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This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9-13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood.

Background: Evaluation of pubertal development is crucial in Endocrinology. The rise in telemedicine during COVID-19 has made conduct of physical examinations more challenging, especially for pubertal assessment. Previous studies on validity of pubertal self-staging versus clinical examination have yielded mixed results. This study aimed to determine validity and reliability of self-staging of puberty, with potential application during telemedicine visits. The present study is the first to assess pediatric self-rated pubertal staging during the pandemic. Methods: The study included patients aged 7-22 years referred to Pediatric Endocrinology for specialty care, including pubertal staging. At clinic check-in, patients received a packet with study description, an option to "opt in" or "opt out", sex-specific self-staging instructions, and Tanner (T) stage illustrations. Males received materials for pubic hair (PH) stages T1-T5; females received materials for PH and breast (BR) stages T1-T5. Patients who opted in had 10 minutes to select the image(s) that best matched their bodies, which they sealed in an envelope. This was followed by a clinic visit, where a board-certified pediatric endocrinologist conducted a physical examination, including breast staging (females), testicular size measurement (males), and pubic hair staging (both sexes). Pubertal stage Kappa statistics with 95% CI were calculated for each body part by sex, with Kappa ≥ 0.60 indicating significant agreement between self-assessment and physician assessment (0.40-0.60 moderate; 0.20-0.40 fair). Results: Of 516 distributed packets, 243 self-assessments (125 females) were returned, with 81% (94 females/102 males) being complete (including pediatric endocrinologist staging). Mean age of participants was 12.8 years. Mean BMI was 22.2 kg/m² (males) and 23.7 kg/m² (females). Hypothyroidism was the most common endocrine diagnosis. For females, kappa was highest for BR and PH in T1 (BR 0.65, PH 0.57) and T5 (BR 0.57, PH 0.65). For males, kappa was highest in T1 (0.73) and T2 (0.58). Grouping Tanner stages into prepuberty (T1), early to mid-puberty (T2-T3), and late puberty (T4-T5) showed greater agreement. Conclusion: Patients can reliably distinguish between "puberty" and "no puberty" using self-staging, though differentiating between later pubertal stages is more challenging. These findings help define the utility and limitations of self-staging during telemedicine visits. [ABSTRACT FROM AUTHOR]

BackgroundEvaluation of pubertal development is crucial in Endocrinology. The rise in telemedicine during COVID-19 has made conduct of physical examinations more challenging, especially for pubertal assessment. Previous studies on validity of pubertal self-staging versus clinical examination have yielded mixed results. This study aimed to determine validity and reliability of self-staging of puberty, with potential application during telemedicine visits. The present study is the first to assess pediatric self-rated pubertal staging during the pandemic.MethodsThe study included patients aged 7-22 years referred to Pediatric Endocrinology for specialty care, including pubertal staging. At clinic check-in, patients received a packet with study description, an option to “opt in” or “opt out”, sex-specific self-staging instructions, and Tanner (T) stage illustrations. Males received materials for pubic hair (PH) stages T1-T5; females received materials for PH and breast (BR) stages T1-T5. Patients who opted in had 10 minutes to select the image(s) that best matched their bodies, which they sealed in an envelope. This was followed by a clinic visit, where a board-certified pediatric endocrinologist conducted a physical examination, including breast staging (females), testicular size measurement (males), and pubic hair staging (both sexes). Pubertal stage Kappa statistics with 95% CI were calculated for each body part by sex, with Kappa ≥ 0.60 indicating significant agreement between self-assessment and physician assessment (0.40-0.60 moderate; 0.20-0.40 fair).ResultsOf 516 distributed packets, 243 self-assessments (125 females) were returned, with 81% (94 females/102 males) being complete (including pediatric endocrinologist staging). Mean age of participants was 12.8 years. Mean BMI was 22.2 kg/m² (males) and 23.7 kg/m² (females). Hypothyroidism was the most common endocrine diagnosis. For females, kappa was highest for BR and PH in T1 (BR 0.65, PH 0.57) and T5 (BR 0.57, PH 0.65). For males, kappa was highest in T1 (0.73) and T2 (0.58). Grouping Tanner stages into prepuberty (T1), early to mid-puberty (T2-T3), and late puberty (T4-T5) showed greater agreement.ConclusionPatients can reliably distinguish between “puberty” and “no puberty” using self-staging, though differentiating between later pubertal stages is more challenging. These findings help define the utility and limitations of self-staging during telemedicine visits.

Epidemiological studies have linked obesity to the onset of puberty, while its causality and the potential metabolite mediators remain unclear. We employed a two-sample Mendelian randomization (MR) design to evaluate the causal effects of obesity on puberty onset and its associated diseases including type 2 diabetes (T2D) and cardiovascular diseases (CVDs). The potential mediators in this pathway were further explored using a two-step MR design. The robustness of our findings was evaluated using sensitivity analyses. Our MR results revealed that childhood obesity/BMI were causally associated with an increased Tanner stage in girls, younger age at menarche, and increased risk of adulthood T2D and CVD. However, neither childhood BMI nor obesity had a causal effect on the Tanner stage in boys. Mediation analysis further indicated that increased creatine served as a mediator for the causal pathway from childhood obesity/BMI to the Tanner stage of girls, while early puberty onset in girls played a mediating role in the pathway linking childhood obesity to increased risk of adulthood T2D and CVD. This study indicated that the risk of early puberty onset in girls and its associated health issues can be potentially reduced by preventing childhood obesity. The involvement of creatine in this process needs to be further validated and explored. [ABSTRACT FROM AUTHOR]

This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9–13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood.

