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1.
Do gender and puberty influence allergic diseases?
Rosário, CS, Cardozo, CA, Neto, HJC, Filho, NAR
Allergologia et immunopathologia. 2021;(2):122-125
Abstract
Differences between biological sex, gender identity, and their impact on health may have significant implications for the prevention, screening, diagnosis, and treatment of several diseases, including allergies. Asthma, allergic rhinitis (AR), atopic dermatitis (AD), and allergic conjunctivitis (AC) have different prevalences and different risk factors in infancy. Although boys present allergies more often in childhood, it quickly changes during girls' sexual development, leading to lifelong female predominance of allergic diseases. This can be explained by the influence of sexual hormones, different lifestyles adopted by men and women, microbiota diversity, diet distinctions, professional options, and adherence to treatment, among others. Gender-related aspects should become essential parameters in allergology to diagnostic and therapeutic stratification, associated with molecular, genetic, and epigenetic patterns. Longitudinal studies would be interesting to evaluate possible mechanisms underlying these differences in prevalence. Sex- and gender-specific observations beyond 14 years of age are scarce and further allergic multimorbidity studies in different populations, especially in adults, are necessary.
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2.
Racial differences in prostate cancer: does timing of puberty play a role?
Hur, J, Giovannucci, E
British journal of cancer. 2020;(3):349-354
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Abstract
The burden of prostate cancer has a remarkably disproportionate distribution across racial groups. For example, in the USA, African Americans are twice as likely as individuals of European ancestry to develop or die from prostate cancer, and have a more aggressive disease nature at diagnosis. In contrast, Asian American men have the lowest incidence and mortality rates of prostate cancer. That considerable racial disparities exist even in the subclinical stage of prostate cancer among young men in their 20-30s suggests that patterns of prostate carcinogenesis start to diverge even earlier, perhaps during puberty, when the prostate matures at its most rapid rate. Mendelian randomisation studies have provided strong population-based evidence supporting the hypothesis that earlier onset of puberty increases the risk of prostate cancer-particularly of high grade-and prostate cancer-specific mortality later in life, observations which correspond to the epidemiology of the disease in African Americans. Notably, African American boys initiate genital development ~1 year earlier and thus go through longer periods of pubertal maturation compared with European American boys. In this perspective, bringing together existing evidence, we point to puberty as a potential critical window of increased susceptibility to prostate carcinogenesis that could account for the marked prevailing racial differences in the burden of prostate cancer.
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Clinical expression of endocrine disruptors in children.
Iughetti, L, Lucaccioni, L, Street, ME, Bernasconi, S
Current opinion in pediatrics. 2020;(4):554-559
Abstract
PURPOSE OF REVIEW Health status is the result of complex interaction between individual factors, general environmental factors and specific factors as nutrition or the presence of chemicals. Aim of this review is to point out the more recent knowledge covering the role of the endocrine disrupting chemical (EDC) on pediatric population wellbeing. RECENT FINDINGS Prenatal, postnatal life and puberty are the three main temporal windows of susceptibility when EDCs may act. The mechanism is independent from dose or duration of exposition, sex, age or combination of chemicals and may also be transgenerational, affecting both growth and pubertal timing. A window of susceptibility for breast cancer has been detected. Thyroid gland is influenced by environmental chemicals, both in utero and during childhood. Alteration in Thyrotropin stimulating hormone (TSH) levels and neurodevelopmental impairment have been demonstrate. It has been detected a pro-obesogenic action of specific chemicals, impairing also glucose homeostasis during childhood. SUMMARY With a multidisciplinary approach and the use of big data platforms, an attempt has to be made to verify biological variations related to a disease, and how much the risk is influenced by the presence of the endocrine disruptors. This may help the future generation to better interpret uncommunicable diseases.
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Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence.
Steegers-Theunissen, RPM, Wiegel, RE, Jansen, PW, Laven, JSE, Sinclair, KD
International journal of molecular sciences. 2020;(21)
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-Müllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.
