RESUMO
The consumption of fructose has increased in children and adolescents and is partially responsible for the high incidence of metabolic diseases. The lifestyle during postnatal development can result in altered metabolic programming, thereby impairing the reproductive system and fertility during adulthood. Therefore, the aim of this study was to evaluate the effect of a high-fructose diet in the male reproductive system of pubertal and adult rats. Male Wistar rats (30 d old) were assigned to four different groups: Fr30, which received fructose (20%) in water for 30 d and were euthanized at postnatal day (PND) 60; Re-Fr30, which received fructose (20%) for 30 d and were euthanized at PND 120; and two control groups C30 and Re-C30, which received water ad libitum and were euthanized at PND 60 and 120, respectively. Fructose induced an increase in abnormal seminiferous tubules with epithelial vacuoles, degeneration, and immature cells in the lumen. Moreover, Fr30 rats showed altered spermatogenesis and daily sperm production (DSP), as well as increased serum testosterone concentrations. After discontinuing high-fructose consumption, DSP and sperm number decreased significantly. We observed tissue remodeling in the epididymis, with a reduction in stromal and epithelial compartments that might have influenced sperm motility. Therefore, we concluded that fructose intake in peripubertal rats led to changes in the reproductive system observed both during puberty and adulthood.
Assuntos
Epididimo/patologia , Qualidade dos Alimentos , Xarope de Milho Rico em Frutose/efeitos adversos , Testículo/patologia , Animais , Modelos Animais de Doenças , Epididimo/efeitos dos fármacos , Epididimo/fisiopatologia , Xarope de Milho Rico em Frutose/metabolismo , Masculino , Puberdade/sangue , Puberdade/metabolismo , Ratos Wistar/crescimento & desenvolvimento , Ratos Wistar/metabolismo , Contagem de Espermatozoides/métodos , Contagem de Espermatozoides/estatística & dados numéricos , Testículo/efeitos dos fármacos , Testículo/fisiopatologia , Testosterona/análise , Testosterona/sangueRESUMO
Our objective was to explore the longitudinal trajectory of hemoglobin A1c (HbA1c) in well-characterized youth (n = 84) with normal weight and obesity during puberty. HbA1c rose from early puberty to Tanner stage 5, even in healthy, normal weight youth, revealing important implications for defining normal glycemia and prediabetes in adolescents.
Assuntos
Peso Corporal , Hemoglobinas Glicadas/análise , Obesidade Infantil/epidemiologia , Puberdade/sangue , Adolescente , Criança , Feminino , Humanos , Masculino , Valores de ReferênciaRESUMO
INTRODUCTION: Objective: to analyze the relationship of age at menarche and leptin with the metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes in adolescent girls in different body mass index (BMI) categories. Method: an observational and cross-sectional study consisting of 139 female adolescents attended to at the Adolescent Reference Center in Macaé, Rio de Janeiro. Menarche was classified as early (EM) when the first menstruation occurred at or before 11 years of age; normal menarche (NM) was categorized at ages 12 to 14; menarche was considered late (LM) when it occurred at age 15 or older. The factors required to ascertain the subjects' phenotype, as well as their leptin levels, weight, and height, were measured and their BMIs were calculated. The girls were classified as MH or MUH based on the NCEP-ATP III criteria as adapted for children and adolescents. Results: 82 % (n = 114) of the girls were classified as MH and 18 % (n = 25) as MUH. Mean age at menarche was 11.79 ± 1.39 years. There was a higher prevalence of MUH amongst the girls who had EM (p = 0.04). A higher inadequacy of serum leptin concentrations was found in girls who had EM (p = 0.05) and in those classified as MUH (p = 0.01). The adolescents who were severely obese exhibited inadequate leptin levels (p < 0.01) and had gone through EM (p = 0.02). A total of 8.1 % (n = 7) of the normal-weight girls were classified as MUH, and 29.4 % (n = 5) of those who were severely obese were classified as MH (p < 0.01). Conclusion: early menarche and high serum leptin concentrations are related with the MUH phenotype in adolescent girls in different BMI categories.
