Is there a secular trend regarding puberty in children with down syndrome?

Abstract

IntroductionThere are very few studies on the age of onset and end of puberty in children with Down syndrome (DS). Also, data regarding the course of puberty in these children compared to their healthy peers is limited. Moreover, there is limited information regarding the effects of factors such as obesity and hypothyroidism on the puberty process in children with DS. Our aim in our study is to determine whether the pubertal development of children with DS differs from their healthy peers and from previous studies conducted with DS children.MethodsThe medical records of DS children were examined retrospectively. The anthropometric measurements and the age of onset of pubertal stages, and menarche were recorded. The patients’ age at puberty onset, the puberty processes, and age at menarche were compared with their healthy peers and previously published data on children with DS.ResultsOf the 140 Down syndrome patients followed in our clinic, 51 of whom with puberty constituted the study group. The mean age of onset of puberty was 10.3 ± 1.0 years in our group (10.0 ± 0.8 years for girls, 10.6 ± 1.2 years for boys, respectively). Obesity occurred in 46% of pubertal girls with DS. The age of menarche in girls with DS was 11.8 ± 0.7 years. The menarche age of girls with DS was significantly different from healthy girls. In the DS boys, only the Tanner V stage ages were different from the healthy children. True- precocious-puberty was detected in three children.ConclusionAlthough breast development begins later in females with DS than in their healthy peers; menarche is detected earlier than in their peers and a tendency towards obesity in the whole population. While the age of pubertal onset was similar to healthy children in male patients, our findings suggest that their puberty duration is longer.

Endocrine, auxological and metabolic profile in children and adolescents with Down syndrome: from infancy to the first steps into adult life

“…These data apparently differ from those drawn by more recent studies. For example, in a cohort of children with DS, Erdoğan and colleagues reported pubertal onset at a median age of 10.0 years for both genders, which is superimposable with the outcomes more recently described for age-matched peers ( 58 ). In addition, the average age of menarche in adolescents with DS is consistent with the general population in several study cohorts ( 58 – 60 ).…”

“…For example, in a cohort of children with DS, Erdoğan and colleagues reported pubertal onset at a median age of 10.0 years for both genders, which is superimposable with the outcomes more recently described for age-matched peers ( 58 ). In addition, the average age of menarche in adolescents with DS is consistent with the general population in several study cohorts ( 58 – 60 ). Overall, the difference in the timing of pubertal attainment reported by different authors likely mirrors most of the changes experienced by the general pediatric population over the last decades.…”

“…Indeed, few analyses have assessed luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels among subjects with DS, aiming at reporting the prevalence of hypogonadism in this population ( 54 , 56 ). Approximately 70% of the individuals enrolled displayed elevated FSH and LH levels compared to the median values observed in post-pubescent controls, while testosterone levels were found to be superimposable with the average values recorded in otherwise healthy adult males ( 56 – 58 ). Based on these biochemical criteria, a non-unremarkable share of people with DS could be classified as presenting “compensated hypogonadism” (high LH levels in the setting of normal total testosterone levels).…”

Normal joint range of motion in children with Down syndrome

“…This was only seen for the males in the 9–18 years age group for hip flexion and elbow flexion and extension. It is unclear if this could indicate a difference in puberty for females with DS, and it has been suggested that puberty onset and course may be different in females with DS compared to healthy neurotypical children (Erdogan & Guven, 2022). Additionally, children with DS are at increased risk for endocrine disorders such as short stature, obesity, and hypothyroidism (Cebeci et al, 2013; Rubin et al, 1998), which can also impact joint ROM and could contribute to decreased joint ROM seen in the female groups.…”