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Klin Padiatr 2008; 220(1): 10-15
DOI: 10.1055/s-2007-971046
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Postnatale Konsequenzen fetaler Entwicklung: Einfluss der Geburtsmaße auf spätere Pubertätsentwicklung und potentielle Interaktion mit einer Wachstumshormontherapie

Postnatal Consequences of Intrauterine Development: Pubertal Development in Children Born Small for Gestational AgeJ. Woelfle 1
  • 1Zentrum für Kinderheilkunde der Universität Bonn
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Publication History

Publication Date:
02 January 2008 (online)

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Zusammenfassung

Etwa 5-10% aller Kinder kommen, bezogen auf das jeweilige Gestationsalter, mit zu niedrigen Körpermaßen zur Welt („small for gestational age”=SGA). Neben dem Risiko, infolge fehlenden Aufholwachstums kleinwüchsig zu bleiben, wurden verschiedene metabolische und endokrine Störungen mit der SGA-Geburtlichkeit in Verbin-dung gebracht. So wurden wiederholt bei ehemalig hypotrophen Neugeborenen Auffälligkeiten bei der Pubertätsentwicklung beschrieben, insbesondere das Auftreten einer vorzeitigen Schambehaarung (prämature Pubarche). Die vorliegende Übersichtsarbeit gibt einen Überblick über den derzeitigen Wissenstand zu den Auswirkungen eines zu niedrigen Geburtsgewichtes auf die spätere Pubertätsentwicklung und die damit verknüpften Wechselwirkungen zwischen Puber-täts-und Längenentwicklung bei Kindern mit und ohne Wachstumshormontherapie.

Abstract

Five to ten percent of all children are born small for gestational age (SGA). SGA children are not only at risk of remaining small as an adult in case of lacking catch-up growth, but may develop several metabolic disturbances which might have a serious impact on the future health of these children. In this context, several studies described abnormalities of the pubertal development in SGA children, especially in SGA children demonstrating rapid postnatal weight gain. This review highlights the current knowledge of the relationship between auxiological birth para-meters and subsequent pubertal course, and the interrelationships between puberty and growth in SGA children with and without growth hormone therapy.