INTRODUCCIÓN: Objetivo: analizar la relación de la edad de la menarquia y los niveles de leptina con los fenotipos metabólicamente saludables (MS) y metabólicamente no saludables (MNS) en adolescentes de diferentes categorías de índice de masa corporal (IMC). Método: estudio observacional y transversal compuesto por 139 adolescentes de sexo feminino, atendidas en el Centro de Referencia para Adolescentes de Macaé, Río de Janeiro. La menarquia se clasificó como precoz (MP) cuando se produjo la primera menstruación a o antes de los 11 años de edad; la menarquia normal (MN) se clasificó como aquella sucedida a la edad de 12 a 14 años; la menarquia se consideró tardía (MT) cuando ocurrió a los 15 años o más. Se midieron los factores necesarios para determinar el fenotipo de los sujetos, y se midieron sus niveles de leptina, peso y altura, y se calculó su IMC. Las adolescentes se clasificaron como MS y MNS según los criterios de NCEP-ATP III, adaptados para niños y adolescentes. Resultados: el 82 % (n = 114) de las adolescentes se clasificaron como MH y el 18 % (n = 25) como MUH. La edad media de la menarquia fue de 11,79 ± 1,39 años. Hubo una mayor prevalencia de MUH entre las adolescentes que tenían MP (p = 0,04). Se encontró una mayor insuficiencia de las concentraciones séricas de leptina en las adolescentes que tenían MP (p = 0,05) y en aquellas clasificadas como MNS (p = 0,01). Las adolescentes que eran severamente obesas exhibieron niveles inadecuados de leptina (p < 0,01) y habían pasado por una MP (p = 0,02). El 8,1 % (n = 7) de las adolescentes de peso normal se clasificaron como MNS y el 29,4 % (n = 5) de las que eran severamente obesas se clasificaron como MS (p < 0,01). Conclusión: la menarquia temprana y las altas concentraciones séricas de leptina están relacionadas con el fenotipo MNS en las adolescentes de diferentes categorías de IMC.
Assuntos
Índice de Massa Corporal , Leptina/sangue , Menarca/sangue , Obesidade Infantil/sangue , Adolescente , Fatores Etários , Estatura , Peso Corporal , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Menarca/fisiologia , Obesidade Infantil/classificação , Fenótipo , Puberdade/sangue , Puberdade/fisiologia , Maturidade SexualRESUMO
Background Cardiorespiratory fitness (CRF) and pubertal stages have been related to many health outcomes, including obesity and adipocytokines. Thus, the present study aimed to analyze the moderator role of CRF and pubertal stage in the relationship between adiposity and adipocytokines in girls. Method This cross-sectional study was performed with 42 pre-pubertal girls aged from 7 to 11 years and 54 post-pubertal girls aged from 13 to 17 years. Blood samples were collected to determine the serum levels of leptin and adiponectin, and then the leptin/adiponectin ratio (L/A ratio) was calculated. CRF, anthropometric and body composition indicators were assessed. For statistical analysis, descriptive statistics and several linear regression models were used. The moderation analysis was tested using the PROCESS macro. Results An interaction between body mass index (BMI) and CRF (ß: -0.70; confidence interval [CI]: -1.29, -0.12), as well as between BMI and pubertal stage (ß: 0.79; CI: 0.28, 1.30) with leptin, was found. Regarding the L/A ratio, an interaction was found only in BMI × CRF (ß: -0.56; CI: -1.06, -0.06). Using a combined interaction (CRF and pubertal stage), the results showed a positive association between BMI with leptin and L/A ratio only in low CRF, pre-pubertal and post-pubertal stages. Conclusion This study suggests a protective role of high levels of CRF in the relationship between BMI and adipocytokines. Despite the effect of pubertal stage, the results suggest that youth should be engaged in physical activity in order to improve CRF levels and consequently improve cardiometabolic health.
Assuntos
Adiponectina/sangue , Adiposidade/fisiologia , Aptidão Cardiorrespiratória/fisiologia , Exercício Físico/fisiologia , Leptina/sangue , Puberdade/fisiologia , Adolescente , Composição Corporal/fisiologia , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Puberdade/sangueRESUMO
OBJECTIVES: To assess whether the serum levels of anti-Müllerian hormone (AMH) are increased in girls with premature adrenarche because they are at a higher risk of developing polycystic ovary syndrome (PCOS) later in life. STUDY DESIGN: We measured serum levels of AMH, dehydroepiandrosterone sulfate (DHEAS), testosterone, sex hormone binding globulin, androstenedione, and 17-hyroxyprogesterone in 89 girls with premature adrenarche aged 6.98 ± 1.60 years, and in 55 prepubertal normal girls aged 6.78 ± 1.60 years. RESULTS: AMH was significantly higher in girls with premature adrenarche (2.95 ± 1.20 ng/mL) compared with normal prepubertal girls (2.00 ± 0.95 ng/mL; P < .001), whereas their body mass index SD score was similar (P > .05). DHEAS, testosterone, and androstenedione were increased in premature adrenarche, whereas sex hormone binding globulin was decreased in girls with premature adrenarche. Among the 89 girls with premature adrenarche, 33 were daughters of mothers with a positive history of PCOS, whereas the mothers of the remaining 56 girls with premature adrenarche had a negative history of PCOS. The girls with a mother with a positive history of PCOS had significantly higher AMH serum levels compared with girls with a mother with a negative history of PCOS (3.37 ± 1.72 ng/mL vs 2.70 ± 1.25 ng/mL; P < .05) with no differences in testosterone, DHEAS, androstenedione, and sex hormone binding globulin. The serum concentration of AMH was only positively related to androstenedione (r = 0.538; P < .0001). CONCLUSIONS: Girls with premature adrenarche, especially those from mothers with a history of PCOS, could have a higher risk of developing PCOS later in life because they have increased serum AMH.
