Environmental Factors and Puberty Timing: Expert Panel Research Needs

Louis, Germaine M. Buck; Gray, L. Earl; Marcus, Michele; Ojeda, Sergio R.; Pescovitz, Ora Hirsch; Witchel, Selma F.; Sippell, Wolfgang G.; Abbott, David H.; Soto, Ana M.; Tyl, Rochelle W.; Bourguignon, J P; Skakkebæk, Niels E.; Swan, Shanna H.; Golub, Mari S.; Wabitsch, Martin; Toppari, Jorma; Euling, Susan Y.

doi:10.1542/peds.1813e

Cited by 280 publications

(146 citation statements)

References 129 publications

(138 reference statements)

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“…An increasing body of evidence supports environmental influences on pubertal onset and progression [33]. The results of this study show for the first time an association between higher PBDE serum concentrations and PT.…”

Section: Discussionsupporting

confidence: 62%

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

et al. 2016

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Background/Aims: Polybrominated diphenyl ethers (PBDEs) are widely used as flame retardants and have shown endocrine disruption properties in experimental studies. The aim of this study was to investigate the association between the exposure to PBDEs and alterations of puberty in girls referred for idiopathic central precocious puberty (ICPP) and premature thelarche (PT). Methods: A case-control study was conducted in 124 girls: 37 girls with ICPP (mean age 7.4 ± 0.9 years), 56 with PT (mean age 5.7 ± 2.1 years) and 31 controls (mean age 5.4 ± 1.9 years). PBDE serum concentrations, hormone levels and anthropometry were assessed. PBDE concentrations were corrected for total serum lipid content. Individual exposure to PBDEs was evaluated through ad hoc questionnaires. Results: PBDE serum concentrations corrected for total lipid content were significantly higher in girls with PT (mean 1.49 ± 0.63 log ng/g) than in controls (mean 1.23 ± 0.54 log ng/g; p < 0.05). PT girls showed higher levels of PBDE than ICPP girls (1.49 ± 0.63 vs. 1.37 ± 0.49 log ng/g), though this was not significant. An analysis of the questionnaires revealed no significant differences in exposure between the three groups. Conclusion: Our findings suggest that higher concentrations of serum PBDEs are associated with PT in girls.

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Section: Discussionsupporting

confidence: 62%

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

et al. 2016

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“…Although the obesity epidemic is most likely involved in the recent pubertal changes in girls [21,50], advancement in age at puberty has been reported without significant changes in BMI [10]. Thus, other environmental factors that can modify sex steroid bioavailability and sensitivity such as changes in physical fitness [51] and nutrition as well as exposure to endocrine disruption chemicals [52] need to be considered. …”

Section: Secular Trends In Reproductive Hormone Levelsmentioning

confidence: 99%

Recent Secular Trends in Pubertal Timing: Implications for Evaluation and Diagnosis of Precocious Puberty

et al. 2012

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The decline in age at puberty in the general population has been paralleled by an increase in the number of girls referred for evaluation of precocious puberty (PP). In 1999, The Lawson Wilkins Pediatric Endocrine Society recommended a lowering of the age limit for evaluation of PP in girls. However, the limited evidence on which these recommendations were based led many experts to question these new suggestions. The emergence of new European pubertal timing data evaluated by robust clinical as well as biochemical markers has broadened our insight on how to interpret the recent pubertal changes. The recent pubertal trends have resulted in a concomitant lowering of the lower limit of normality of the pubertal onset. However, evidence suggests that age at the gonadotropin and sex steroid surges have not changed. Thus, it looks as if an increasing proportion of contemporary early pubertal girls may experience isolated gonadotropin-independent thelarche rather than central PP, which may not be discernible on pubertal examination alone. Thus, the population-based limits of normality should not be directly translated into revision of age limits for evaluation of PP due to the risk of misdiagnosing rapid progressive PP as well as intracranial and other underlying pathology.

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“…Thus, we cannot exclude the possibility that we are measuring environmental endocrine disrupting chemicals (EDCs). In animal models and in human studies, there is evidence to support a potential effect of EDCs on timing of pubertal onset and progression (32). Dichorodipehnyltichloroetane, dioxins, bisphenol A, polybrominated biphenyl, and phthalate esters have been associated with earlier puberty onset, measured as breast development, or age at menarche (33,34).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Ultrasensitive estrogen levels at 7 years of age predict earlier thelarche: evidence from girls of the growth and obesity Chilean cohort

Pereira

Uauy

Klein

et al. 2015

European Journal of Endocrinology

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Objective: Prepubertal estradiol equivalents have been inconsistently linked to age at thelarche; elucidating this relationship becomes relevant given the worldwide decline in the age of puberty onset. Thus, our aim is to assess whether prepubertal girls with higher serum levels of estradiol equivalents at age 7 have a greater risk of presenting early thelarche (ET). Design: Nested case-control study within the Growth and Obesity Cohort Study of 1196 low-middle income children (w50% girls) from Santiago, Chile. Girls were defined as cases (ET; nZ61) if breast bud appeared prior to 8 years of age; controls (nZ91) had thelarche O8 years. Methods: At 6.7 years, weight, height and waist circumference were measured and a fasting blood sample was obtained for measuring estrogen equivalent (ultrasensitive recombinant cell bioassay), DHEAS, leptin, insulin and IGF1. Beginning at 7 years old, Tanner staging was assessed prospectively twice a year and the appearance of breast bud was assessed by palpation. Results: Mean serum estradiol-equivalent at 6.7 years was 3.9G3.6 pg/ml for cases and 3.6G2.3 pg/ml for controls. Girls with ET had a higher risk of presenting elevated estradiol-equivalent (R5 pg/ml) at 7 years (ORZ2.05, 95% CI: 0.96-4.36) than controls that was borderline significant. However, after adjusting by BMI, insulin and IGF1 at age 7, the association between estradiol-equivalent and ET was significant (ORZ2.29 (95% CI: 1.05-5.01)). Conclusions: Chilean girls from low to middle socioeconomic status with ET exhibited double the risk of having high levels of estradiol-equivalent at 7 years than girls with a later age of thelarche. Whole-body adiposity and increased adrenal activity did not explain the observed prepubertal estrogen increase.

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Environmental Factors and Puberty Timing: Expert Panel Research Needs

Cited by 280 publications

References 129 publications

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

Serum Levels of Polybrominated Diphenyl Ethers in Girls with Premature Thelarche

Recent Secular Trends in Pubertal Timing: Implications for Evaluation and Diagnosis of Precocious Puberty

Ultrasensitive estrogen levels at 7 years of age predict earlier thelarche: evidence from girls of the growth and obesity Chilean cohort

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