ObjectiveThis study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3–18 and examine their associations with puberty development.MethodsA cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed.ResultsFrom an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3.ConclusionBoys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

Background. The objective of this study was to ascertain disparities in growth and maturation between male adolescents engaged in soccer and their non-athletic counterparts, as well as to examine the injury features specific to young soccer players. Methods. A total of 206 soccer players between the ages of 11-16 years, and 208 non-athletic peers were enrolled. Height, weight, body mass index (BMI), annual growth rate, and skeletal age evaluated using a left handwrist x-ray were determined. Biological and sexual maturation were evaluated using skinfold thickness, body composition, and Tanner stages. The game positions, initial age for playing soccer, the number of games per/week, the number of sports injuries, date of injury, duration for return to activity, the site, nature, mechanism, and rate of injury were recorded for soccer players. Using an injury card, the characteristics of soccer player injuries were recorded. Results. The mean age of the participants was 13.6 ± 1.5 years. There was no difference in the growth rates between the groups at the ages of 11.0, 12.0, and 15.0 but at the ages of 13.0 and 14.0 years growth rates were higher in the soccer group. The soccer players were taller than the controls. For all Tanner stages, soccer players had a lower BMI and total body fat percentage, as well as a faster growth rate. Injuries occurred at a rate of 39.3% per year among soccer players. The most common being toe injuries, and playing soccer increased the risk of multiple injuries. Additionally, injuries occurred more frequently in soccer players who were taller, heavier, with higher total body fat and/or higher growth rate, and most commonly occurred during Tanner stage 4. Futhermore, Tanner stage 4 had a higher incidence of two or more injuries than the other stages. Conclusions. Adolescent male soccer players have higher growth rates than their non-athletic peers, and their biological maturity status is associated with an increased risk of injury. [ABSTRACT FROM AUTHOR]

Epidemiological studies have linked obesity to the onset of puberty, while its causality and the potential metabolite mediators remain unclear. We employed a two-sample Mendelian randomization (MR) design to evaluate the causal effects of obesity on puberty onset and its associated diseases including type 2 diabetes (T2D) and cardiovascular diseases (CVDs). The potential mediators in this pathway were further explored using a two-step MR design. The robustness of our findings was evaluated using sensitivity analyses. Our MR results revealed that childhood obesity/BMI were causally associated with an increased Tanner stage in girls, younger age at menarche, and increased risk of adulthood T2D and CVD. However, neither childhood BMI nor obesity had a causal effect on the Tanner stage in boys. Mediation analysis further indicated that increased creatine served as a mediator for the causal pathway from childhood obesity/BMI to the Tanner stage of girls, while early puberty onset in girls played a mediating role in the pathway linking childhood obesity to increased risk of adulthood T2D and CVD. This study indicated that the risk of early puberty onset in girls and its associated health issues can be potentially reduced by preventing childhood obesity. The involvement of creatine in this process needs to be further validated and explored.

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IntroductionPhysical examinations to assess pubertal development are challenging in large epidemiological surveys. This study aimed to assess the reliability of judgment of pubertal onset in Japanese children by the original pubertal self-assessment sheet.MethodsA total of 144 children aged 10 or 12 years were recruited between March 2019 and September 2020 from the pediatric endocrine outpatient clinics of participating institutions. Agreement between the physician- and participantassessed pubertal onsets was determined using unweighted kappa (UK) and Gwet's agreement coefficient (AC1).ResultsThe physician's assessment of pubertal onset was in slight agreement with that of the self-assessment sheet in 10-year-old boys (UK: 0.23 and AC1: 0.14), whereas the agreement between the physician's assessment and self-assessment sheet results was good and the physician's assessment was fair (UK: 0.64 and AC1: 0.94) in 12-year-old boys. The physician's assessment of pubertal onset were in good and moderate agreement with the self-assessment sheet in 10-year-old girls (UK/AC1: 0.74/0.78, respectively). In 12-year-old girls, although it showed poor agreement with UK (0.46), there was a very good agreement with AC1 (0.88).ConclusionsAlthough self-assessment of breast development was in good agreement with that of the physician's assessment for determining pubertal onset in girls, large-scale epidemiological studies are difficult to conduct for adolescent boys, especially for those in the early pubertal stage.

To critically assess the literature focused on sex-specific trajectories in physical characteristics associated with anterior cruciate ligament (ACL) injury risk by age and maturational stage. PubMed, CINAHL, Scopus, and SPORTDiscus databases were searched through December 2021. Longitudinal and cross-sectional studies of healthy 8- to 18-year-olds, stratified by sex and age or maturation on ≥1 measure of body composition, lower extremity strength, ACL size, joint laxity, knee-joint geometry, lower extremity alignment, balance, or lower extremity biomechanics were included. Extracted data included study design, participant characteristics, maturational metrics, and outcome measures. We used random-effects meta-analyses to examine sex differences in trajectory over time. For each variable, standardized differences in means between sexes were calculated. The search yielded 216 primary and 22 secondary articles. Less fat-free mass, leg strength, and power and greater general joint laxity were evident in girls by 8 to 10 years of age and Tanner stage I. Sex differences in body composition, strength, power, general joint laxity, and balance were more evident by 11 to 13 years of age and when transitioning from the prepubertal to pubertal stages. Sex differences in ACL size (smaller in girls), anterior knee laxity and tibiofemoral angle (greater in girls), and higher-risk biomechanics (in girls) were observed at later ages and when transitioning from the pubertal to postpubertal stages. Inconsistent study designs and data reporting limited the number of included studies. Critical gaps remain in our knowledge and highlight the need to improve our understanding of the relative timing and tempo of ACL risk factor development. [ABSTRACT FROM AUTHOR]