Assuntos
Adrenarca/sangue , Hormônio Antimülleriano/sangue , Predisposição Genética para Doença , Mães , Núcleo Familiar , Síndrome do Ovário Policístico/sangue , Puberdade/sangue , Biomarcadores/sangue , Índice de Massa Corporal , Criança , Feminino , Humanos , Síndrome do Ovário Policístico/etiologia , Síndrome do Ovário Policístico/genética , RadioimunoensaioRESUMO
Background Adolescents having early puberty (EP) are more likely to have obesity and increased cardiometabolic and inflammatory markers and atherosclerosis risk. We aimed to assess the indirect and mediated effects of leptin and adiposity on the relation between EP and cardiometabolic and inflammatory markers in European adolescents. Methods A sample of 511 adolescents with EP (12.5-17.5 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study was studied. To assess whether leptin levels and adiposity mediate the relation between EP and several biomarkers, linear regression models for mediation analyses were performed. Results EP was positively associated with the atherogenic index (Ath-I) (ß=0.174; 95%CI 0.029-0.265) and negatively associated with the C-reactive protein (CRP) (ß=-0.284; 95%CI -0.542 to -0.028) in girls. These associations were fully mediated by leptin levels (9.5%) and adiposity (44%), respectively. Moreover, EP has indirect effects on the apolipoprotein A-1 (ApoA-1) levels through adiposity in girls (for body mass index [BMI], ß=0.014; 95%CI 0.005-0.028, and for waist circumference [WC], ß=0.011; 95%CI 0.003-0.024), and on ApoA-1 (ß=0.012; 95%CI 0.004-0.025), apolipoprotein B (ApoB) (ß=-0.004; 95%CI -0.011 to -0.0004) and CRP (ß=-0.265; 95%CI -0.819 to -0.047) through abdominal fat in boys. Conclusions Leptin levels and adiposity seem to play an important indirect and mediation role in the association between EP and cardiometabolic and inflammatory markers in adolescents. Weight control should be recommended in order to control the impaired cardiometabolic and inflammatory status arising in early pubertal adolescents.
Assuntos
Adiposidade/fisiologia , Índice de Massa Corporal , Leptina/sangue , Puberdade Precoce/sangue , Puberdade/sangue , Circunferência da Cintura/fisiologia , Adolescente , Apolipoproteína A-I/sangue , Biomarcadores , Proteína C-Reativa/metabolismo , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Masculino , Puberdade Precoce/fisiopatologiaRESUMO
BACKGROUND: Studies examining the association of anogenital distance (AGD), a biomarker of prenatal androgen exposure, with sexual development in children are lacking. OBJECTIVE: To assess the association between AGD measures and reproductive outcomes, including puberty onset, testicular volume, reproductive hormone levels, and urogenital malformations in boys aged 9-11 years. MATERIALS AND METHODS: A cross-sectional study was conducted among children belonging to the Spanish Environment and Childhood (INMA) Project, a population-based birth cohort study. The present sample included 279 boys for whom data were available on AGD, pubertal stage, testicular volume, and relevant covariates. Out of the boys with AGD data, 187 provided a blood sample for hormone analysis. AGD was measured from the center of the anus to the base of the scrotum. Pubertal development was assessed according to Tanner stage of genital development (G1-G5), and testicular volume was measured with an orchidometer. RESULTS: After adjusting for potential confounders, logistic regression analysis showed that AGD was positively associated with testicular volume but not with Tanner stage (>G1 vs. G1), serum hormone levels, or undescended testis. Regardless of their age, body mass index, and Tanner stage (G1 or >G1), boys with longer AGD showed increased odds of a testicular volume >3 mL (OR = 1.06, 95%CI = 1.00-1.19 per 10% increment in AGD; and OR = 3.14, 95%CI = 0.99-9.94 for AGD >42 mm vs. <33 mm). DISCUSSION: Longer AGD was associated with testicular growth, an indicator of gonadarche, but not with other reproductive outcomes. CONCLUSIONS: Although AGD was positively associated with testicular volume, it remains unclear whether AGD predicts testis size at puberty or is related to puberty onset.
Assuntos
Canal Anal/anatomia & histologia , Desenvolvimento Infantil , Puberdade , Escroto/anatomia & histologia , Testículo/anatomia & histologia , Fatores Etários , Biomarcadores/sangue , Criança , Estudos Transversais , Criptorquidismo/sangue , Criptorquidismo/diagnóstico , Criptorquidismo/epidemiologia , Hormônios/sangue , Humanos , Hipospadia/sangue , Hipospadia/diagnóstico , Hipospadia/epidemiologia , Masculino , Tamanho do Órgão , Valor Preditivo dos Testes , Puberdade/sangue , Fatores de Risco , Espanha/epidemiologiaRESUMO
OBJECTIVE: To assess the impact of weight changes on the onset of puberty in overweight children. STUDY DESIGN: We evaluated the timing of puberty onset in 160 prepubertal overweight children (aged 11.2 ± 1.0 years) depending on the changes of their weight status in a 1-year lifestyle intervention. We determined body mass index (BMI), pubertal stage, luteinizing hormone (LH), follicle-stimulating hormone, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein-3, insulin resistance index homeostatic model assessment, and serum gonadotropins at baseline and 1 year later. RESULTS: Puberty onset during the 1-year follow-up was significantly (P = .014) more frequent in girls without BMI-SDS reduction (75.0%) compared with girls with BMI-SDS reduction (45.7%). The start of puberty was significantly (P = .024) more frequent in boys with BMI-SDS reduction (76.9%) compared with boys without BMI-SDS reduction (53.6%). In logistic regression analyses adjusted for baseline age and BMI-SDS, BMI-SDS reduction was associated with a decreased likelihood for puberty onset in girls (OR 0.24; 95% CI 0.07-0.85) and an increased likelihood in boys (OR 3.77; 95% CI 1.34-10.52). Central onset of puberty was confirmed by an increase of LH concentration and LH/follicle-stimulating hormone ratio in both boys and girls. Homeostatic model assessment, IGF-1, and IGF-1/insulin-like growth factor binding protein-3 ratio as marker for free IGF-1 at baseline or their changes were not associated with the onset of puberty. CONCLUSIONS: BMI-SDS reduction in overweight children was associated with earlier gonadotropin-dependent onset of puberty in boys and later onset of puberty in girls, suggesting earlier puberty in obese girls and later puberty in obese boys. We found no evidence that insulin resistance or IGF-1 have an impact on the start of puberty in obese children. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00435734.
Assuntos
Sobrepeso/fisiopatologia , Puberdade , Redução de Peso , Adolescente , Criança , Feminino , Humanos , Masculino , Sobrepeso/sangue , Puberdade/sangueRESUMO
BACKGROUND: Considering that modification in body composition and growth velocity leads to alterations in zinc and copper nutritional status, the purpose of the study was to assess erythrocyte zinc and serum copper in adolescents of both genders, according to the stage of sexual maturity at different growth phases. METHODS: Two hundred and eighty-six adolescents were assessed, 157 were female, with body mass index Z-scorebetween−2 and +2. Clinical biochemical measurements were assessed using atomic absorption spectrophotometry. Student's t, Kruskal-Wallis, and Bonferroni tests were used. RESULTS Median serum copper was superior, and zinc was inferior to respective reference values in all groups. Serum copper presented significant reduction in the final stages of pubertal development in males; in turn, erythrocyte zinc values increased linearly with the evolution of puberty stages in both genders. Comparison between genders in each stage of growth showed significant difference in peak acceleration and in deceleration for erythrocyte zinc and serum copper, with both being higher in females. CONCLUSIONS: Serum copper is inversely influenced by modifications that occur with the evolution of puberty in males, whereas erythrocyte zinc is directly influenced in both genders, although always with deficient deposition. At peak acceleration and deceleration of growth, there is greater mobilization of erythrocyte zinc and serum copper in males, when compared with females, which does not occur at the onset of the acceleration of growth.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Cobre/sangue , Cobre/metabolismo , Puberdade/sangue , Puberdade/metabolismo , Zinco/sangue , Zinco/metabolismoRESUMO
BACKGROUND: Acne in adult women is a frequent hard-to-manage disease with many relapse cases. It mostly interferes with the quality of life of patients, bringing them major metabolic and social losses. As androgenic hormones play a very important role in the acne pathogenesis, the early diagnosis of hyperandrogenic states is very useful for the proper evaluation of each patient and for a better choice of therapeutic management. Defining a pattern for laboratory profile analysis is important for the control of relapses of acne breakouts in adult women, which lately has been the aim of many published studies. AIM: To establish the relation between 3 alpha-diol G levels and acne in female patients with normal androgenic status without menstrual dysfunctions. PATIENTS/METHODS: The evaluation of serum 3 alpha-androstanediol glucuronide levels through an enzymatic immunoassay method (Androstanediol Glucuronide ELISA Kit) for a direct quantitative measurement in 26 patients with grade II and III acne, ages ranging from 13 to 50. RESULTS: Among the analyzed patients, 83% had grade II acne, and among this total, 60% were aged 14 or over. According to age, 12 studied patients showed serum 3 alpha-diol G levels within normal range and 11 patients had increased levels. CONCLUSIONS: A total of 60% of adult women with acne present increased levels of androgens and among those with normal levels and without menstrual dysfunctions, 50% show an increase in 3 alpha-diol G. Therefore, a pharmacological approach with anti-androgenic drugs for acne therapy in most of these patients is advisable.
Assuntos
Acne Vulgar/sangue , Acne Vulgar/enzimologia , Androstano-3,17-diol/análogos & derivados , Acne Vulgar/complicações , Adolescente , Adulto , Fatores Etários , Androstano-3,17-diol/sangue , Biomarcadores/sangue , Colestenona 5 alfa-Redutase/metabolismo , Hirsutismo/sangue , Hirsutismo/complicações , Humanos , Estudos Prospectivos , Puberdade/sangue , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVE: To describe longitudinal changes in plasma lipid levels and pubertal stage in youths from age 8-18 years, in Project HeartBeat! STUDY DESIGN: Fasting blood samples and pubertal stage, using physical assessment of secondary sex characteristics, were obtained every 4 months for up to 4 years in a mixed longitudinal study of 633 children (49.1% female, 20.1% black), initially aged 8, 11, and 14 years. Total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, triglycerides (TG), and nonhigh density lipoprotein-cholesterol measurements were obtained. Data were collected from 1991-1995. RESULTS: Pubertal stage correlations with age varied among all race-sex groups (range, r = 0.61-0.70), and a given pubertal stage could represent a range of 5 years or more of chronological age. Throughout puberty, levels of total cholesterol, low density lipoprotein-cholesterol, and nonhigh density lipoprotein-cholesterol decreased, TG in males increased, and high density lipoprotein-cholesterol and TG in females showed no changes. Within a given pubertal stage, plasma lipid levels tended to differ by race, sex, or both. CONCLUSIONS: Lipid levels change markedly by pubertal stage, and patterns differ by sex and race. Chronological age ranges widely within a given pubertal stage and is an insensitive indicator of pubertal stage and the related changes in lipid levels. Pubertal development should be considered when determining screening criteria to identify youths with adverse blood lipid levels.
Assuntos
Jejum/sangue , Lipídeos/sangue , Puberdade/sangue , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Grupos Raciais , Fatores Sexuais , TexasRESUMO
OBJECTIVES: To characterize associations among psychosocial well-being, physical phenotype, and sex hormones in a sample of youth with Klinefelter syndrome (KS). We hypothesized that KS physical traits (phenotype) are associated with adverse psychosocial health measures and that testosterone levels are associated with adverse psychosocial health. STUDY DESIGN: Forty-three boys with KS (ages 8-18 years) participated in a cross-sectional study. Participants underwent physical examination, hormone analyses, and psychosocial health questionnaires. RESULTS: Using an investigator-developed Klinefelter Phenotype Index Scale, the number of KS physical traits ranged from 1-13 (mean 5.1 ± 1.9). Pubertal boys presented with more KS traits compared with prepubertal boys (5.6 vs 4.2, P = .01). Boys diagnosed prenatally had a milder phenotype compared with those diagnosed postnatally. Gonadotropins were elevated without androgen deficiency in 45%. Psychosocial health scores indicated adverse quality of life (QOL) (67%), low self-esteem (38%), poor self-concept (26%), and risk for depression (16%) without a difference between pubertal groups. Linear regression showed that 22% of the variance in QOL (P = .0001) was explained by phenotype. Testosterone level was not associated with psychosocial health measures. CONCLUSIONS: Depending on the degree of phenotypic abnormality, boys with KS may be at risk for impaired QOL. Testosterone levels were not shown to influence psychosocial health. The Klinefelter Phenotype Index Scale may be a useful tool to characterize KS features in boys.
