Abstract
Objective: Publications have shown increased rate of precocious puberty and rapidly progressing puberty during the pandemic period. During the pandemic period, obesity has become widespread in children due to sedentary life, an increase in the time spent at home, and prolonged use of mobile devices. Obesity is a significant contributor to early puberty in females.We aimed to investigate whether obesity is a factor in the increase of puberty precocious cases during the pandemic.
Material and Methods: In the study, female patients diagnosed with Puberty precocious /Rapidly Progressive Puberty in our clinic were divided into three groups August 2019-February 2020 before the pandemic (Group1-G1), August 2020-February 2021 during the pandemic (online education - Group2-G2), August 2021-February 2022 during the pandemic (face-to-face education -Group3-G3). The groups were retrospectively compared in terms of clinical, laboratory, and imaging findings.
Results: A total of 495 female patients were included in the study. There was no difference between the groups in terms of age at the presentation. The most common complaint at presentation in the three groups was thelarche. Also, presentation with combination of thelarche and pubarche was more common in G3, and presentation due to menarche was more common in G2 (p=0.011). No difference was found between the groups regarding body weight SDS, and height SDS. The BMI SDS was 0.69±1 SD for all patients, 0.78±0.94 SD for G1, 0.67±1 SD for G2, and 0.67±1 for G3, and the BMI SDS of the groups were comparable (p=0.630). The majority of patients at the presentation were Breast Tanner stage 3. G2 (9%) and G3 (9%) were presented with Breast Tanner stage 4 at a higher frequency compared to G1 (2%). There was no difference between the groups’ FSH, LH, estradiol, LHRH test peak FSH, peak LH, and LH/FSH values. There was no difference between the bone ages of the groups at the presentation. The uterus size, right and left ovary volumes of G2 and G3 were significantly bigger than those of G1 (p=0.001). No difference was found between the groups in the rates of precocious puberty and rapidly progressing puberty cases.
Conclusion: In our study, the age at presentation and BMI were similar pre-pandemic group G1 and during the pandemic, online education (G2) and pandemic face-to-face education (G3). We determined that obesity may not be one of the factors triggering precocious puberty cases during the pandemic period.
Supporting Institution
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Project Number
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Thanks
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References
- Rubin C, Maisonet M, Kieszak S, Monteilh C, Holmes A, Flanders D, et al. Timing of maturation and predictors of menarche in girls enrolled in a contemporary British cohort. Paediatr Perinat Epidemiol 2009;23:492–504.
- Clarkson J, Han S-K, Liu X, Lee K, Herbison AE. Neurobiological mechanisms underlying kisspeptin activation of gonadotropin-releasing hormone (GnRH) neurons at puberty. Mol Cell Endocrinol 2010;324:45–50.
- Chen C, Zhang Y, Sun W, Chen Y, Jiang Y, Song Y, et al. Investigating the relationship between precocious puberty and obesity: A cross-sectional study in Shanghai, China. BMJ Open 2017;7:1–8.
- https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Turkey.
- Stagi S, De Masi S, Bencini E, Losi S, Paci S, Parpagnoli M, et al. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr 2020;46:165.
- Chioma L, Bizzarri C, Verzani M, Fava D, Salerno M, Capalbo D, et al. Sedentary lifestyle and precocious puberty in girls during the COVID-19 pandemic: an Italian experience. Endocr Connect 2022;11: e210650.
- Street ME, Sartori C, Catellani C, Righi B. Precocious Puberty and Covid-19 Into Perspective: Potential Increased Frequency, Possible Causes, and a Potential Emergency to Be Addressed. Front Pediatr 2021;9 734899.
- Rosenfield RL, Cooke DW, Radovick S. Puberty in the female and its disorders. İn: Sperling Pediatric Endocrinology. Elsevier 2021:528–626.
- Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 2015;7:280-93.
- Fu D, Li T, Zhang Y, Wang H, Wu X, Chen Y, et al. Analysis of the Incidence and Risk Factors of Precocious Puberty in Girls during the COVID-19 Pandemic. Int J Endocrinol 2022;2022:9229153.
- Yesiltepe Mutlu G, Eviz E, Haliloglu B, Kirmizibekmez H, Dursun F, Ozalkak S, et al. The effects of the covid-19 pandemic on puberty: a cross-sectional, multicenter study from Turkey. Ital J Pediatr 2022;48:144. doi: 10.1186/s13052-022-01337-z.
- Mondkar SA, Oza C, Khadilkar V, Shah N, Gondhalekar K, Kajale N, et al. Impact of COVID-19 lockdown on idiopathic central precocious puberty - Experience from an Indian centre. J Pediatr Endocrinol Metab 2022;35:895–900.
- Oliveira Neto CP de, Azulay RS de S, Almeida AGFP de, Tavares M da GR, Vaz LHG, Leal IRL, et al. Differences in Puberty of Girls before and during the COVID-19 Pandemic. Differences in Puberty of Girls before and during the COVID-19 Pandemic. Int J Environ Res Public Health 2022;19:4733.
