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患有特发性性早熟的已治疗和未治疗女性:第三个和第五个十年间的体重指数变化、代谢结果及总体健康状况

Treated and untreated women with idiopathic precocious puberty: BMI evolution, metabolic outcome, and general health between third and fifth decades.

作者信息

Lazar Liora, Lebenthal Yael, Yackobovitch-Gavan Michal, Shalitin Shlomit, de Vries Liat, Phillip Moshe, Meyerovitch Joseph

机构信息

The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes (L.L., Y.L., M.Y.-G., S.S., L.d.V., M.P., J.M.), National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva 49202, Israel; and Sackler Faculty of Medicine (L.L., Y.L., S.S., L.d.V., M.P., J.M.), Tel Aviv University, Tel Aviv 69978, Israel.

出版信息

J Clin Endocrinol Metab. 2015 Apr;100(4):1445-51. doi: 10.1210/jc.2014-3748. Epub 2015 Feb 4.

Abstract

CONTEXT

Central precocious puberty (CPP) may have clinical implications in adulthood.

OBJECTIVE

To assess the prevalence of obesity, metabolic outcome (hyperlipidemia, diabetes, and hypertension), and malignancy rate of former CPP women between the third and fifth decades of life.

DESIGN

This was a case control study of a historical cohort using the computerized database of a health management organization.

SETTING

The setting was the Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, and Clalit Health Services.

PARTICIPANTS

The study group comprised of 142 CPP women aged 27-50 years [100 GnRH analog (GnRHa) treated; 42 untreated]. The control group comprised of 413 women randomly matched for age, year of birth, and community clinic (283 for the GnRHa treated; 130 for the untreated).

METHODS

Extracted from the database were demographic data, medical history, medications dispensed, recorded anthropometric measurements, vital signs, and laboratory data.

RESULTS

At young adulthood, body mass index (percentile and distribution) of treated and untreated former CPP women was comparable to that of their respective controls. Elevated body mass index at presentation was a risk factor for obesity in adulthood in the GnRHa-treated group (r = 0.257; P = .01). The prevalence of metabolic comorbidities (16 vs 13.4%; 21.4 vs 24.6%) and malignancy rate (1.0 vs 1.5%; 4.8 vs 1.5%) were similar in the former CPP women and their controls, with no significant difference between CPP groups.

CONCLUSION

CPP (treated or untreated) is not associated with increased risk of obesity, metabolic derangements, or cancer morbidities in young adulthood. The finding that the health status of former CPP women is similar to that of the general population is reassuring.

摘要

背景

中枢性性早熟(CPP)可能对成年期有临床影响。

目的

评估曾患CPP的女性在30至50岁之间肥胖、代谢结局(高脂血症、糖尿病和高血压)及恶性肿瘤发生率。

设计

这是一项利用健康管理组织计算机数据库对历史队列进行的病例对照研究。

地点

以色列施耐德儿童医学中心内分泌与糖尿病研究所及克拉利特健康服务机构。

参与者

研究组由142名年龄在27至50岁的CPP女性组成[100名接受促性腺激素释放激素类似物(GnRHa)治疗;42名未治疗]。对照组由413名按年龄、出生年份和社区诊所随机匹配的女性组成(283名接受GnRHa治疗;130名未治疗)。

方法

从数据库中提取人口统计学数据、病史、所配药物、记录的人体测量数据、生命体征和实验室数据。

结果

在成年早期,接受治疗和未接受治疗的曾患CPP的女性的体重指数(百分位数和分布)与其各自对照组相当。GnRHa治疗组中,就诊时体重指数升高是成年期肥胖的一个危险因素(r = 0.257;P = 0.01)。曾患CPP的女性及其对照组的代谢合并症患病率(分别为16%对13.4%;21.4%对24.6%)和恶性肿瘤发生率(分别为1.0%对1.5%;4.8%对1.5%)相似,CPP各亚组之间无显著差异。

结论

CPP(无论是否接受治疗)与成年早期肥胖、代谢紊乱或癌症发病率增加无关。曾患CPP的女性健康状况与普通人群相似这一发现令人安心。

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