Assuntos
Síndrome de Klinefelter/psicologia , Qualidade de Vida , Adolescente , Criança , Estudos Transversais , Depressão/etiologia , Gonadotropinas/sangue , Humanos , Síndrome de Klinefelter/sangue , Deficiências da Aprendizagem/etiologia , Modelos Lineares , Masculino , Fenótipo , Puberdade/sangue , Autoimagem , Índice de Gravidade de Doença , Testosterona/sangueRESUMO
BACKGROUND: The same reference values for cortisol have been used for adults and children, but laboratory results obtained from an adult population might not be suitable for pediatric patients. AIMS: To determine morning serum basal cortisol levels in children and adolescents. METHODS: The study was conducted on 120 suitable reference individuals, healthy Brazilian children and adolescents from both genders aged 4-19 years old. The method used for cortisol assessment was the chemiluminescent enzyme immunoassay (VITROS® 5600 MicroWell; Johnson & Johnson, High Wycombe, UK, 2009), and the kit reference interval was 4.46-22.7 µg/dl (122.7-626.2 nmol/l). The setting limits were calculated according to the Clinical Laboratory Standards Institute guidelines. RESULTS: The morning serum basal cortisol levels increased with age and pubertal maturation, but there were no differences based on gender. The cortisol reference values were established based on the 2.5th and 97.5th percentiles as 2.97 µg/dl [81.9 nmol/l, 90% confidence interval (CI) 1.44-3.69 µg/dl] and 23.4 µg/dl (645.5 nmol/l; 90% CI 16.3-26.4 µg/dl), respectively. CONCLUSIONS: The assessment of the morning serum basal cortisol levels showed a unique pattern, with a different lower limit for the cohort compared to current values established for adult subjects.
Assuntos
Hidrocortisona/sangue , Sistema Hipotálamo-Hipofisário/fisiologia , Sistema Hipófise-Suprarrenal/fisiologia , Puberdade/sangue , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Adulto JovemRESUMO
BACKGROUND: A physiological increase in androgen levels occurs during adolescence. Measuring androgen concentrations is the best method to distinguish normal evolution processes from hyperandrogenic disorders. HYPOTHESIS: The increase in circulating androgens during puberty is inversely associated with insulin sensitivity in normal weight girls. OBJECTIVE: To assess circulating levels of ovarian androgens and anti-Müllerian hormone (AMH) at baseline and after GnRH analogue (GnRH-a) stimulation in normal pubertal girls across different Tanner stages. We also studied the association between this response and insulin sensitivity. DESIGN: Prospective study of healthy girls (6-12 years) from the local community (n = 63). METHODS: Tanner I (n = 23) subjects were assessed cross-sectionally, and Tanner II girls (n = 40) were evaluated every 6 months until they reached Tanner V. Early morning dehydroepiandrosterone sulphate (DHEA-S), AMH, sex hormone-binding globulin (SHBG), androstenedione, glucose and insulin levels were measured. A GnRH-a test (500 µg/m(2) ; sc) and oral glucose intolerance test (OGTT) were performed. Differences throughout puberty were evaluated. RESULTS: Basal and/or stimulated Testosterone DHEA-S and 17-hydroxyprogesterone (17OHP) were inversely associated with insulin sensitivity (WIBSI) from the beginning of puberty, whereas androstenedione was directly associated with gonadotrophins. AMH was inversely associated with basal and stimulated gonadotrophins and directly with insulin area under the curve (AUC) only in the early stages of puberty. 17OHP and testosterone responsiveness increased significantly during puberty in all subjects, whereas testosterone levels changed less consistently. This pattern of ovarian-steroidogenic response was most evident during mid- and late puberty. Moreover, during late puberty only, basal 17OHP, testosterone and DHEA-S were positively associated with gonadotrophins. CONCLUSION: In normal nonobese girls born appropriate for gestational age, androgen synthesis was associated with insulin sensitivity in early puberty and with LH only in late puberty.
