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患有早熟肾上腺初现的女孩在幼儿期生长加速。

Girls with premature adrenarche have accelerated early childhood growth.

作者信息

Utriainen Pauliina, Voutilainen Raimo, Jääskeläinen Jarmo

机构信息

Department of Pediatrics, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.

出版信息

J Pediatr. 2009 Jun;154(6):882-7. doi: 10.1016/j.jpeds.2008.12.038. Epub 2009 Feb 23.

Abstract

OBJECTIVE

To evaluate the effect of premature adrenarche (PA) on prepubertal growth.

STUDY DESIGN

The prepubertal growth of 54 girls with PA and 52 control girls was analyzed retrospectively. Birth measures were noted, and childhood length/height and weight were measured annually until age 5 years and at the current visit (at a median age of 7.6 years). The growth variables were correlated with serum insulin-like growth factor (IGF)-1, dehydroepiandrosterone sulfate, and insulin concentrations.

RESULTS

There were no significant differences in birth length or weight standard deviation scores (SDSs) between the 2 study groups. The girls with PA demonstrated a significant length SDS increment during the first 2 years of life (median +1.0 SDS; P < .001). Compared with controls, they were taller (median current height 1.2 vs 0 SDS; P < .001) and gained more weight throughout childhood. The difference in weight-for-height became significant at a later age compared with the difference in height. Median serum IGF-1 concentration adjusted for both age and body mass index SDS was higher in the PA group (24 vs 19 nmol/L; P < .031).

CONCLUSIONS

PA was not associated with small birth size in our population. Girls with PA had enhanced growth already in early childhood, which was not explained by weight gain. Enhanced IGF-1 production may contribute to the prepubertal growth acceleration in PA.

摘要

目的

评估青春期早熟(PA)对青春期前生长的影响。

研究设计

对54例患PA的女孩和52例对照女孩的青春期前生长情况进行回顾性分析。记录出生时的各项指标,每年测量儿童期的身长/身高和体重,直至5岁,并在本次就诊时(中位年龄7.6岁)进行测量。将生长变量与血清胰岛素样生长因子(IGF)-1、硫酸脱氢表雄酮和胰岛素浓度进行相关性分析。

结果

两个研究组之间出生时的身长或体重标准差评分(SDS)无显著差异。患PA的女孩在生命的前2年身长SDS有显著增加(中位增加1.0 SDS;P <.001)。与对照组相比,她们更高(当前中位身高1.2 vs 0 SDS;P <.001),并且在整个儿童期体重增加更多。与身高差异相比,身高体重差异在较晚年龄才变得显著。根据年龄和体重指数SDS调整后的血清IGF-1中位浓度在PA组中更高(24 vs 19 nmol/L;P <.031)。

结论

在我们的研究人群中,PA与出生时体型小无关。患PA的女孩在幼儿期就已经生长加速,这不能用体重增加来解释。IGF-1分泌增加可能导致PA患儿青春期前生长加速。

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