During puberty, rapid, complex hormonal, physical and cognitive changes occur that affect body image and eating behavior. The aim of this cross-sectional study, a secondary analysis of data from the Greek Healthy Growth Study, was to explore associations of disordered eating behaviors and body image in 1206 10–12-year-old girls during pubertal maturation, with serum leptin and adiponectin levels, according to body mass index (BMI). Eating behavior and disordered eating were assessed with the Dutch Eating Behavior Questionnaire (DEBQ) and the Children Eating Attitudes Test Questionnaire (ChEAT), respectively. Associations of components of DEBQ and ChEAT with maturation according to Tanner Stage (TS) and levels of leptin and adiponectin were explored by univariate and multivariate regression analysis. Adiponectin levels in girls at TS 1 were positively associated with the “social pressure to eat” score of ChEAT. Leptin levels in girls at TS 4 were positively correlated with the “restraint eating” score of DEBQ, and the “dieting”, “body image” and “food awareness” scores of ChEAT. After adjustment for TS and BMI, only “body image” and leptin remained significant. Further research may shed light on how these hormonal changes affect eating behaviors at various pubertal stages, contributing to “TS-specific” preventive strategies for eating disorders in girls.

Introduction: To a considerable extent, the magnitude of blood volume (BV) and hemoglobin mass (Hbmass) contribute to the maximum O2-uptake (VO2max), especially in endurance-trained athletes. However, the development of Hbmass and BV and their relationships with VO2max during childhood are unknown. The aim of the present cross-sectional study was to investigate Hbmass and BV and their relationships with VO2max in children and adolescents. In addition, the possible influence of endurance training and chronic hypoxia was evaluated. Methods: A total of 475 differently trained children and adolescents (girls n = 217, boys n = 258; untrained n = 171, endurance trained n = 304) living at two different altitudes (∼1,000 m, n = 204, ∼2,600 m, n = 271) and 9–18 years old participated in the study. The stage of puberty was determined according to Tanner; Hbmass and BV were determined by CO rebreathing; and VO2max was determined by cycle ergometry and for runners on the treadmill. Results: Before puberty, there was no association between training status and Hbmass or BV. During and after puberty, we found 7–10% higher values in the trained groups. Living at a moderate altitude had a uniformly positive effect of ∼7% on Hbmass in all groups and no effect on BV. The VO2max before, during and after puberty was strongly associated with training (pre/early puberty: boys +27%, girls +26%; mid puberty: +42% and +45%; late puberty: +43% and +47%) but not with altitude. The associated effects of training in the pre/early pubertal groups were independent of Hbmass and BV, while in the mid- and late pubertal groups, 25% of the training effect could be attributed to the elevated Hbmass. Conclusions: The associated effects of training on Hbmass and BV, resulting in increased VO2max, can only be observed after the onset of puberty. [ABSTRACT FROM AUTHOR]

Background: High survival rates of children diagnosed with cancer have led to a growing population of women with premature ovarian failure (POF) due to chemotherapy and radiotherapy. The POF process occurs due to the disruption of the hypothalamic–pituitary and gonadal axis followed by the delay of puberty development. Evaluation of reproductive function in children with cancer is essential to determine the fertility preservation plan. This study aimed to describe reproductive functions in children and adolescents with cancer who received chemotherapy based on Tanner stage evaluation, menstrual cycle, and anti-Mullerian hormone (AMH) examination using electro-chemiluminescence immunoassay kit. Results: Twenty-three girls aged 12–18 years old and had menarche who underwent cancer therapy in January–August 2019 in Dr. Sardjito General Hospital were included in the study. Among them, 61% had low AMH levels and were defined as diminished ovarian reserve (DOR). Two subjects with DOR experienced delayed puberty. Regular menstrual cycle was reported in 65.2% of subjects and irregular menstrual cycle in 34.8%, while 21.7% with irregular menstrual cycle encountered secondary amenorrhea. Conclusion: Chemotherapy exposure affected DOR occurrence in 60.9% of patients with childhood and adolescence cancer. Moreover, it also altered menstrual regularity in 34.8% and delayed puberty development in 8.7% subjects. [ABSTRACT FROM AUTHOR]