Assuntos
Androgênios/sangue , Leuprolida/química , Ovário/metabolismo , Puberdade/sangue , 17-alfa-Hidroxiprogesterona/sangue , Androstenodiona/sangue , Antropometria , Hormônio Antimülleriano/sangue , Área Sob a Curva , Glicemia/análise , Índice de Massa Corporal , Peso Corporal , Criança , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Feminino , Teste de Tolerância a Glucose , Hormônio Liberador de Gonadotropina/sangue , Humanos , Insulina/sangue , Estudos Prospectivos , Globulina de Ligação a Hormônio Sexual , Testosterona/sangueRESUMO
BACKGROUND: Evaluation of lipid profile in children and adolescents is important for early diagnosis of dyslipidemias. Physiological changes might be observed in the concentration of the lipid profile components, according to the stage of sexual maturation. OBJECTIVE: To evaluate the variation in lipid and lipoprotein concentrations in boys during puberty. METHODS: The sample consisted of 570 male adolescents with ages between 10 and 17 years. Weight, height, and body mass index (BMI) were assessed. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were determined by the enzymatic method, and low-density lipoprotein cholesterol (LDL-C) was calculated. Puberty was classified according to Tanner references. The percentile criterion was adopted for the distribution and identification of lipoprotein levels. The analysis of variance and description tests with p<0.05 was applied. RESULTS: Participants had similar BMI z-score and physical activity habits in all groups. A significant reduction in TC and HDL-C concentrations between the start and end of puberty was observed. LDL-C levels rose during stage 3 of development, decreasing at the end of the pubertal process. TG levels did not change significantly with pubertal status. CONCLUSION: Lipid and lipoprotein concentrations tend to undergo changes during puberty in boys. The use of percentile values can be very useful to track variations in lipid and lipoprotein levels during the maturation process.
Assuntos
Lipídeos/sangue , Lipoproteínas/sangue , Puberdade/sangue , Adolescente , Pesos e Medidas Corporais , Brasil/epidemiologia , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Humanos , Masculino , Triglicerídeos/sangueRESUMO
BACKGROUND: Low-grade inflammation is the link between obesity and insulin resistance. Because physiologic insulin resistance occurs at puberty, obese pubertal children are at higher risk for insulin resistance. Excessive diets in refined carbohydrates and saturated fats are risk factors for insulin resistance, but calcium, magnesium, vitamin-D, and the omega-3 fatty acids likely protect against inflammation and insulin resistance. OBJECTIVE: To analyze interactions among dietary saturated fat, refined carbohydrates, calcium, magnesium, vitamin D, and omega-3 fatty acids on the risk of inflammation and insulin resistance in a sample of prepubertal and pubertal children. METHODS: A sample of 229 children from Mexico City was analyzed in a cross-sectional design. Anthropometric measurements, 24 h recall questionnaires, and blood samples were obtained. Serum insulin, glucose, calcium, magnesium, 25-OHD3, C-reactive protein, leptin, adiponectin, and erythrocytes fatty acids were measured. Parametric and nonparametric statistics were used for analysis. RESULTS: While mean macronutrients intake was excessive, micronutrients intake was deficient (P < 0.01). Inflammation determinants were central obesity and magnesium-deficient diets. Determinants of insulin resistance were carbohydrates intake and circulating magnesium and adiponectin. CONCLUSIONS: Magnesium-deficient diets are determinants of inflammation, while high intake of refined carbohydrates is a risk factor for insulin resistance, independently of central adiposity.
Assuntos
Carboidratos da Dieta/efeitos adversos , Mediadores da Inflamação/sangue , Resistência à Insulina , Micronutrientes/deficiência , Obesidade/sangue , Adiponectina/sangue , Adolescente , Criança , Estudos Transversais , Registros de Dieta , Carboidratos da Dieta/administração & dosagem , Feminino , Humanos , Magnésio/sangue , Masculino , Micronutrientes/administração & dosagem , Puberdade/sangue , Fatores de RiscoRESUMO
BACKGROUND: Central adrenal insufficiency (CAI) is due to a decrease of CRH and/or ACTH secretion. ACTH-dependent dehydroepiandrosterone sulphate (DHEAS) has been postulated as a possible marker of adrenal function in adult patients. AIMS: To evaluate the usefulness of basal serum DHEAS determination to diagnose CAI in pubertal patients with a suspected diagnosis of CAI. METHODS: Ninety-four pubertal patients suspected of having CAI were divided into two groups according to sufficient (group 1) or insufficient (group 2) low-dose ACTH test serum cortisol response. Concordance with low (<2.5th percentile) or normal (≥2.5th percentile) basal serum DHEAS levels for age and sex, respectively, was analysed. RESULTS: Fifty patients (53.2%) in group 1 and 44 (46.8%) in group 2 were included. The median value of serum DHEAS levels in group 2 (0.7 µmol/l, interquartile range 0.44-1.49) was significantly lower than in group 1 (2.13 µmol/l, interquartile range 0.87-3.5; p < 0.03). Nevertheless, serum basal DHEAS levels as a diagnostic marker of CAI showed 39% sensitivity and 80% specificity. CONCLUSION: In pubertal patients, basal serum DHEAS levels do not seem to be a useful tool to diagnose either sufficiency or insufficiency of secondary adrenal function.