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5.
Putative Effects of Obesity on Linear Growth and Puberty
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Shalitin, S, Kiess, W
Hormone research in paediatrics. 2017;(1):101-110
Abstract
Childhood obesity is a major public health problem that has grown to epidemic proportions throughout the world. Obesity is influenced by genetic and environmental factors. The nutritional status plays an important role in growth and body weight regulation. Excess adiposity during childhood can affect the process of growth and puberty. Obese children are frequently tall for their age, with accelerated epiphyseal growth plate maturation despite low growth hormone levels. Several regulatory hormones may affect the process of linear growth in the constellation of obesity, as high levels of insulin and leptin are observed in obese children. Leptin can act as a skeletal growth factor, with a direct effect on skeletal growth centers. The finding that overweight children, especially girls, tend to mature earlier than lean children has led to the hypothesis that the degree of body fatness may trigger the neuroendocrine events that lead to the onset of puberty. Leptin receptors have been identified in the hypothalamus, as well as in gonadotrope cells, ovarian follicular cells, and Leydig cells. The increased leptin and androgen levels seen in obese children may be implicated in their earlier onset of puberty and accelerated pubertal growth. This review is focused on the interaction between childhood obesity and growth and pubertal processes.
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A Multidisciplinary Approach to Puberty and Fertility in Girls with Turner Syndrome.
Colindres, JV, Childress, KJ, Axelrad, M, McCullough, LB, Shao, Y, Macias, C, Loveless, J, Gunn, SK, Bercaw-Pratt, J, Sutton, R, et al
Pediatric endocrinology reviews : PER. 2016;(1):33-47
Abstract
Women with Turner Syndrome (TS) have a variety of medical needs throughout their lives; however, the peripubertal years are particularly challenging. From a medical perspective, the burden of care increases during this time due to growth optimization strategies, frequent health screenings, and puberty induction. Psychologically, girls begin to comprehend the long-term implications of the condition, including their diminished fertility potential. Unfortunately, clear guidelines for how to best approach this stage have not been established. It remains to be determined what is the best age to begin treatment; the best compound, dose, or protocol to induce puberty; how, when or what to discuss regarding fertility and potential fertility preservation options; and how to support them to accept their differences and empower them to take an active role in their care. Given the complexity of this life stage, a multidisciplinary treatment team that includes experts in endocrinology, gynecology, and psychology is optimal.
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Sleep efficiency as a determinant of insulin sensitivity in overweight and obese adolescents.
Dorenbos, E, Rijks, JM, Adam, TC, Westerterp-Plantenga, MS, Vreugdenhil, AC
Diabetes, obesity & metabolism. 2015;:90-8
Abstract
UNLABELLED Insulin resistance (IR) occurs in a transient manner during puberty. Obese adolescents may be at risk for persistent IR during puberty. The objective of the study is to review the literature on the association of the anthropometry and lifestyle characteristics with insulin sensitivity in overweight and obese adolescents, and include data from a new study. Relevant papers were selected and reviewed. In addition, 137 overweight and obese adolescents (42 male/95 female, age 14.4 ± 2.3 years, BMI z-score +3.3 ± 0.7, HOMA-IR 3.4 ± 1.8) from the Centre for Overweight Adolescent and Children's Healthcare (MUMC+) were included in this study. Anthropometrics, Tanner stages, sleep characteristics, food intake behaviour and physical activity were determined, and possible associations with homeostasis model assessment of insulin resistance (HOMA-IR) were tested. RESULTS Overweight and obese adolescents with unfavourable fat partitioning and family history of NIDDM are at risk for persistent IR. Overweight and obese adolescents from the new cohort showed a higher HOMA-IR postpubertally. BMI z-score, age, pubertal stage and prepubertally total sleeping time (TST) and sleep efficiency (SE) were identified as significant contributors. Overweight and obese adolescents showed a persistently higher instead of transiently higher HOMA-IR during puberty, associated with BMI z-score, age, pubertal stage and prepubertally less TST and SE.