Introduction: To a considerable extent, the magnitude of blood volume (BV) and hemoglobin mass (Hbmass) contribute to the maximum O2-uptake (VO2max), especially in endurance-trained athletes. However, the development of Hbmass and BV and their relationships with VO2max during childhood are unknown. The aim of the present cross-sectional study was to investigate Hbmass and BV and their relationships with VO2max in children and adolescents. In addition, the possible influence of endurance training and chronic hypoxia was evaluated.Methods: A total of 475 differently trained children and adolescents (girls n = 217, boys n = 258; untrained n = 171, endurance trained n = 304) living at two different altitudes (∼1,000 m, n = 204, ∼2,600 m, n = 271) and 9–18 years old participated in the study. The stage of puberty was determined according to Tanner; Hbmass and BV were determined by CO rebreathing; and VO2max was determined by cycle ergometry and for runners on the treadmill.Results: Before puberty, there was no association between training status and Hbmass or BV. During and after puberty, we found 7–10% higher values in the trained groups. Living at a moderate altitude had a uniformly positive effect of ∼7% on Hbmass in all groups and no effect on BV. The VO2max before, during and after puberty was strongly associated with training (pre/early puberty: boys +27%, girls +26%; mid puberty: +42% and +45%; late puberty: +43% and +47%) but not with altitude. The associated effects of training in the pre/early pubertal groups were independent of Hbmass and BV, while in the mid- and late pubertal groups, 25% of the training effect could be attributed to the elevated Hbmass.Conclusions: The associated effects of training on Hbmass and BV, resulting in increased VO2max, can only be observed after the onset of puberty.

Abstract Background Further knowledge about the pubertal development mode of girls with Turner syndrome (TS) who have undergone hormone replacement therapy (HRT) is beneficial to the proposal of an optimal HRT regimen. This study examined the pubertal development mode of girls with TS who underwent HRT and evaluated the characteristics of optimal sex induction therapy in girls with TS. Method We conducted a retrospective, longitudinal study over the past two decades at The First Affiliated Hospital, Sun Yat-sen University. Patients Seventy-one patients with TS and two groups of normal Chinese girls. Results The total investigation time was 3.00 (2.00, 4.66) years. The interval of each stage was significantly longer (P

Abstract Background There is growing scientific evidence supports a link between increased childhood adiposity and early onset of puberty in girls worldwide in recent decades. However, the data from Chinese girls remain ambiguous. The aims of this study were to estimate the puberty milestones and examine attainment of puberty associated with obesity and central obesity in Chinese Han schoolgirls. Methods The cross-sectional school-based study examined 2996 Han schoolgirls aged 9 to 19 years from 6 provinces in China. Trained clinicians assessed the girls for height, weight, waist circumference, Tanner stages of breast and pubic hair development, and menarcheal status. We classified girls as normal weight, overweight, or obese based on BMI, and as normal weight or central obese based on the waist-height ratio, then estimated and compared median age at a given Tanner stage or greater by weight class using Probit models. Results The median age at menarche was 12.36 years. The median ages at breast stages(B) 2 through 5 were 10.03, 11.38, 13.39, and 15.79 years, respectively, and at pubic hair stages(PH) 2 through 5 were 11.62, 12.70, 14.38, and 16.92 years, respectively. Girls from urban areas experienced menarche, B3 and B4 stages, and PH3 through PH5 stages earlier. Girls with central obesity and overweight/obesity reached puberty earlier at almost every Tanner stage of breast and pubic hair than normal girls. Girls with obesity developed PH2 and PH3 earlier than their overweight peers. However, we did not find any significant differences between girls with overweight and obesity at all stages of breast development. Conclusions Childhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls.

Abstract Importance A web‐based instrument for self‐assessment of puberty could be convenient and feasible for large‐scale multicenter population‐based epidemiological studies for Tanner stages evaluation. Objective To validate web‐based self‐assessment of pubertal development against assessment by a pediatrician. Methods Outpatients aged 8–18 years were consecutively recruited in the endocrinology department of Beijing Children's Hospital from October 2016 to August 2017. A web‐based self‐assessment instrument for pubertal development was introduced to participants by an appointed pediatrician. Tanner stage of puberty was self‐assessed by participants in a private environment. Participants were then examined by a senior pediatrician underwent blinded assessment. Weighted kappa and Spearman correlation analyses were conducted to evaluate agreement. The accuracy of the web‐based instrument for self‐assessment of pubertal onset was evaluated according to sensitivity, specificity, positive predictive value and negative predictive value Results A total of 174 participants (including 82 girls and 92 boys) were assessed consecutively. Correlation coefficients were 0.872 for pubic hair and 0.933 for testicular volume (P

Background/AimsInformation regarding the efficacy of early infliximab treatment in pediatric patients with Crohn’s disease (CD) is limited. We aimed to evaluate the impact of early combined immunosuppression on linear growth in pediatric patients with CD by performing step-up comparisons.Methods : This retrospective study included pediatric patients with moderate-to-severe CD, who received a combination therapy with infliximab and azathioprine for at least 3 years and sustained corticosteroid-free remission without loss of response. The z-scores of the growth indicators obtained at the time of diagnosis and annually for 3 years thereafter were compared between the two groups.Results : The early combined immunosuppression group displayed significantly increased linear growth 3 years after diagnosis (p=0.026). A significant difference was also observed in the linear growth 3 years after diagnosis between subgroups of Tanner stages 1–2 (p=0.016).Conclusion : sThe early introduction of biologics should be considered to improve linear growth in pediatric patients with CD.

