Secondary Sexual Characteristics in Boys: Data From the Pediatric Research in Office Settings Network

Herman-Giddens, Marcia E.; Steffes, Jennifer; Harris, Donna; Slora, Eric J.; Hussey, Michael A.; Dowshen, Steven A.; Wasserman, Richard C.; Serwint, Janet R.; Smitherman, Lynn C.; Reiter, Edward O.

doi:10.1542/peds.2011-3291

Cited by 302 publications

(220 citation statements)

References 35 publications

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“…Idiopathic CPP represents 90% of the cases in girls, whereas organic etiologies are more frequent (60% to 70%) in boys. However, these epidemiological data are currently being revised with the new genetic and imaging diagnostic methods (8).…”

Section: Central Precocious Puberty Etiologymentioning

confidence: 99%

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Central precocious puberty: revisiting the diagnosis and therapeutic management

Brito

Spinola-Castro

Kochi

et al. 2016

Arch. Endocrinol. Metab.

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Clinical and laboratory diagnosis and treatment of central precocious puberty (CPP) remain challenging due to lack of standardization. The aim of this revision was to address the diagnostic and therapeutic features of CPP in Brazil based on relevant international literature and availability of the existing therapies in the country. The diagnosis of CPP is based mainly on clinical and biochemical parameters, and a period of follow-up is desirable to define the "progressive" form of sexual precocity. This occurs due to the broad spectrum of pubertal development, including isolated premature thelarche, constitutional growth and puberty acceleration, progressive and nonprogressive CPP, and early puberty. Measurement of basal and stimulated LH levels remains challenging, considering that the levels are not always in the pubertal range at baseline, short-acting GnRH is not readily available in Brazil, and the cutoff values differ according to the laboratory assay. When CPP is suspected but basal LH values are at prepubertal range, a stimulation test with short-acting or long-acting monthly GnRH is a diagnostic option. In Brazil, the treatment of choice for progressive CPP and early puberty is a long-acting GnRH analog (GnRHa) administered once a month or every 3 months. In Brazil, formulations of GnRHa (leuprorelin and triptorelin) are available and commonly administered, including 1-month depot leuprorelin 3.75 mg and 7.5 mg, 1-month depot triptorelin 3.75 mg, and 3-month depot leuprorelin 11.25 mg. Monthly or 3-month depot GnRHa are effective and safe to treat CPP. Arch Endocrinol Metab. 2016;60(2):163-72

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Section: Central Precocious Puberty Etiologymentioning

confidence: 99%

“…However, recent epidemiological studies have suggested that the initial pubertal age is decreasing mainly in girls (5-7), but also in boys (8,9). …”

Section: Introductionmentioning

confidence: 99%

Central precocious puberty: revisiting the diagnosis and therapeutic management

Brito

Spinola-Castro

Kochi

et al. 2016

Arch. Endocrinol. Metab.

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“…74 Early signs of puberty manifest around the age of 10 years in girls (breast development) and 11.5 years in boys (testicular enlargement and spermarche-appearance of spermatozoa in first morning void). [75][76][77] Considerable interindividual variation in the timing of pubertal onset exists, ranging from 8 years to 13 years in girls and 9 years to 14 years in boys. 78,79 Subsequent hallmarks of puberty in boys include deepening of the voice and a growth spurt.…”

Section: Puberty and Reproductionmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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“…During recent decades, age at pubertal onset seems to have markedly declined in girls (2,3,4,5,6) and to a lesser extent in boys (6,7,8,9).…”

Section: Introductionmentioning

confidence: 99%

BMI percentile-for-age overestimates adiposity in early compared with late maturing pubertal children

Sørensen

Juul

2015

European Journal of Endocrinology

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Objective: Early pubertal timing is consistently associated with increased BMI percentile-for-age in pubertal girls, while data in boys are more ambiguous. However, higher BMI percentile-for-age may be a result of the earlier puberty per se rather than vice versa. The aim was to evaluate markers of adiposity in relation to pubertal timing and reproductive hormone levels in healthy pubertal boys and girls. Study design: Population-based cross-sectional study (The Copenhagen Puberty Study). Eight-hundred and two healthy Caucasian children and adolescents (486 girls) aged 8.5-16.5 years participated. BMI and bioelectric impedance analyses (BIA) were used to estimate adiposity. Clinical pubertal markers (Tanner stages and testicular volume) were evaluated. LH, FSH, estradiol, testosterone, SHBG and IGF1 levels were determined by immunoassays. Results: In all age groups, higher BMI (all 1 year age-groups, P%0.041) was found with early compared with late maturation, despite similar BIA-estimated body fat percentage (BIA-BF%). Neither BMI nor BIA-BF% differed for a given stage of maturation. BMI percentile-for-age and prevalence of overweight/obesity were higher in the early compared with late matured pubertal children (all P%0.038), despite similar BIA-BF%. Pubertal girls with BIA-BF O29% had significantly lower LH and FSH levels compared with normal-weight girls (P%0.041). Conclusions: Early maturational timing was not associated with higher adiposity for a given stage of puberty. Using BMI percentile-for-age overestimated the degree of adiposity in early pubertal compared with late pubertal children.

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Secondary Sexual Characteristics in Boys: Data From the Pediatric Research in Office Settings Network

Cited by 302 publications

References 35 publications

Central precocious puberty: revisiting the diagnosis and therapeutic management

Central precocious puberty: revisiting the diagnosis and therapeutic management

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

BMI percentile-for-age overestimates adiposity in early compared with late maturing pubertal children

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