Ibáñez L, de Zegher F
University of Barcelona, Spain.
Horm Res. 2006;65 Suppl 3:112-5. doi: 10.1159/000091515. Epub 2006 Apr 10.
There is increasing evidence for a link between prenatal growth and pubertal development. Here we highlight a selection of pubertal characteristics in children who were born small for gestational age (SGA). Boys born SGA are at risk of high levels of follicle-stimulating hormone (FSH) and low levels of inhibin B and a small testicular volume during adolescence. In girls born SGA, the age at pubertal onset and the age at menarche are advanced by about 5-10 months; prenatal growth restraint may also be associated with higher FSH levels and smaller internal genitalia in adolescence. The ovulation rate was found to be reduced in adolescent girls born SGA, and an insulin-sensitizing therapy was capable of raising this low ovulation rate. Menarche is definitely advanced in girls born SGA with precocious pubarche and in those with an early-normal onset of puberty. Current evidence suggests that insulin resistance is a key mechanism linking a post-SGA state to early menarche; hence, insulin sensitization may become a valid approach to prevent early menarche and early growth arrest in girls born SGA.
越来越多的证据表明产前生长与青春期发育之间存在联系。在此，我们重点介绍一些小于胎龄儿（SGA）出生儿童的青春期特征。SGA出生的男孩在青春期有促卵泡生成素（FSH）水平高、抑制素B水平低和睾丸体积小的风险。在SGA出生的女孩中，青春期开始年龄和初潮年龄提前约5至10个月；产前生长受限也可能与青春期较高的FSH水平和较小的内生殖器有关。研究发现，SGA出生的青春期女孩排卵率降低，胰岛素增敏疗法能够提高这种低排卵率。在伴有青春期阴毛早现的SGA出生女孩和青春期正常早发的女孩中，初潮肯定提前。目前的证据表明，胰岛素抵抗是将SGA出生后的状态与初潮提前联系起来的关键机制；因此，胰岛素增敏可能成为预防SGA出生女孩初潮提前和早期生长停滞的有效方法。