This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9–13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood. • This study examined sex and pubertal differences in reward motivation and neural processing in the ABCD data. • Boys had higher reward motivation than girls. • Girls had lower neural activation during reward feedback than boys in reward-related striatal and frontal areas. • There were no associations between pubertal development and neural activation during reward anticipation and feedback. [ABSTRACT FROM AUTHOR]

Abstract Background Animal studies suggest that bisphenol A (BPA) may perturb pubertal development in females. However, evidence from human studies is limited. Methods This was a cross-sectional study to investigate the association between BPA exposure and pubertal development in school-aged girls. A total of 655 girls aged 9–18 years were selected from three schools in Shanghai, from May to June 2011. We collected one single spot urine sample from each girl. Urine BPA concentrations were measured by modified high-performance liquid chromatography and categorized according to LOD and the median of those above LOD. Pubertal development status was assessed by using Tanner staging, and age at menarche was collected as a milestone for mid-puberty. Modified Poisson regression was used to estimate adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). Results After adjustment for potential confounders, girls with detected BPA were more likely to have delayed menarche, a mid-puberty event, compared with girls with undetectable BPA; the prevalence ratios (PR) were 0.73 (0.56, 0.95) for those with moderate BPA(LOD-median) and 0.72 (0.52, 0.99) for those with high BPA(>median), respectively. Girls aged 9–12 years with detected BPA were more likely to have reached pubic hair stage 2, the indicator of pubarche; while among girls aged >15 years, those with detected BPA were less likely to have reached pubic hair stage 5, the late stage of pubic hair development. Conclusions BPA exposure was associated with alterations in the timing of pubertal development. Results in the present study should be interpreted with caution because of its cross-sectional nature and the limited sample size in each age group.

Study Question: Is maternal age at menarche associated with pubertal development in sons and daughters?Summary Answer: Maternal age at menarche was associated with pubertal development in both sons and daughters.What Is Known Already: Studies have shown that age at menarche is greatly inherited from mother to daughter, but it remains largely unknown to what extent age at menarche in mothers is associated with timing of puberty in sons.Study Design, Size, Duration: In this population-based study we used data from the Puberty Cohort nested within the Danish National Birth Cohort. Live-born singletons aged 11 were followed from 2012 to 2016.Participants/materials, Setting, Methods: In total, 15 822 children (7697 sons and 8125 daughters) gave half-yearly information on puberty from the age of 11 years until full sexual maturity or 18 years of age through self-administrated questionnaires (participation rate 71%). Information on maternal age at menarche was reported by the mothers during pregnancy. Maternal age at menarche was used both as a continuous and as a categorical variable (earlier, same time or later than peers). A multivariable regression model for interval-censored data was used.Main Results and the Role Of Chance: Maternal age at menarche was positively associated with timing of genital development, pubic hair development, first ejaculation of semen, voice break, axillary hair development and acne in sons, and with timing of breast development, pubic hair development, menarche, axillary hair development and acne in daughters. In sons, the associations were of similar strength for all pubertal markers, whereas in daughters, the associations were strongest for breast development and menarche.Limitations, Reasons For Caution: Age at menarche was recalled during pregnancy. However, studies indicate that age at menarche is recalled moderately in adulthood. Information on puberty was self-reported, but inaccuracy of data would probably cause non-differential misclassification.Wider Implications Of the Findings: Early maternal age at menarche was associated with earlier pubertal development, and late maternal age at menarche was associated with later pubertal development in both sons and daughters. The largest effect-estimates were for the associations between maternal age at menarche and the daughters' age at menarche and age at breast development.Study Funding/competing Interest(s): The study was funded by the Danish Council for Independent Research (4183-00152). There are no competing interests.Trial Registeration Number: N/A. [ABSTRACT FROM AUTHOR]

Background Menarche is an important event in a female's reproductive health. However, the age at menarche is variable and has implications on the future health of the girl. The purpose of this study was to estimate the mean age at menarche of North Indian adolescent girls and its association with the Tanner stage and to study the trend of menarcheal age in India in the 21st century. Materials & methods A longitudinal descriptive study was conducted on 470 healthy girls aged nine to 16 years in expectant menarche (Tanner stage II). They were followed for six months to check for the attainment of menarche. Those who achieved menarche were grouped in Group I and the rest in Group II. The data were analyzed using the independent t-test. Results Menarche was achieved by 263 girls in the six-month follow-up period. The mean (SD) age of menarche was 13.13 (1.23) years. Group I girls were mostly in Tanner stage IV and above. Group II girls had a mean (SD) age of 11.53 (1.1) years and were mostly in Tanner stage III or below. The estimated decline in the age of menarche in the 21st century was about 0.41 years per decade. Conclusion The girls who achieved menarche had a significantly higher age and Tanner stage of sexual maturity than girls who did not achieve menarche in the study period. Tanner stage is a better measure to estimate the pubertal onset than age. The studies on the age of menarche in the current century reveal that the declining trend in the menarcheal age is continuing in India., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bajpai et al.)

Objectives: To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages., Methods: A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP., Results: For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group ( P <0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone ( P <0.001), but with no significant difference compared with that of basal LH level measurement alone ( P >0.05)., Conclusions: Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.