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Puberty as an accelerator for diabetes complications.
Cho, YH, Craig, ME, Donaghue, KC
Pediatric diabetes. 2014;(1):18-26
Abstract
Much is written about how difficult it is to deal with diabetes during adolescence, and rightly so. Less is understood as to how puberty may be an accelerator of vascular complications. With the increase in childhood diabetes, complication risks need to be revisited in relation to puberty and the secular increase in adiposity. Recent data suggest greater risk for severe vascular complications in those with diabetes during puberty, compared with young people who develop diabetes after puberty. It is also widely recognized that higher hemoglobin A1c (HbA1c) results are often seen during the pubertal period. This article will review complication outcomes in relation to puberty and examine mechanisms by which puberty may modify risk above glycemic exposure, and possible gender disparities in the risk of complications in the adolescent period.
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9.
Effect of obesity on linear growth.
Fennoy, I
Current opinion in endocrinology, diabetes, and obesity. 2013;(1):44-9
Abstract
PURPOSE OF REVIEW To describe our current understanding of the mechanisms involved in the regulation of linear growth in childhood obesity. RECENT FINDINGS The developmental origins hypothesis has focused on low birth weight individuals with subsequent obesity, identifying a cascade of neuroendocrine regulatory factors involved in the progressive increase in body fat and metabolic risk. Yet, tall stature is the common clinical outcome of childhood obesity. Recent data have expanded our understanding of environmental influences on developing systems. Here, we review the elements of neuroendocrine systems contributing to the integration of metabolic controls involved in growth regulation in the obese child with particular emphasis on growth hormone, ghrelin, insulin-like growth factors and insulin. SUMMARY Growth patterns of obesity during childhood are well described, documenting increased linear growth in early childhood associated with accelerated pubertal maturation resulting in normal adult height. Despite recent data suggesting that ghrelin and the growth hormone secretagogue receptor, as well as the insulin-like growth factors, their binding proteins and insulin have potential to be mediators of nutrient exposure and linear growth, it remains to be determined how these systems interrelate and determine growth. This is an area of ongoing investigation.
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10.
Influence of developmental and hormonal factors on bone health in adolescent females: a cross-sectional study and review of the literature.
Sarra, A, Karantza, M, Papaefthymiou, M, Soultanakis, H, Papaefstathiou, A, Nikolaidou, P, Bakoula, C, Chrousos, G
Journal of pediatric endocrinology & metabolism : JPEM. 2013;(3-4):239-46
Abstract
OBJECTIVE To study bone density in healthy Greek girls going through puberty and determine the influence of developmental and hormonal factors. DESIGN Sixty healthy female adolescents (average age of 13.88±2.53 years) were included. Bone mineral density (BMD) was measured at the hip by DXA (dual energy X-ray absorptiometry). Pubertal stage was determined by Tanner's criteria. Creatinine, calcium, phosphorus, parathyroid hormone, calcitonin and 25-OH-vitamin D levels were measured in blood samples. The European physical fitness test battery (EUROFIT) was used to assess the parameters of physical fitness that are related to strength. RESULTS Adolescent girls had a mean (±SD) BMD value of 0.947±0.144 g/cm2 at the total hip (total hip BMD). Tanner's stage for pubic hair and body mass index (BMI) constituted significant, positive and independent predicting factors for bone density of total hip. Deficiency of 25OH-vitamin D was a negative predicting factor of bone density. Blood levels of calcium and phosphorus, the hours that adolescents devoted to sports, and handgrip strength, were independent predicting factors of bone density at the hip. CONCLUSIONS Bone density and consequently bone health is determined by factors that can be modified in order to achieve optimal bone growth and reduce the risk of fractures and osteoporosis in later life.