0.51 (95% CI: 0.24, 1.01)]. In addition, urinary 3-PBA showed a negative association with genitalia development in boys and menarche in girls [genitalia development: OR=0.73 (95% CI: 0.55, 0.96); menarche: OR=0.56 (95% CI: 0.32, 1.00)]. Conclusions: The results of this study support the hypothesis that exposure to environmental mercury, cadmium and pyrethroid pesticides may affect puberty delays. Additional evidence needs to be obtained through further prospective studies.

사춘기 여학생의 월경곤란증에 대한 이압요법(耳壓療法)의 효과 (Effect of the Auricular Acupressure Therapy on Dysmenorrhea of Puberty Girls)

  • 김소영;이향련
    • 여성건강간호학회지
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    • 제16권1호
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    • pp.20-28
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    • 2010
  • Purpose: The purpose of this study was to identify the effect of auricular acupressure therapy on dysmenorrhea of puberty girls. Methods: This study was a pretest-posttest design with a nonequivalent control group. The subjects of this study were 61 girls who were middle and high school students in Seoul and the experiencing dysmenorrhea; 31 for the experimental group and 30 for the control group. The obtained data were analyzed by SPSS/WIN 12.0 program. Results: The experimental group which applied the auricular acupressure therapy scored lower for low abdominal pain (F=136.13, p=.000), low back pain (F=62.79, p=.000). autonomic nervous system reactions (F=102.31, p=.000) and negative emotions on the menstruation (F=102.31, p=.000) compared to the control group. There were significant interaction effects of auricular acupressure on low abdominal pain, low back pain, autonomic nervous system reactions, and negative emotions on the menstruation between time and group. Conclusion: We observed that auricular acupressure therapy is effective for reliving pain and the symptom of dysmenorrhea. Based on these result, auricular acupuncture is useful by individual nursing intervention and improves the quality of life for dysmenorrhea of puberty girls.

A Study on Dietary Habits and Lifestyle of Girls with Precocious Puberty

  • Heo, Jae-Seong;Moon, Hyeok-Soo;Kim, Mi-Kyeong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제19권2호
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    • pp.130-138
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    • 2016
  • Purpose: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. Methods: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. Results: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. Conclusion: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.

Human 성장호르몬을 도입한 Transgenic Rats의 작출과 번식표현형에 관한 연구 I. mWAP/hGH을 도입한 Rat의 Endogenous GH분비 변화와 성성숙에 미치는 영향 (Studies on Phenotype of Reproduction and Production of Human Growth Hormone(hGH) with Transgenic Rats I. Changes in Endogenous Grwoth Hormone Secretion and Onset of Puberty in hGH Transgenic Rats)

  • 장규태;김성현;성환후;주학진;박미령;윤창현
    • 한국가축번식학회지
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    • 제22권2호
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    • pp.127-136
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    • 1998
  • A chimeric gene comprising murine whey acidic protein(mWAP) and human growth hormone(hGH) was used to produce transgenic rats express hGH and secrete it into the blood. Two lines of transgenic rats carrying the mWAP/hGH construct were established; High line was characterized by relatively high levels of serum hGH, and low line had relatively low levels. The secretory profiles of rat GH(rGH) as well as hGH, the transgene product, were obtained in transgenic males and females of low line; both hGH and rGH serum levels were flattened with no episodic fluctuations, and the overall mean concentration of rGH was significantly lower than in normal littermates. Although the animals of High line showed an acceles, as assessed by vaginal opening and occurrence of first ovulation, advanced by 7∼8 days in both lines of animals. Accordingly, the body weight at puberty of low line transgenic females was much lower than that of normal littermates, indicating that continuous hGH expression could induce precocious puberty without enhancing the growth rate.

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초등학교 저학년 여학생의 성 성숙과 신체상 및 자아존중감에 관한 연구 (Sexual maturation, Body image, and Self-esteem among Girls of Lower Grades in Elementary School)

  • 노소영;김계하
    • 지역사회간호학회지
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    • 제23권4호
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    • pp.405-414
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    • 2012
  • Purpose: The purpose of this study was to examine the sexual maturation, body image, and self-esteem of Korean elementary school girls with symptoms of precocious puberty compared to those with no symptoms of precocious puberty. Methods: The subjects were 309 girls of lower grades in elementary school. Tanner's Sexual Maturation Rating (SMR), Self Image Scale, and Self-esteem Scale were utilized to determine the presence of symptoms of precocious puberty, body image, and self esteem. Collected data were analyzed by Chi-square test, independent t-test, and one-way ANOVA using the SPSS/WIN 17.0 program. Results: The percentage of the girls with breast development was 14.9%. Breast development usually began in the third grade (56.5%). Of the subjects, 0.3% were experiencing menstruation. Breast development was related to grade, age, height, weight, and a cause of worry. There was a significant difference of body image between girls with breast development in the first grade and in the second grade. Conclusion: An effective intervention that can improve the self-image of children with symptoms of precocious puberty should be developed to prevent and treat physical and mental problems related to sexual maturation.

Milk yield and kit development of four breeds of rabbit in Ibadan, Nigeria

  • Jimoh, Olatunji Abubakar;Ewuola, Emmanuel Olabisi
    • Journal of Animal Science and Technology
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    • 제59권12호
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    • pp.25.1-25.7
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    • 2017
  • Background: Rabbit breeding with high performance imported ones would be of benefit for genetic diversity and improvement of performance in domestic rabbit breeds. The rearing of more productive rabbit breeds could be pathway to improve the productivity and reduce the production cost. Maternal nutritional status exert a great influence on reproductive functions of does, which may expand from conception, through gestation and parturition and development of kits to puberty. Methods: Four breeds of rabbit were evaluated for their parturition, weaning and pubertal differences among the rabbit population in Ibadan, Nigeria. The breed consist of Fauve De Bourgogne (FDB), Chinchilla (CHA), British Spot (BS) and New Zealand White (NZW) rabbits. A total of 60 bucks and 360 does consisting of 15 bucks and 90 does per breed were mated in 6 mating cycles, three each of natural mating and artificial insemination. All does were synchronized for estrus with 20 IU pregnant mare serum gonadotropin 48 h prior to mating. The does after parturition were assessed for milk yield (g) and kit survival rate (%) till weaning, weight changes of kits from birth to puberty. At puberty, the pubertal age (days) and weight (g) of the offspring were assessed. Result: Results obtained reveals that British Spot doe had highest milk yield among the breeds which significantly increased growth of kit and weight at weaning in British Spot rabbits. Survival rates of Chinchilla kits were significantly (p < 0.05) higher than Fauve de Bourgogne, British Spot and New Zealand White kits. Puberty attainment of the rabbits indicates that British spot does and Fauve de Bourgogne bucks are early maturing. Conclusion: Chinchilla shows high kit survivability and British spot has highest milk yield among the four breeds of rabbit.

Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • 제58권1호
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.