Assuntos
Insuficiência Adrenal/sangue , Desidroepiandrosterona/sangue , Puberdade/sangue , Adolescente , Hormônio Adrenocorticotrópico/sangue , Adulto , Biomarcadores/sangue , Criança , Humanos , Hidrocortisona/sangue , MasculinoRESUMO
BACKGROUND: Glycosylated prolactin (G-PRL) is considered as the major post-translational modification of prolactin (PRL) showing reduced lactotropic and mitogenic activities compared to non-glycosylated prolactin (NG-PRL). AIM: To evaluate the evolution of G-PRL in normoprolactinemic children and adolescents and to analyze possible variations in glycosylated/total prolactin (T-PRL) ratios. METHODS: T-PRL, G-PRL and NG-PRL were evaluated in 111 healthy female and male children and adolescents (4.1-18 years), classified as group 1 (Tanner I), group 2 (Tanner II-III) and group 3 (Tanner IV-V). G-PRL and NG-PRL were identified by chromatography on concanavalin-A-Sepharose. RESULTS: G-PRL/T-PRL (median-range): females, group 1: 0.59 (0.17-0.77), group 2: 0.56 (0.31-0.78), group 3: 0.60 (0.38-0.79); males, group 1: 0.64 (0.39-0.80), group 2: 0.61 (0.24-0.79), group 3: 0.62 (0.35-0.90); the p value is not significant among the different groups in both genders. G-PRL/T-PRL ratios do not change when comparing low (first quartile) versus high (third quartile) T-PRL levels in the different groups. CONCLUSION: Our study would appear to support cosecretion of G-PRL and NG-PRL from childhood to the end of puberty. Such cosecretion would not be dependent on sex steroid levels. It is important to point out that puberty does not change the proportions of G-PRL and NG-PRL.
Assuntos
Desenvolvimento do Adolescente , Desenvolvimento Infantil , Prolactina/análogos & derivados , Prolactina/sangue , Puberdade/sangue , Adolescente , Algoritmos , Argentina , Criança , Pré-Escolar , Cromatografia de Afinidade , Feminino , Glicosilação , Hormônios Esteroides Gonadais/sangue , Humanos , Masculino , Adeno-Hipófise/crescimento & desenvolvimento , Adeno-Hipófise/metabolismo , Prolactina/metabolismo , Puberdade/metabolismo , Radioimunoensaio , Sefarose/análogos & derivadosRESUMO
CONTEXT: We have previously described increased serum levels of anti-Müllerian hormone (AMH) and stimulated insulin in daughters of women with polycystic ovary syndrome (PCOS), suggesting that these girls may have an altered ovarian follicular development which may be modulated by insulin. However, the specific relationship between serum AMH and insulin levels during each Tanner stage of puberty in this cohort has not been established. OBJECTIVE: The aim of our study was to establish the relationship between AMH and poststimulated insulin serum concentrations during each stage of puberty in daughters of women with PCOS (PCOSd), compared to daughters of control women (Cd). DESIGN: We studied 135 PCOSd and 93 Cd classified according to their Tanner stage. Gonadotrophins, sex steroids, sex hormone-binding globulin (SHBG), and AMH were determined in a fasting sample. Ovarian volume was measured by pelvic ultrasound. In addition, in both groups we performed an oral glucose tolerance test with measurements of glucose and insulin. RESULTS: Anti-Müllerian hormone levels were significantly higher in PCOSd compared to Cd at all Tanner stages. Daughters of women with PCOS having AMH concentrations greater than 2 standard deviation (SD) above the mean AMH value for the Cd group showed decreased serum follicle-stimulating hormone (FSH) concentrations and increased stimulated levels of insulin during Tanner stages I, II, and III. CONCLUSIONS: Anti-Müllerian hormone levels are increased in PCOSd during all stages of puberty. We suggest that those PCOSd with the highest AMH levels probably represent a group of girls with more severe ovarian dysfunction and metabolic derangements.