Popular Science | Don’t let flowers bloom too early, grow taller at the right time - how much do you know early?

In recent years, the incidence of central precocious puberty has been increasing year by year. The incidence of precocious puberty in children aged 6-18 in my country is about 0.43%, which means that about 4.3 children out of 1,000 have precocious puberty, and the incidence rate in girls is 5-10 times that of boys. Precocious puberty has become the second largest endocrine disease in children after obesity.

So what is precocious puberty?

Central precocious puberty refers to: early appearance of sexual characteristics, i.e. breast development before 7.5 years old or menarche before 10 years old in girls, and testicular enlargement before 9 years old in boys; enlarged gonads, i.e. pelvic ultrasound shows enlarged uterus and ovarian volume in girls and multiple follicles with a diameter of ≥4 mm in the ovaries, and testicular volume ≥4 ml in boys; serum gonadotropin and sex hormones reach puberty levels; advanced bone age, which is ≥1 year older than the actual age; accelerated linear growth, and the annual growth rate is higher than that of healthy children of the same age.

What causes central precocious puberty in so many children?

The hypothalamus-pituitary-gonadal axis is the key "switch" for children's development. Therefore, any factor that triggers the early activation of the hypothalamus-pituitary-gonadal axis function is the "fuse" for precocious puberty.

The first is environmental factors. People's lives are inseparable from the environment, and the environment has a subtle influence on people. Studies have confirmed that the pollution level of environmental endocrine disruptors (EEDs) is correlated with the degree of pathological changes in reproductive organs and bones. EEDs pollution is one of the pathogenic factors of precocious puberty in children. Plants, fish and shrimps grown in polluted water sources and soil will interfere with normal endocrine when eaten by children, thus leading to precocious puberty.

The second is obesity. Excessive accumulation of fat in obese children will lead to higher estrogen secretion than normal children, which will stimulate the hyperfunction of the hypothalamus-pituitary-gonadal axis and lead to early sexual development. With the improvement of living standards, children's diets are becoming more and more abundant: excessive intake of "big fish and meat", "healthy nutritional products" and "high-calorie bombs" such as fried puffed foods, fast food, sweets, sugary carbonated drinks, etc., directly contributing to the appearance of "little fat people".

The third is the sleeping environment. Children lack a sense of security when sleeping and keep the night light on for a long time. Sleeping with the light on for a long time will significantly reduce the secretion of melatonin, leading to increased secretion of pituitary gonadotropin, which will cause children to have precocious puberty.

Fourth, the information environment. Now is the information age, which includes some sexual information, such as love movies, some ambiguous scenes with sexual implications in TV programs, etc. If children are exposed to it too early, it may stimulate the early activation of the hypothalamus-pituitary-gonad axis of the body, and also promote the early sexual development of children.

The fifth is genetic factors. Many diseases are related to genetic factors, and precocious puberty is no exception. If the parents develop puberty at an early age, the child's secondary sexual characteristics will also develop earlier than their peers, especially if the mother's menarche age is early, which is a risk factor for precocious puberty in girls.

Sixth, disease factors. Some precocious puberty is caused by organic diseases, especially in boys. Although the incidence of precocious puberty in boys is relatively low, nearly half of boys with precocious puberty are ultimately diagnosed with organic diseases, including gonadal tumors and organic central nervous system lesions (such as intracranial infection, trauma or tumors, etc.).

So how to prevent precocious puberty in children?

First, pay attention to children with a family history of genetic precocious puberty. Pay attention to children in families with hereditary precocious puberty. During the growth and development of children, pay close attention to their height, weight, body shape, etc. If there are any abnormalities, take them to regular hospitals for diagnosis and treatment in a timely manner and make reasonable interventions.

Secondly, create a good living environment. Ensure that children have a good work and rest environment and regularity, avoid long-term exposure to radio waves, excessive exposure to electronic information and screens, and guide children to accept information content that suits their characteristics.

Secondly, ensure proper nutritional intake. Avoid taking food or medicine containing sex hormones; change the unhealthy diet structure, reduce the intake of high-calorie, high-fat food, ensure sufficient high-quality protein, vitamin-rich and mineral-rich food; eat in moderation and avoid overeating.

Finally, stick to appropriate exercise. Regular aerobic exercise can induce changes in the growth hormone axis that are beneficial to growth [4]. Choose appropriate exercise methods according to the age of the child, add some fun, and stick to it for a long time.

Contributing authors: Yuan Jing and Chen Runan

The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Department of Nursing, Naval Medical University, Shanghai, 200433