| Purpose:To explore the clinical characteristics of girls with central precocious puberty in Hainan area,evaluate the therapeutic effect of gonadotropin-releasing hormone analogue in CPP girls,and understand the influencing factors of CPP occurrence in Hainan area,so as to provide scientific research evidence for the prevention and individualized treatment of CPP in Hainan area in the future.Method:A total of 96 girls diagnosed with CPP were collected from the Department of Endocrinology and Pediatrics of Hainan People’s Hospital from August 2020 to December 2022.The general data(city and county of residence,course of disease,age of initiation of secondary sex characteristics,actual age,height,weight,body mass index,bone age,development of secondary sex characteristics)and clinical data(sex hormone levels,uterine length,uterine volume,GnRH excitation test)were analyzed statistically.Children receiving GnRHa treatment were divided into menarche group and non-menarche group,and follow-up visits were conducted every 3,6 and 12 months.Changes in height,difference between bone age and actual age,predicted adult height,luteinizing hormone,follicle stimulating hormone,and secondary sex characteristics of the two groups before and after treatment were compared,so as to evaluate the therapeutic effect of GnRHa.The 1:1 case-control method was used to select the girls diagnosed with CPP as the case group,and 96healthy girls of the same period and age were selected as the control group.Girls in the two groups completed questionnaires with the help of their parents and physicians,and then linear regression analysis was used to understand the influencing factors of CPP.Study process signed informed consent.All data were input into Excel2010 and summarized,and then IBM SPSS Statistics 22.0 software was used for statistical description and analysis of relevant data.Results:1.The patients were from 14 cities and counties in Hainan Province,among which the number of patients from Haikou was the largest,accounting for about58.33%.The median CA was 8(8,9)years old,the median BA was 11(9.55,11)years old,the median BA-CA was 2(1,3),the average height was(136.36±7.69)cm,and the average weight was(32.11±6.51)kg.28.12%of the patients had menarche at the first visit.TannerⅡand TannerⅢwere the most common breast stages at initial diagnosis,accounting for 48.96%and 41.67%of the total population,respectively.TannerⅠwas the most common pubic hair staging,accounting for82.30%of the total.Among all the children,the number of patients with BMI in the normal range was the largest,accounting for 71.88%of the total.The median basal LH was 1.02(0.33,2.65)IU/L,the mean FSH was(3.86±2.02)IU/L,and the median estradiol was 81.5(40,139)pmol/L.The median length and diameter of uterus were2.8(2.4,3.1)cm,the median volume of uterus was 5.25(3.05,7.65)cm~3,and the median peak LH was 16.46(8.6,26.47)IU/L.2.After 12 months of GnRHa treatment,the height and PAH of the non-menarche group were higher than those before treatment,while BA-CA,LH and FSH were lower than those before treatment,with statistical significance(P<0.05),while BA before and after treatment had no statistical difference(P>0.05).After 12months of treatment,the height of menarche group was higher than before treatment,BA-CA,LH and FSH were lower than before treatment,and BA was higher than before treatment,with statistical significance(P<0.05).There was no statistical difference in PAH after treatment compared with before treatment(P>0.05).There were statistical differences in BA-CA,△H,PAH,△PAH and LH between the two groups after 12 months of treatment(P<0.05),while there were no statistical differences in FSH levels between the two groups after 12 months of treatment(P>0.05).With the extension of treatment time,the number of breast stage regression increased,and there was statistically significant difference between the breast stage of different treatment stages on the whole(P<0.05).A total of 2 children were treated with GnRHa+recombinant human growth hormone combined intervention,accounting for 2.08%of the total.3.Maternal education level,annual household income,time to fall asleep at night,average sleep time per day,whether to sleep with the light on,whether to contact skin care products or cosmetics,frequency of consumption of sugary drinks,whether to eat potato chips,churro and other fried foods,whether to eat fruits,vegetables or grains,whether to chew straws or suck thumb,whether to hide unhappy things in the CPP group and the health group There was a difference(P<0.05).The annual income of the family is more than 150,000 yuan[OR=4.298(95%CI:1.554,11.888),P=0.005],often drink sugary drinks[OR=4.13(95%CI:1.676,10.18),P=0.002],often bite straw or suck thumb[OR=2.7(95%CI:1.234,5.908),P=0.013]were the risk factors for CPP in girls in Hainan area,and the mother’s education level was above bachelor’s degree[OR=0.398(95%CI:0.167,0.952),P=0.038],sleeping without the light[OR=0.243(95%CI:0.096,0.618),P=0.003],no contact with skin care products or cosmetics[OR=0.312(95%CI:0.142,0.685),P=0.004]were the protective factors for CPP in girls in Hainan area.Conclusions:1.CPP girls are widely distributed in Hainan,with breast stage TannerⅡ,stage TannerⅢand pubic hair stage TannerⅠbeing the most common at first diagnosis,BMI being the most common within the normal range,overall bone age being significantly advanced by 2 years,and early pubertal development of CPP girls being found late.2.The overall therapeutic effect of GnRHa on CPP girls in Hainan is good.The overall therapeutic effect of CPP girls with menarche before treatment is not as good as that of CPP girls without menarche before treatment.3.The risk factors for CPP among girls in Hainan were high annual family income,frequent consumption of sugary drinks,frequent biting of straws or thumb sucking,and the protective factors were that the mother had a bachelor’s degree or above,did not turn on the light when sleeping,and did not touch skin care products or cosmetics.4.It is necessary to educate people in Hainan about the knowledge of precocious puberty so as to deepen the public’s understanding of precocious puberty,so as to reduce the occurrence of precocious puberty and make more girls with precocious puberty benefit from timely intervention. |
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