ABSTRACT Childhood and adolescence are critical periods of bone mineral content (BMC) accrual that may have long-term consequences for osteoporosis in adulthood. Adequate dietary calcium intake and weight-bearing physical activity are important for maximizing BMC accrual. However, the relative effects of physical activity and dietary calcium on BMC accrual throughout the continuum of pubertal development in childhood remains unclear. The purpose of this study was to determine the effects of self-reported dietary calcium intake and weight-bearing physical activity on bone mass accrual across the five stages of pubertal development in a large, diverse cohort of US children and adolescents. The Bone Mineral Density in Childhood study was a mixed longitudinal study with 7393 observations on 1743 subjects. Annually, we measured BMC by dual-energy X-ray absorptiometry (DXA), physical activity and calcium intake by questionnaire, and pubertal development (Tanner stage) by examination for up to 7 years. Mixed-effects regression models were used to assess physical activity and calcium intake effects on BMC accrual at each Tanner stage. We found that self-reported weight-bearing physical activity contributed to significantly greater BMC accrual in both sexes and racial subgroups (black and nonblack). In nonblack males, the magnitude of the activity effect on total body BMC accrual varied among Tanner stages after adjustment for calcium intake; the greatest difference between high- and low-activity boys was in Tanner stage 3. Calcium intake had a significant effect on bone accrual only in nonblack girls. This effect was not significantly different among Tanner stages. Our findings do not support differential effects of physical activity or calcium intake on bone mass accrual according to maturational stage. The study demonstrated significant longitudinal effects of weight-bearing physical activity on bone mass accrual through all stages of pubertal development. © 2014 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

The steep adolescent decline in the slow wave (delta, 1-4 Hz) electroencephalogram (EEG) of nonrapid eye movement (NREM) sleep is a dramatic maturational change in brain electrophysiology thought to be driven by cortical synaptic pruning. A perennial question is whether this change in brain electrophysiology is related to sexual maturation. Applying Gompertz growth models to longitudinal data spanning ages 9-18 y, we found that the timing of the delta decline was significantly (P < 0.0001) linked to timing of pubertal maturation. This timing relation remained significant when sex differences in the timing of the delta decline were statistically controlled. Sex differences and the relation to the timing of puberty jointly explained 67% of the between-subject variance in the timing of the delta decline. These data provide a demonstration of a temporal relation between puberty and an electrophysiological marker of adolescent brain development. They can guide research into whether the neuroendocrine events of puberty are mechanistically linked to cortical maturation or whether, instead, the two maturational processes are parallel but independent programs of human ontogenesis. [ABSTRACT FROM AUTHOR]

Background:Short sleep duration is associated with obesity during childhood and adulthood.Objective:The objective of our study was to investigate the relationship between sleep duration and body mass index (BMI) from Tanner stages 1 to 5 in a Dutch children cohort.Design:In 98 children, anthropometric measurements and leptin concentrations were measured from age 7 to 16 years; body composition, physical activity (Baecke questionnaire), hours television viewing and self-reported sleep duration were measured yearly from age 12 to 16 years. Moreover, the polymorphisms of the FTO gene (rs9939609) and parental BMI's were determined.Results:At Tanner stages 1-5 sex differences were observed in height, body weight, waist circumference, fat mass per squared meter height and leptin concentrations per kg fat mass. Inverse relationships were observed between the change in BMI (kg m-2) and the change in hours of sleep per night (h) from Tanner stages 1 to 4 (r=−0.68, P<0.001), from Tanner stages 2 to 5 (r=−0.35, P<0.05) and from Tanner stages 1 to 5 (r=−0.33, P<0.05). Univariate analysis of variance showed that with progressive Tanner stages, BMI increases and sleep duration decreases in an interrelated way independent of possible confounders (R 2=0.38, P<0.02).Conclusion:Changes in BMI during puberty were inversely related to changes in sleep duration, independent of possible confounders. [ABSTRACT FROM AUTHOR]

Context: Previous researchers have not investigated the thermoregulatory responses to multiple consecutive days of American football in adolescents. Objective: To examine the thermoregulatory and hydration responses of high school players during formal preseason football practices. Design: Observational study. Setting: Players practiced outdoors in late August once per day on days 1 through 5, twice per day on days 6 and 7, and once per day on days 8 through 10. Maximum wet bulb globe temperature averaged 23 ± 4°C. Patients or Other Participants: Twenty-five heat-acclimatized adolescent boys (age = 15 ± 1 years, height = 180 ± 8 cm, mass = 81.4 ± 15.8 kg, body fat = 12 ± 5%, Tanner stage = 4 ± 1). Main Outcome Measure(s): We observed participants within and across preseason practices of football. Measures included gastrointestinal temperature (TGI), urine osmolality, sweat rate, forearm sweat composition, fluid consumption, testosterone to cortisol ratio, perceptual measures of thirst, perceptual measures of thermal sensation, a modified Environmental Symptoms Questionnaire, and knowledge questionnaires assessing the participants' understanding of heat illnesses and hydration. Results were analyzed for differences across time and were compared between younger (14-15 years, n = 13) and older (16-17 years, n = 12) participants. Results: Maximum daily TGI values remained less than 40°C and were correlated with maximum wet bulb globe temperature (r = 0.59, P = .009). Average urine osmolality indicated that participants generally experienced minimal to moderate hypohydration before (881 ± 285 mOsmol/kg) and after (856 ± 259 mOsmol/kg) each practice as a result of replacing approximately two-thirds of their sweat losses during exercise but inadequately rehydrating between practices. Age did not affect most variables; however, sweat rate was lower in younger participants (0.6 ± 0.2 L/h) than in older participants (0.8 ± 0.1 L/h) (F1,18 = 8.774, P = .008). Conclusions: Previously heat-acclimatized adolescent boys (TGI , 40°C) can safely complete the initial days of preseason football practice in moderate environmental conditions using well-designed practice guidelines. Adolescent boys replaced most sweat lost during practice but remained mildly hypohydrated throughout data collection, indicating inadequate hydration habits when they were not at practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE:To examine cross-sectional differences in insulin sensitivity, insulin secretion and β-cell function during puberty in overweight Hispanic boys and girls with a family history of type 2 diabetes.STUDY DESIGN AND PARTICIPANTS:This cross-sectional, observational study included 214 8–13-y-old Hispanic children with a BMI percentile ≥85th percentile and family history of type 2 diabetes.METHODS AND ANALYSES:Participants underwent a physical examination, body composition measures, oral glucose tolerance test (OGTT), and frequently-sampled intravenous glucose tolerance test. Unadjusted and adjusted general linear models (GLM) tested whether insulin/glucose dynamics differed by Tanner stage and gender.RESULTS:Unadjusted group comparisons showed that fasting insulin increased whereas insulin sensitivity (SI) and the disposition index (DI) (a measure of pancreatic β-cell function) decreased across Tanner stage groups (all P<0.05). No differences in the acute insulin response to glucose (AIRg), fasting glucose or 2-h glucose were found. After adjusting for covariates, there was no independent effect of Tanner stage on SI (P=0.9) or AIRg (P=0.2), but DI was slightly lower in later Tanner stages suggesting decreased β-cell function in the more mature groups (P=0.10).CONCLUSIONS:Overweight Hispanic children with a family history of type 2 diabetes may represent a unique population given that pubertal insulin resistance was not evident once analyses controlled for body composition. Longitudinal analyses are required to determine whether the slightly diminished β-cell function in later Tanner stages plays a role in the development of type 2 diabetes.International Journal of Obesity (2005) 29, 1471–1477. doi:10.1038/sj.ijo.0803044; published online 2 August 2005 [ABSTRACT FROM AUTHOR]