- Calcaterra V, Cena H, Regalbuto C, Vinci F, Porri D, Verduci E, et al. The role of fetal, infant, and childhood nutrition in the timing of sexual maturation. Nutrients 2021;13:419.
- Verzani M, Bizzarri C, Chioma L, Bottaro G, Pedicelli S, Cappa M. Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center. Ital J Pediatr 2021;47:52.
- Wagner I V, Sabin MA, Pfäffle RW, Hiemisch A, Sergeyev E, Körner A, et al. Effects of obesity on human sexual development. Nat Rev Endocrinol 2012;8:246–54.
- Ju M, Yang L, Zhu J, Chen Z, Zhang M, Yu J, et al. MiR-664-2 impacts pubertal development in a precocious-puberty rat model through targeting the NMDA receptor-1. Biol Reprod 2019;100:1536–48.
- Giannattasio A, Girotti M, Williams K, Hall L, Bellastella A. Puberty influences expression of phospholipid hydroperoxide glutathione peroxidase (GPX4) in rat testis: Probable hypophysis regulation of the enzyme in male reproductive tract. J Endocrinol Invest 1997;20:439–44.
- Chioma L, Bizzarri C, Verzani M, Fava D, Salerno M, Capalbo D, et al. Sedentary lifestyle and precocious puberty in girls during the COVID-19 pandemic: an Italian experience. Endocr Connect 2022;11: e210650.
- Umano GR, Maddaluno I, Riccio S, Lanzaro F, Antignani R, Giuliano M, et al. Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study. Ital J Pediatr 2022;48:60.
Abstract
Amaç: Pandemi döneminde puberte prekoks ve hızlı ilerleyen ergenlik olgularında artış olduğunu gösteren yayınlar mevcuttur. Pandemi döneminde sedanter yaşam, evde kalınan sürede artış ve mobil cihaz kullanım sürelerinin uzaması nedeni ile obezite çocuklarda yaygınlaşmıştır. Obezite, kızlarda ergenliği öne çeken önemli bir faktördür. Bu çalışmada pandemi döneminde puberte prekoks ve hızlı ilerleyen ergenlik vakalarının artışında obezitenin bir faktör olup olmadığını araştırılması amaçlanmıştır.
Pandemi döneminde puberte prekoks ve hızlı ilerleyen ergenlik olgularında artış olduğunu gösteren yayınlar mevcuttur. Pandemi döneminde sedanter yaşam, evde kalınan sürede artış ve mobil cihaz kullanım sürelerinin uzaması nedeni ile obezite çocuklarda yaygınlaşmıştır. Obezite, kızlarda ergenliği öne çeken önemli bir faktördür. Bu çalışmada pandemi döneminde puberte prekoks ve hızlı ilerleyen ergenlik vakalarının artışında obezitenin bir faktör olup olmadığını araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Çalışmada kliniğimizde Puberte Prekoks/Hızlı ilerleyen ergenlik tanısı alan kız olgular pandemi öncesi Ağustos 2019-Şubat 2020 (Grup1-G1), pandemi dönemi Ağustos 2020-Şubat 2021 (çevirimiçi eğitim- Grup2-G2), pandemi dönemi Ağustos 2021-Şubat 2022 (yüzyüze eğitim-Grup3-G3) olarak üç gruba ayrıldı. Gruplar klinik, laboratuvar ve radyolojik bulguları açısından retrospektif olarak karşılaştırıldı.
Bulgular: Toplam 495 kız hasta çalışmaya alındı. Gruplar arasında başvuru yaşı açısından fark saptanmadı. Üç grubun başvuru şikayetleri en sık telarş iken (n:76) iken, telarş ve pubarş birlikteliği ile başvuru Grup 3’ te, menarş nedeni ile başvuru Grup 2’ de diğer gruplara göre daha fazla saptandı (p=0.011). Gruplar arasında vücut ağrılığı, boy ve vücut kitle indeksi SD açısından fark saptanmadı. Başvuru esnasındaki meme tanner evrelemesi en sık evre üçtü. Grup 2 ve Grup 3’ te meme evre 4 ile başvuru Grup1’e göre daha sık gözlendi. Grupların FSH, LH, östrodiol, LHRH testi pik FSH ve pik LH, LH/FSH değerleri arasında fark saptanmadı. Grupların başvurudaki kemik yaşları arasında fark saptanmadı. Grup 2 ve Grup 3’ün uterus boyutu, sağ ve sol over hacimleri Grup 1’e göre daha büyüktü (p=0.001). Gruplar arasında puberte prekoks ve hızlı ilerleyen ergenlik olgularının oranları arasında fark saptanmadı.