Schlüsselwörter

Geburtsgewicht - Pubertät - Hypotroph

Key words

SGA - IUGR - puberty - pubarche - adrenarche

Literatur

  • 1 Albertsson-Wikland K, Wennergren G, Wennergren M, Vilbergson G, Rosberg S. Longitudinal follow-up of growth in children born small for gestational age.  Acta Paediatr. 1993;  82 438-443
    CrossrefPubMedGoogle Scholar
  • 2 Boonstra V, Pareren Y van, Mulder P, Hokken-Koelega A. Puberty in growth hormone-treated children born small for gestational age (SGA).  J Clin Endocrinol Metab. 2003;  88 5753-5758
    CrossrefPubMedGoogle Scholar
  • 3 Boonstra VH, Mulder PG, Jong FH, Hokken-Koelega AC. Serum dehydroepiandrosterone sulfate levels and pubarche in short children born small for gestational age before and during growth hormone treatment.  J Clin Endocrinol Metab. 2004;  89 712-717
    CrossrefPubMedGoogle Scholar
  • 4 Brandt I. Postnatales Wachstum von SGA Frühgeborenen sehr niedrigen Geburtsgewichts bis ins Erwachsenenalter. In: Zabransky S: SGA-Syndrom. Jonas-Verlag (Marburg) 2003: 141-148
    Google Scholar
  • 5 Dahlgren J, Boguszewski M, Rosberg S, Albertsson-Wikland K. Adrenal steroid hormones in short children born small for gestational age.  Clin Endocrinol. 1998;  49 353-361
    CrossrefPubMedGoogle Scholar
  • 6 Dunger DB, Ahmed ML, Ong KK. Early and late weight gain and the timing of puberty.  Mol Cell Endocrinol. 2006;  , 254-255 140-145
    PubMedGoogle Scholar
  • 7 Dunning AM, MacBride S, Gregory J, Durocher F, Foster NA, Healey CS, Smith N, Pharoah PD, Luben RN, Easton DF, Ponder BA. No association between androgen or vitamin D receptor gene polymorphisms and risk of breast cancer.  Carcinogenesis. 1999;  20 2131-2135
    CrossrefPubMedGoogle Scholar
  • 8 Eriksson JG, Forsen T, Tuomilehto J, Jaddoe VW, Osmond C, Barker DJ. Effects of size at birth and childhood growth on the insulin re-sistance syndrome in elderly individuals.  Diabetologia. 2002;  45 342-348
    CrossrefPubMedGoogle Scholar
  • 9 Ezzahir N, Alberti C, Deghmoun S, Zaccaria I, Czernichow P, Levy-Marchal C, Jaquet D. Time course of catch-up in adiposity influences adult anthropometry in individuals who were born small for gestational age.  Pediatr Res. 2005;  58 243-247
    CrossrefPubMedGoogle Scholar
  • 10 Francois I, Zegher F de. Adrenarche and fetal growth.  Pediatr Res. 1997;  41 440-442
    PubMedGoogle Scholar
  • 11 Ghirri P, Bernardini M, Vuerich M, Cuttano AM, Coccoli L, Merusi I, Ciulli C, D'Accavio L, Bottone U, Boldrini A. Adrenarche, pubertal development, age at menarche and final height of full-term, born small for gestational age (SGA) girls.  Gynecol Endocrinol. 2001;  91-97
    CrossrefPubMedGoogle Scholar
  • 12 Ghizzoni L, Virdis R, Ziveri M, Lamborghini A, Alberini A, Volta C, Bernasconi S. Adrenal steroid, cortisol, adrenocorticotropin, and beta-endorphin responses to human corticotropin-releasing hormone stimulation test in normal children and children with premature pubarche.  J Clin Endocrinol Metab. 1989;  69 875-880
    PubMedGoogle Scholar
  • 13 Hay JB, Hodgins MB. Distribution of androgen metabolizing enzymes in isolated tissues of human forehead and axillary skin.  J Endocrinol. 1987;  79 29-39
    PubMedGoogle Scholar
  • 14 Ibanez L, Potau N, Marcos MV, Deegher F. Corticotropin-releasing hormone: a potent androgen secretagogue in girls with hyperandroge-nism after precocious pubarche.  J Clin Endocrinol Metab. 1999;  84 4602-4607
    CrossrefPubMedGoogle Scholar
  • 15 Ibanez L, Potau N, Marcos MV, Zegher F. Exaggerated adrenarche and hyperinsulinism in adolescent girls born small for gestational age.  J Clin Endocrinol Metab. 1999;  84 4739-4741
    CrossrefPubMedGoogle Scholar
  • 16 Ibanez L, Dimartino-Nardi J, Potau N, Saenger P. Premature adrenarche-normal variant or forerunner of adult disease?.  Endocr Rev. 2000;  21 671-696
    CrossrefPubMedGoogle Scholar
  • 17 Ibanez L, Ferrer A, Marcos MV, Hierro FR, Zegher F de. Early puberty: rapid progression and reduced final height in girls with low birth weight.  Pediatrics. 2000;  106 E72
    CrossrefPubMedGoogle Scholar
  • 18 Ibanez L, Potau N, Marcos MV, Zegher F De. Adrenal hyperandrogenism in adolescent girls with a history of low birthweight and precocious pubarche.  Clin Endocrinol. 2000;  53 523-527
    CrossrefPubMedGoogle Scholar
  • 19 Ibanez L, Valls C, Potau N, Marcos MV, Zegher F. Polycystic ovary syndrome after precocious pubarche: ontogeny of the low-birthweight effect.  Clin Endocrinol. 2001;  55 667-672
    CrossrefPubMedGoogle Scholar
  • 20 Ibanez L, Ong KK, Mongan N, Jaaskelainen J, Marcos MV, Hughes IA, De Zegher F, Dunger DB. Androgen receptor gene CAG repeat polymorphism in the development of ovarian hyperandrogenism.  J Clin Endocrinol Metab. 2003;  88 3333-3338
    CrossrefPubMedGoogle Scholar
  • 21 Ibanez L, Ferrer A, Ong K, Amin R, Dunger D, Zegher F de. Insulin sensitization early after menarche prevents progression from precocious pubarche to polycystic ovary syndrome.  J Pediatr. 2004;  144 23-29
    PubMedGoogle Scholar
  • 22 Ibanez L, Ong K, Dunger DB, Zegher F de. Early Development of Adipo-sity and Insulin Resistance after Catch-Up Weight Gain in Small-for-Gestational-Age Children.  The Journal of Clinical Endocrinology & Metabolism. 2006;  91 2153-2158
    PubMedGoogle Scholar
