Blogowska Anna, Rzepka-Górska Izabella, Krzyzanowska-Swiniarska Barbara
Clinic of Surgical Gynaecology and Oncology of Adults and Children, Pomeranian Academy of Medicine, Al. Powstanców Wlkp 72, 70-111 Szczecin, Poland.
Arch Gynecol Obstet. 2003 Oct;268(4):293-6. doi: 10.1007/s00404-002-0373-9. Epub 2002 Oct 2.
The timing of pubertal changes depends on the concerted function of the hypothalamic - pituitary - ovarian and other endocrine systems. The somatotropin system and insulin play important roles during the growth and maturation of girls. Our clinical observations have enabled us to determine and implement criteria that split the pre-menarcheal period into three phases with distinct features associated with rising levels of estrogens (pre-estrogenization, onset of estrogenization and full estrogenization). The aim of this work was to determine levels of growth hormone, insulin - like growth factor 1 (IGF-1), sex hormone binding globulins (SHBG), insulin, and estradiol in relation to somatic features in girls during subsequent phases of estrogenization. This prospective study was done in 45 healthy girls. Every three months, we recorded weight, height, BMI, maturation of tertiary sex features, estrogen-related changes in hymen, sonographic dimensions of ovaries and uterus and serum levels of growth hormone, IGF-1, SHBG, insulin, and estradiol. Onset of estrogenization was accompanied by reduction of body mass and slowing down of growth associated with declining levels of growth hormone. These changes were followed by weight gain, pubertal acceleration of growth, rising levels of growth hormone, IGF-1, insulin, and estradiol, and falling levels of SHBG.
青春期变化的时间取决于下丘脑 - 垂体 - 卵巢及其他内分泌系统的协同作用。生长激素系统和胰岛素在女孩的生长和成熟过程中发挥着重要作用。我们的临床观察使我们能够确定并实施相关标准，将月经初潮前期分为三个阶段，每个阶段具有与雌激素水平升高相关的不同特征（预雌激素化、雌激素化开始和完全雌激素化）。这项研究的目的是确定在雌激素化的后续阶段，女孩体内生长激素、胰岛素样生长因子1（IGF-1）、性激素结合球蛋白（SHBG）、胰岛素和雌二醇的水平与身体特征之间的关系。这项前瞻性研究共纳入了45名健康女孩。每三个月，我们记录体重、身高、BMI、第三性征的成熟情况、处女膜与雌激素相关的变化、卵巢和子宫的超声尺寸，以及生长激素、IGF-1、SHBG、胰岛素和雌二醇的血清水平。雌激素化开始时伴随着体重下降和生长放缓，这与生长激素水平下降有关。随后出现体重增加、青春期生长加速、生长激素、IGF-1、胰岛素和雌二醇水平升高，以及SHBG水平下降。