Background: Body composition and resting energy expenditure (REE) have not been examined longitudinally during puberty. Objective: The purpose of this longitudinal study was to examine the influence of pubertal maturation on REE relative to body composition in African American and white children. Design: The study included 92 white and 64 African American children (mean age at baseline: 8.3 and 7.9 y, respectively) from Birmingham, AL. The children had 2-5 annual measurements of fat mass (FM), lean mass (LM), and REE. The Tanner stages of the children ranged from 1 to 5. Mixed-model repeated-measures analyses were used to test the change in REE relative to body composition with increasing Tanner stage among ethnic and sex groups. Results: LM increased from Tanner stage 1 to subsequent stages. FM relative to LM decreased from Tanner stage 1 to stages 3, 4, and 5 but not from stage 1 to stage 2. The African American children had relatively higher limb LM and lower trunk LM than did the white children. REE declined with Tanner stage after adjustment for ethnicity, sex, FM, and LM. This decline was significant from Tanner stage 1 to stages 3, 4, and 5 but not to Tanner stage 2. After adjustment for age, Tanner stage, FM, and LM or LM distribution, REE was significantly higher in white than in African American children (by ≈250 kJ/d). Conclusion: In a large sample of children at various Tanner stages, we found an ethnic difference in REE after adjustment for age, Tanner stage, FM, and LM that was not explained by the difference in LM distribution. [ABSTRACT FROM AUTHOR]

This 7.5-year prospective controlled exercise intervention study assessed if daily school physical activity (PA), from before to after puberty, improved musculoskeletal traits. There were 63 boys and 34 girls in the intervention group (40 min PA/day), and 26 boys and 17 girls in the control group (60 min PA/week). We measured musculoskeletal traits at the start and end of the study. The overall musculoskeletal effect of PA was also estimated by a composite score (mean Z-score of the lumbar spine bone mineral content (BMC), bone area (BA), total body lean mass (TBLM), calcaneal ultrasound (speed of sound (SOS)), and muscle strength (knee flexion peak torque)). We used analyses of covariance (ANCOVA) for group comparisons. Compared to the gender-matched control group, intervention boys reached higher gains in BMC, BA, muscle strength, as well as in the composite score, and intervention girls higher gains in BMC, BA, SOS, as well as in the composite score (all p < 0.05, respectively). Our small sample study indicates that a daily school-based PA intervention program from Tanner stage 1 to 5 in both sexes is associated with greater bone mineral accrual, greater gain in bone size, and a greater gain in a musculoskeletal composite score for fractures. [ABSTRACT FROM AUTHOR]

Intracranial germ cell tumors (GCTs) account for 3%-5% of all intracranial tumors. They commonly manifest during first two decades of life. We are reporting a case of a young female, who presented with progressive visual loss, polyuria and polydipsia, harboring an intracranial GCT. She presented initially to a neurosurgery clinic and then to an endocrine clinic, with a history of chronic worsening headache and recent onset visual blurring along with polyuria with polydipsia. On further inquiry, she was found to have primary amenorrhea, easy fatigability, and failure of development of secondary sexual characteristics. On examination the patient had bitemporal hemianopia with breast development at tanner stage II and pubic and axillary hair at tanner stage I. Her initial hormonal workup was suggestive of panhypopituitarism with diabetes insipidus. MRI pituitary showed a sellar mass with suprasellar extension, so an initial impression of a pituitary macroadenoma was made and the patient underwent trans-sphenoidal surgery. The histopathology was suggestive of lymphoid hyperplasia. Follow up MRI showed significant residual tumor and her vision and pituitary function did not recover. Neurosurgery was planned as second surgery, but we requested a second opinion of histopathology report and it was suggestive of a germinoma. She was then started on chemotherapy followed by radiotherapy, after which her tumor size reduced significantly, though she still required pituitary hormone replacement therapy.  Pituitary stalk lesions are rare and their diagnosis is challenging as different etiologies present clinically and radiologically in a similar manner with tissue diagnosis being the gold standard. Germinoma is a radiosensitive tumor. In our patient it took a long time to reach the correct diagnosis and late diagnosis resulted in permanent visual field defect and panhypopituitarism. This case report emphasizes that we should guide and educate our patients to seek medical advice early in the course of disease. We should also keep differential diagnosis in mind before referring the patient for surgery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Ram et al.)

