title: Central precocious puberty in children living in Spain: incidence, prevalence, and influence of adoption and immigration.
abstract: BACKGROUND
  No epidemiological data are available on central precocious puberty (CPP) in the general population or in adopted or immigrant children in Spain.
  
  
  OBJECTIVE
  We aimed to study the incidence and prevalence of CPP, assess the risk of developing this disorder among adopted and immigrant children, and analyze the predictive variables of CPP associated with intracranial pathology.
  
  
  METHODS
  An observational study of children diagnosed with CPP in Spain was carried out between January 2008 and January 2010. A computer program was designed to process clinical and biological data and information on 250 patients treated in 34 pediatric endocrinology units throughout the country.
  
  
  RESULTS
  Of the patients registered, 226 were girls and 24 were boys. The global incidence rate of CPP was 5.66 cases per million person-years at risk, with an annual incidence ranging between 0.02 and 1.07 new cases per 100,000. The relative risk of CPP in domestic and internationally adopted children compared with those born in Spain was 27.82 (19.99-38.77), whereas the relative risk among immigrants was 1.55 (0.97-2.38). A logistic regression model developed for the study showed that the combined effect of four variables had a significant influence over the presence of organic disease: being male, having been adopted, age at diagnosis, and estimation of adult height.
  
  
  CONCLUSIONS
  CPP is a rare disease whose risk markedly increases with both national and international adoption but is not influenced by immigration. These results suggest a psychological influence on CPP.
authors.affiliation: Pediatric Endocrinology Unit, Institute of Biomedical Research-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, E-28049 Madrid, Spain.
authors.forename: Leandro
authors.initials: L
authors.lastname: Soriano-Guillén
authors.forename: Raquel
authors.initials: R
authors.lastname: Corripio
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Labarta
authors.forename: Ramón
authors.initials: R
authors.lastname: Cañete
authors.forename: Lidia
authors.initials: L
authors.lastname: Castro-Feijóo
authors.forename: Rafael
authors.initials: R
authors.lastname: Espino
authors.forename: Jesús
authors.initials: J
authors.lastname: Argente
mesh_terms: D000300:Adoption / Q000523:psychology; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D011629:Puberty, Precocious / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D013030:Spain / Q000453:epidemiology