Sonuç: Pandemi döneminde tanı alan puberte prekoks ve hızlı ilerleyen ergenlik olgularında artıştan obezite ve mobil cihaz maruziyeti ön planda bahsedilmektedir Çalışmamızda pandemi öncesi Grup 1, pandemi dönemi (çevirimiçi eğitim) Grup 2 ve (yüzyüze eğitim) Grup 3’ ün başvuru yaşı ve VKI benzerdi. Pandemi döneminde obezitenin erken ergenlik vakalarını tetikleyen faktörlerden biri olmayabilir
Project Number
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References
- Rubin C, Maisonet M, Kieszak S, Monteilh C, Holmes A, Flanders D, et al. Timing of maturation and predictors of menarche in girls enrolled in a contemporary British cohort. Paediatr Perinat Epidemiol 2009;23:492–504.
- Clarkson J, Han S-K, Liu X, Lee K, Herbison AE. Neurobiological mechanisms underlying kisspeptin activation of gonadotropin-releasing hormone (GnRH) neurons at puberty. Mol Cell Endocrinol 2010;324:45–50.
- Chen C, Zhang Y, Sun W, Chen Y, Jiang Y, Song Y, et al. Investigating the relationship between precocious puberty and obesity: A cross-sectional study in Shanghai, China. BMJ Open 2017;7:1–8.
- https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Turkey.
- Stagi S, De Masi S, Bencini E, Losi S, Paci S, Parpagnoli M, et al. Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic. Ital J Pediatr 2020;46:165.
- Chioma L, Bizzarri C, Verzani M, Fava D, Salerno M, Capalbo D, et al. Sedentary lifestyle and precocious puberty in girls during the COVID-19 pandemic: an Italian experience. Endocr Connect 2022;11: e210650.
- Street ME, Sartori C, Catellani C, Righi B. Precocious Puberty and Covid-19 Into Perspective: Potential Increased Frequency, Possible Causes, and a Potential Emergency to Be Addressed. Front Pediatr 2021;9 734899.
- Rosenfield RL, Cooke DW, Radovick S. Puberty in the female and its disorders. İn: Sperling Pediatric Endocrinology. Elsevier 2021:528–626.
- Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 2015;7:280-93.
- Fu D, Li T, Zhang Y, Wang H, Wu X, Chen Y, et al. Analysis of the Incidence and Risk Factors of Precocious Puberty in Girls during the COVID-19 Pandemic. Int J Endocrinol 2022;2022:9229153.
- Yesiltepe Mutlu G, Eviz E, Haliloglu B, Kirmizibekmez H, Dursun F, Ozalkak S, et al. The effects of the covid-19 pandemic on puberty: a cross-sectional, multicenter study from Turkey. Ital J Pediatr 2022;48:144. doi: 10.1186/s13052-022-01337-z.
- Mondkar SA, Oza C, Khadilkar V, Shah N, Gondhalekar K, Kajale N, et al. Impact of COVID-19 lockdown on idiopathic central precocious puberty - Experience from an Indian centre. J Pediatr Endocrinol Metab 2022;35:895–900.
- Oliveira Neto CP de, Azulay RS de S, Almeida AGFP de, Tavares M da GR, Vaz LHG, Leal IRL, et al. Differences in Puberty of Girls before and during the COVID-19 Pandemic. Differences in Puberty of Girls before and during the COVID-19 Pandemic. Int J Environ Res Public Health 2022;19:4733.
- Calcaterra V, Cena H, Regalbuto C, Vinci F, Porri D, Verduci E, et al. The role of fetal, infant, and childhood nutrition in the timing of sexual maturation. Nutrients 2021;13:419.
- Verzani M, Bizzarri C, Chioma L, Bottaro G, Pedicelli S, Cappa M. Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center. Ital J Pediatr 2021;47:52.
- Wagner I V, Sabin MA, Pfäffle RW, Hiemisch A, Sergeyev E, Körner A, et al. Effects of obesity on human sexual development. Nat Rev Endocrinol 2012;8:246–54.
- Ju M, Yang L, Zhu J, Chen Z, Zhang M, Yu J, et al. MiR-664-2 impacts pubertal development in a precocious-puberty rat model through targeting the NMDA receptor-1. Biol Reprod 2019;100:1536–48.
- Giannattasio A, Girotti M, Williams K, Hall L, Bellastella A. Puberty influences expression of phospholipid hydroperoxide glutathione peroxidase (GPX4) in rat testis: Probable hypophysis regulation of the enzyme in male reproductive tract. J Endocrinol Invest 1997;20:439–44.
- Chioma L, Bizzarri C, Verzani M, Fava D, Salerno M, Capalbo D, et al. Sedentary lifestyle and precocious puberty in girls during the COVID-19 pandemic: an Italian experience. Endocr Connect 2022;11: e210650.
- Umano GR, Maddaluno I, Riccio S, Lanzaro F, Antignani R, Giuliano M, et al. Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study. Ital J Pediatr 2022;48:60.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Project Number | - |
| Early Pub Date | May 3, 2023 |
| Publication Date | July 25, 2023 |
| Submission Date | February 15, 2023 |
| Published in Issue | Year 2023 Volume: 17 Issue: 4 |
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https://doi.org/10.3389/fendo.2023.1190445
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