Background: Further knowledge about the pubertal development mode of girls with Turner syndrome (TS) who have undergone hormone replacement therapy (HRT) is beneficial to the proposal of an optimal HRT regimen. This study examined the pubertal development mode of girls with TS who underwent HRT and evaluated the characteristics of optimal sex induction therapy in girls with TS. Method: We conducted a retrospective, longitudinal study over the past two decades at The First Affiliated Hospital, Sun Yat-sen University. Patients: Seventy-one patients with TS and two groups of normal Chinese girls. Results: The total investigation time was 3.00 (2.00, 4.66) years. The interval of each stage was significantly longer (P < 0.001) in the girls with TS than that in the normal Chinese girls, except for B2–3 (P = 0.011). The uterine volumes of the girls with TS in stages B2 and 3 were greater than those of the control group (P = 0.046), whereas the uterine volume of the control group was inversely greater than that of the TS group among those who reached stages B4 and 5 (P = 0.034). During HRT, the uterine volume grew significantly from all previous stages except for breast stage 5 (B3 vs.2: Z = − 2.031; P = 0.042; B4 vs. 3: Z = − 2.273; P = 0.023; B5 vs. 4: Z = − 1.368; P = 0.171). The paired data of 27 girls with TS showed that the uterine volume (17.93 ± 9.31 ml vs. 13.75 ± 6.67 ml) and width (2.54 ± 0.66 cm vs. 2.22 ± 0.36 cm) increased significantly during artificial cycles compared with before artificial cycles (t = − 2.79 and − 2.51, P = 0.01 and 0.018). Conclusion: HRT led to normal breast development in girls with TS; half of the girls with TS in our study reached Tanner stage B5, although the uterus ultimately developed suboptimally. The girls' breasts and uteruses grew quickly at the beginning of HRT (stages B2–4). An optimal HRT regimen for girls with TS may specifically focus on Tanner stages B2–4 and artificial cycles. [ABSTRACT FROM AUTHOR]

Alterations in pubertal timing have been associated with long-term health outcomes. While a few reports have shown that dietary intake of selenium is associated with fertility and testosterone levels in men, no human studies have considered the association between selenium and pubertal development in children. We examined the cross-sectional association of childhood dietary intake of selenium with pubertal development among 274 girls and 245 boys aged 10–18 years in Mexico City. Multiple logistic and ordinal regression models were used to capture the association between energy-adjusted selenium intake (below Recommended Dietary Allowance (RDA) vs. above RDA) and stages of sexual maturity in children, adjusted for covariates. We found that boys with consumption of selenium below the RDA had lower odds of a higher stage for pubic hair growth (odds ratio (OR) = 0.51, 95% confidence interval (95% CI): 0.27–0.97) and genital development (OR = 0.53, 95% CI: 0.28–0.99) as well as a lower probability of having matured testicular volume (OR = 0.37, 95% CI: 0.15–0.88) compared with boys who had adequate daily dietary intake of selenium (above RDA). No associations were found in girls. According to our results, it is possible that inadequate consumption of selenium may be associated with later pubertal development in boys, suggesting a sex-specific pattern. Future work with a larger sample size and measures of selenium biomarkers is needed to confirm our findings and improve understanding of the role of this mineral in children's sexual development. [ABSTRACT FROM AUTHOR]

Background: There is growing scientific evidence supports a link between increased childhood adiposity and early onset of puberty in girls worldwide in recent decades. However, the data from Chinese girls remain ambiguous. The aims of this study were to estimate the puberty milestones and examine attainment of puberty associated with obesity and central obesity in Chinese Han schoolgirls.Methods: The cross-sectional school-based study examined 2996 Han schoolgirls aged 9 to 19 years from 6 provinces in China. Trained clinicians assessed  the girls for height, weight, waist circumference, Tanner stages of breast and pubic hair development, and menarcheal status. We classified girls as normal weight, overweight, or obese based on BMI, and as normal weight or central obese based on the waist-height ratio, then estimated and compared median age at a given Tanner stage or greater by weight class using Probit models.Results: The median age at menarche was 12.36 years. The median ages at breast stages(B) 2 through 5 were 10.03, 11.38, 13.39, and 15.79 years, respectively, and at pubic hair stages(PH) 2 through 5 were 11.62, 12.70, 14.38, and 16.92 years, respectively. Girls from urban areas experienced menarche, B3 and B4 stages, and PH3 through PH5 stages earlier. Girls with central obesity and overweight/obesity reached puberty earlier at almost every Tanner stage of breast and pubic hair than normal girls. Girls with obesity developed PH2 and PH3 earlier than their overweight peers. However, we did not find any significant differences between girls with overweight and obesity at all stages of breast development.Conclusions: Childhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls. [ABSTRACT FROM AUTHOR]