Lung Function in Women with Idiopathic Central Precocious Puberty: A Pilot Study

Abstract

Background: Studies have reported that women with early menarche (≤10 years) have lower lung function. Aim: To investigate lung function in women with a history of idio pathic central precocious puberty (ICPP) treated during childhood with gonadotropin-releasing hormone agonist (GnRHa). Methods: ICPP women (n = 23) were compared with healthy age-matched controls (n = 23). Subjects were clinically evaluated by means of a questionnaire, baseline and post-β<Sub>2</Sub> agonist spirometry, impulse oscillometry (a measure of airway resistance), and measurement of fractional exhaled nitric oxide (FeNO). Results: Patients had lower lung function values than controls: forced expiratory volume in 1 s (FEV<Sub>1</Sub>) (median 97.90 vs. 109.45; p = 0.011), FEV<Sub>1</Sub> after β<Sub>2</Sub> agonist (100.80 vs. 114.10; p = 0.013), peak expiratory flow (92.90 vs. 97.95; p = 0.031), and maximum mid-expiratory flow (MMEF) (80.80 vs. 106.30; p = 0.008). FeNO was significantly lower in the patients (p < 0.001). Significant reversibility of FEV<Sub>1</Sub> after β<Sub>2</Sub> agonist was observed in 8.7% of the patients. FEV<Sub>1</Sub>/forced vital capacity and MMEF after β<Sub>2</Sub> agonist correlated negatively with hysterometry at diagnosis (p = 0.009 and p = 0.03, respectively). There was a negative correlation between age at diagnosis and airway resistance. Conclusions: Women with ICPP seem to have lower lung function despite treatment with GnRHa. Further research on the effects of sex hormones on the airways should take into account potential interplay with factors affecting the start of puberty.

Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank: a prospective population-based cohort study

“…Two previous studies reported reduced FEV 1 in adult women who experienced menarche before age 1010 12 but neither found evidence of an association between age at menarche and FEV 1 /FVC. A Mendelian randomisation study of adolescent and adult women across multiple European cohorts, including a subset from UK Biobank, estimated a 24.8 mL increase in FVC per year increase in age at menarche among adult women and a −56.6 mL decrease in FVC per year increase in age at menarche among adolescent girls 11.…”

“…There is more evidence regarding the relationship between female reproductive health indicators and lung function. Early menarche,10–12 nulliparity,13 younger age at first pregnancy12 and postmenopausal status14–19 have each been associated with reduced lung function. Evidence of the effects of HRT is contradictory 14 15 20 21.…”

Pubertal onset with adulthood lung function mediated by height growth in adolescence

“…It is also a critical period for the maturation of lung function [11]. It has been previously shown that age at menarche (in females), body hair growth (in males), and peak height velocity (in both sexes) are associated with lung function in later life [11][12][13][14][15]. For instance, early menarche is associated with better lung function development in adolescence, but the opposite in adulthood [13].…”

Delayed age at menarche in chronic respiratory diseases

“…20 On the other hand, there is a correlation between exposure to oestrogen and pathologic proliferative alteration in airway smooth muscle cells; and women with idiopathic central precocious puberty seem to have lower lung function despite treatment with gonadotropin releasing hormone agonist (GnRHa). 21 The main aim of this study was to investigate menarcheal age and menarcheal determinants in adolescents affected by chronic respiratory diseases such as CF and asthma.…”

“…Patients with mild chronic asthma experienced menarche earlier (9.2 years) than those with sporadic asthma (11.43 years) 20 . On the other hand, there is a correlation between exposure to oestrogen and pathologic proliferative alteration in airway smooth muscle cells; and women with idiopathic central precocious puberty seem to have lower lung function despite treatment with gonadotropin releasing hormone agonist (GnRHa) 21 …”