Endocrinology of female puberty.
OBJECTIVE
Puberty is the developmental process that culminates in reproductive capability. It is initiated by the release of gonadotropin-releasing hormone from specialized neurons of the hypothalamus to stimulate hormonal cascades and gonadal activation. The age of pubertal onset in girls may be younger than in previous decades, emphasizing the gaps in knowledge about pubertal onset and factors that modulate it. This review describes the state of the debate on the age of pubertal initiation, recent insights into the physiology of female puberty and its relationship to childhood obesity, and the regulation of gonadotropin-releasing hormone neurons at puberty.


RESULTS
Recent studies suggest that the average age of pubertal onset is decreasing in American girls, sparking controversy in defining the age at which puberty is considered precocious. Obese girls have hyperinsulinemia and hyperandrogenemia prepubertally, but it is unclear whether these factors play a role in the early onset of puberty in obese girls. The kisspeptin/G protein-coupled receptor 54 pathway is important for pubertal initiation; an activating mutation in the pathway has been associated with precocious puberty.


CONCLUSIONS
The recent trend toward obesity has been proposed to play a role in the cause of early puberty in girls. The molecular mechanisms that initiate puberty are slowly being elucidated, with the discovery of kisspeptin prompting a novel direction in reproductive research.
DiVall
Sara A
SA
Division of Pediatric Endocrinology, Johns Hopkins University, Baltimore, Maryland 21287, USA. sdivall1@jhmi.edu
Radovick
Sally
S
D000367:Age Factors; D044383:Black People; D001940:Breast / Q000254:growth & development; D002648:Child; D005260:Female; D006197:Hair / Q000254:growth & development; D006801:Humans; D009765:Obesity / Q000453:epidemiology; D011627:Puberty / Q000502:physiology*; D014481:United States; D044465:White People; D001741:Black or African American