Wang Ling-Xiao, Cheng Ruo-Qian, Zhang Miao-Ying, Li Xiao-Jing, Xi Li, Zheng Zhang-Qian, Luo Fei-Hong
Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, Shanghai 201100, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):762-767. doi: 10.7499/j.issn.1008-8830.1912076.
To study the association of body fat ratio with precocious puberty in girls. Previous studies have shown that body mass index (BMI) is associated with the girls' age of puberty but have not revealed the association of body fat ratio with age of puberty.
Based on the consensus on the diagnosis and treatment of central precocious puberty (CPP), 128 children with precocious puberty who were admitted to the hospital from July to August, 2017, were divided into a CPP group with 87 children and a peripheral precocious puberty (PPP) group with 41 children. A total of 51 girls without any puberty development signs were enrolled as the control group. Dual-energy X-ray absorptiometry was used to measure the body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body. The association between body fat ratios and precocious puberty was analyzed with reference to age, BMI, BMI-Z score, bone age, ovarian volume, and hormone levels.
Compared with the control group, the CPP and PPP groups had significantly higher body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body, legs/whole body fat ratio, and (upper limbs+legs)/trunk fat ratio (P<0.05), while there were no significant differences in the above body fat ratios and fat distribution indicators between the CPP and PPP groups (P>0.05). For the girls with precocious puberty, the high body fat ratio group had significantly higher luteinizing hormone (LH) base value, luteinizing hormone releasing hormone (LHRH)-stimulated LH peak value, and LH/follicle-stimulating hormone peak value than the low body fat ratio group (P<0.05). Compared with the control group, both the high body fat ratio and low body fat ratio groups had a significantly higher LH base value (P<0.05).
The increase in body fat may be a factor inducing precocious puberty in girls, but further studies are needed to determine the mechanism.
研究女童体脂率与性早熟的相关性。既往研究表明，体重指数（BMI）与女童青春期年龄相关，但未揭示体脂率与青春期年龄的关系。
依据中枢性性早熟（CPP）诊疗共识，选取2017年7至8月收治入院的128例性早熟患儿，分为CPP组87例和外周性性早熟（PPP）组41例。选取51例无任何青春期发育征象的女童作为对照组。采用双能X线吸收法测量上肢、下肢、躯干、男性化区域、女性化区域及全身的体脂率。参照年龄、BMI、BMI-Z评分、骨龄、卵巢容积及激素水平，分析体脂率与性早熟的相关性。
与对照组相比，CPP组和PPP组上肢、下肢、躯干、男性化区域、女性化区域及全身的体脂率、下肢/全身脂肪率及（上肢+下肢）/躯干脂肪率均显著升高（P<0.05），而CPP组和PPP组上述体脂率及脂肪分布指标差异无统计学意义（P>0.05）。对于性早熟女童，高体脂率组的黄体生成素（LH）基础值、促黄体生成素释放激素（LHRH）激发的LH峰值及LH/促卵泡生成素峰值均显著高于低体脂率组（P<0.05）。与对照组相比，高体脂率组和低体脂率组的LH基础值均显著升高（P<0.05）。
体脂增加可能是女童性早熟的诱发因素之一，但尚需进一步研究确定其机制。