  • 23 Ibanez L, Ong K, Valls C, Marcos MV, Dunger DB, Zegher F de. Metformin treatment to prevent early puberty in girls with precocious pubarche.  J Clin Endocrinol Metab. 2006;  91 2888-2891
    CrossrefPubMedGoogle Scholar
  • 24 Korth-Schutz S, Levine LS, New MI. Dehydroepiandrosterone sulfate (DHEA-S) levels, a rapid test for abnormal adrenal androgen secretion.  J Clin Endocrinol Metab. 1967;  42 1005-1013
    PubMedGoogle Scholar
  • 25 L'Allemand D, Penhoat A, Lebrethon MC, Ardevol R, Baehr V, Oelkers W, Saez JM. Insulin-like growth factors enhance steroidogenic enzyme and corticotropin receptor messenger ribonucleic acid levels and corticotropin steroidogenic responsiveness in cultured human adrenocortical cells.  J Clin Endocrinol Metab. 1996;  81 3892-3897
    CrossrefPubMedGoogle Scholar
  • 26 Lazar L, Pollak U, Kalter-Leibovici O, Pertzelan A, Phillip M. Pubertal course of persistently short children born small for gestational age (SGA) compared with idiopathic short children born appropriate for gestational age (AGA).  Eur J Endocrinol. 2003;  149 425-432
    CrossrefPubMedGoogle Scholar
  • 27 Levy-Marchal C, Czernichow P. Small for gestational age and the meta-bolic syndrome: which mechanism is suggested by epidemiological and clinical studies?.  Horm Res. 2006;  65 123-130
    PubMedGoogle Scholar
  • 28 Lienhardt A, Carel JC, Preux PM, Coutant R, Chaussain JL. Amplitude of pubertal growth in short stature children with intrauterine growth retardation.  Horm Res. 2002;  57 88-94
    CrossrefPubMedGoogle Scholar
  • 29 Martin DD, Schweizer R, Schwarze CP, Elmlinger MW, Ranke MB, Binder G. The early dehydroepiandrosterone sulfate rise of adrenarche and the delay of pubarche indicate primary ovarian failure in Turner syndrome.  J Clin Endocrinol Metab. 2004;  89 1164-1168
    CrossrefPubMedGoogle Scholar
  • 30 Monteiro PO, Victora CG. Rapid growth in infancy and childhood and obesity in later life - a systematic review.  Obes Rev. 2005;  6 143-154
    CrossrefPubMedGoogle Scholar
  • 31 Ong KK, Ahmed ML, Sherriff A, Woods KA, Watts A, Golding J, Dunger DB. Cord blood leptin is associated with size at birth and predicts infancy weight gain in humans. ALSPAC Study Team.  J Clin Endocrinol Metab. 1999;  84 1145-1148
    CrossrefPubMedGoogle Scholar
  • 32 Ong KK, Ahmed ML, Emmett PM, Preece MA, Dunger DB. the ALSPAC Study Team . Association between postnatal catch-up growth and obesity in childhood: prospective cohort study.  BMJ. 2000;  320 967-971
    CrossrefPubMedGoogle Scholar
  • 33 Ong KK, Potau N, Petry CJ, Jones R, Ness AR, Honour JW, Zegher F, Ibanez L, Dunger DB. Avon Longitudinal Study of Parents and Children Study Team . Opposing influences of prenatal and postnatal weight gain on adrenarche in normal boys and girls.  J Clin Endocrinol Metab. 2004;  89 2647-2651
    CrossrefPubMedGoogle Scholar
  • 34 Orentreich N, Brind JL, Rizer RL, Vogelman JH. Age changes and sex differences in serum dehydroepiandrosterone sulphate concentrations throughout adulthood.  J Clin Endocrinol Metab. 1984;  59 551-555
    CrossrefPubMedGoogle Scholar
  • 35 Preece MA. Puberty in children with intrauterine growth retardation.  Horm Res. 1997;  48 30-32
    PubMedGoogle Scholar
  • 36 Reiter EO, Fuldauer VG, Root AW. Secretion of the adrenal androgen, dehydroepiandrosterone sulphate, during normal infancy, childhood, and adolescence, in sick infants, and in children with endocrine abnormalities.  J Pediatr. 1977;  80 766-770
    PubMedGoogle Scholar
  • 37 Remer T, Manz F. Role of nutritional status in the regulation of adrenarche.  J Clin Endocrinol Metab.. 1999;  84 3936-3944
    CrossrefPubMedGoogle Scholar
  • 38 Teller WM, Homoki J, Wudy S, Schlickenrieder JH. Adrenarche is dissociated from gonadarche -studies in patients with Turner's syndrome.  Acta Endocrinol Suppl (Copenh). 1986;  279 232-240
    PubMedGoogle Scholar
  • 39 Turnipseed MR, Bentley K, Reynolds JW. Serum dehydroepiandrosterone sulfate in premature infants and infants with intrauterine growth retardation.  J Clin Endocrinol Metab. 1976;  43 1219-1225
    PubMedGoogle Scholar
  • 40 Urban M, Lee PA, Guta JP, Migeon CJ. Androgens in pubertal males with Addison's disease.  J Clin Endocrinol Metab. 1980;  5 925-929
    PubMedGoogle Scholar
  • 41 Van Dop C, Burstein S, Conte FA, Grumbach MM. Isolated gonadotropin deficiency in boys: clinical characteristics and growth.  J Pediatr. 1987;  111 684-692
    PubMedGoogle Scholar
  • 42 Vicens-Calvet E, Espadero RM, Carrascosa A. Spanish SGA Collaborative Group . Small for Gestational Age Longitudinal study of the pubertal growth spurt in children born small for gestational age without postnatal catch-up growth.  J Pediatr Endocrinol Metab. 2002;  15 381-388
    PubMedGoogle Scholar
  • 43 Woelfle J, Chia DJ, Massart-Schlesinger MB, Moyano P, Rotwein P. Mole-cular physiology, pathology, and regulation of the growth hormone/insulin-like growth factor-I system.  Pediatr Nephrol. 2005;  20 295-302
    CrossrefPubMedGoogle Scholar

Korrespondenzadresse

PD. Dr. Joachim Woelfle

Pädiatrische Endokrinologie/Diabetologie

Universitäts-Kinderklinik

Rheinische Friedrich-Wilhelms-Universität

Adenauerallee 119

53113 Bonn

Phone: +49/228/2873 33 33

Fax: +49/228/2873 33 14

Email: joachim.woelfle@ukb.uni-bonn.de