Center for the Prevention and Management of Overweight and Obesity, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527 Athens, Greece.
Second Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 'Aretaieion' University Hospital, 11528 Athens, Greece.
Nutrients. 2023 Oct 9;15(19):4306. doi: 10.3390/nu15194306.
The prevalence of central precocious puberty (CPP) in girls has increased worldwide and is often associated with obesity in childhood as well as high fat/high glycemic index diets. Evidence suggests that subjects with obesity present with alterations in appetite-regulating hormones. The arcuate and paraventricular nuclei of the hypothalamus are the centers of action of appetite hormones, as well as the location of gonadotropin-releasing hormone (GnRH) neurons, the activation of which results in the onset of puberty. This anatomical proximity raises the question of possible alterations in appetite-regulating hormones in patients with CPP. Furthermore, diet-induced hypothalamic inflammation constitutes a probable mechanism of the pathophysiology of CPP, as well as alterations in appetite-regulating hormones in young children. In this article, we summarize the evidence investigating whether girls with CPP present with alterations in appetite-regulating hormones. We present evidence that leptin concentrations are elevated in girls with CPP, ghrelin concentrations are lower in girls with CPP, nesfatin-1 and orexin-A concentrations are elevated among girls with premature thelarche, and insulin concentrations are increased in girls with early menarche.
中枢性性早熟（CPP）在全球范围内的患病率有所增加，且常与儿童肥胖以及高脂肪/高血糖指数饮食有关。有证据表明，肥胖者存在食欲调节激素的改变。下丘脑的弓状核和室旁核是食欲激素的作用中心，也是促性腺激素释放激素（GnRH）神经元的位置，GnRH 神经元的激活导致青春期的开始。这种解剖学上的邻近性提出了 CPP 患者中可能存在食欲调节激素改变的问题。此外，饮食诱导的下丘脑炎症构成了 CPP 病理生理学以及儿童期食欲调节激素改变的可能机制。在本文中，我们总结了关于 CPP 女孩是否存在食欲调节激素改变的证据。有证据表明，CPP 女孩的瘦素浓度升高，CPP 女孩的胃饥饿素浓度降低，性早熟女孩的 nesfatin-1 和食欲素-A 浓度升高，初潮提前的女孩的胰岛素浓度升高。
