title: Clinical and laboratory characteristics of children referred for early puberty: preponderance in 7-8 years of age.
abstract: OBJECTIVE
  The aim of this study was to evaluate the girls referred to the pediatric outpatient clinic with a presumptive diagnosis of early puberty due to early onset of breast development or pubarche.
  
  
  METHODS
  Within the study period, we evaluated 289 subjects referred for concerns about early onset of puberty. History, anthropometric data, bone age (BA), hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and dehydroepiandrosterone sulfate, as well as pelvic ultrasonography (USG)-derived ovarian and uterine volumes were analyzed.
  
  
  RESULTS
  Of the 289 girls referred for early onset of pubertal development, 64 (22.1%) had false alarms for puberty. Of the remaining 225 girls, 41 (18.2%) were diagnosed as premature pubarche, 56 (24.9%) as premature thelarche (PT), and 128 (56.9%) as precocious puberty (PP). Girls with early-onset puberty had more advanced BA, greater uterine and ovarian volumes, and also higher LH values than subjects with PP and PT. Nearly half of these girls were 7-8 years of age. Body mass index (BMI) standard deviation score was significantly higher in the PP cases.
  
  
  CONCLUSIONS
  There is a need for primary care physicians to be more knowledgeable on puberty and on puberty problems. There seems to be a preponderance of PP in 7-8-year-old children . Increased BMI may have a role in the trend towards earlier onset of puberty.
authors.affiliation: İstanbul University İstanbul Medical Faculty, Pediatrics, İstanbul, Turkey. ayse.kilic@tnn.net
authors.forename: Ayşe
authors.initials: A
authors.lastname: Kılıç
authors.forename: Mehmet Sait
authors.initials: MS
authors.lastname: Durmuş
authors.forename: Emin
authors.initials: E
authors.lastname: Ünüvar
authors.forename: Ismail
authors.initials: I
authors.lastname: Yıldız
authors.forename: Banu Küçükemre
authors.initials: BK
authors.lastname: Aydın
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uçar
authors.forename: Rüveyde
authors.initials: R
authors.lastname: Bundak
authors.forename: Firdevs
authors.initials: F
authors.lastname: Baş
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
authors.forename: Fatma
authors.initials: F
authors.lastname: Oğuz
authors.forename: Müjgan
authors.initials: M
authors.lastname: Sıdal
authors.forename: Ensar
authors.initials: E
authors.lastname: Yekeler
mesh_terms: D000365:Age Determination by Skeleton; D015992:Body Mass Index; D001842:Bone and Bones / Q000473:pathology*; D002648:Child; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D010044:Outpatient Clinics, Hospital; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology*; D011629:Puberty, Precocious / Q000097:blood / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D043373:Follicle Stimulating Hormone, Human; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone