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Development of children and adolescents: physiological, pathophysiological, and therapeutic aspects
1Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Insights
Puberty significantly increases luteinizing hormone (LH) and growth hormone (GH) levels, impacting insulin resistance and bone mineral density (BMD). These hormonal shifts are crucial for adolescent development and bone health.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Bone Metabolism
Background:
- Luteinizing hormone (LH) secretion exhibits pulsatile patterns with nocturnal increases, even in prepubertal children.
- LH concentrations rise dramatically (100-fold) during puberty.
Purpose of the Study:
- To elucidate the hormonal dynamics during puberty, focusing on LH, estradiol, growth hormone (GH), and insulin-like growth factor-I (IGF-I).
- To understand the role of these hormones in bone mineral density (BMD) accretion during puberty.
Main Methods:
- Hormonal assays to measure LH, estradiol, GH, and IGF-I levels.
- Assessment of insulin resistance and insulin levels.
- Bone mineral density (BMD) measurements.
Main Results:
- Rising estradiol levels correlate with transient increases in GH concentrations.
- GH and IGF-I, alongside estrogens, are vital for pubertal bone mineral density (BMD) accretion.
- Hormonal hypofunction during this period can lead to permanently low bone density.
Conclusions:
- The interplay of LH, estradiol, GH, and IGF-I is critical for pubertal development and achieving peak bone mass.
- Disruptions in these hormonal pathways can have long-term consequences on bone health.
- Growth hormone therapy in conditions like Turner syndrome demonstrates its efficacy in improving final height.
Abstract:
Luteinizing hormone (LH) secretion is pulsatile with nocturnal augmentation even in prepubertal children, though at very low concentrations. With puberty wake-time, LH concentration increases 100-fold. Rising estradiol levels transiently increase growth hormone (GH) concentrations, which in turn leads to increases in insulin-like growth factor (IGF)-I, insulin resistance, and physiological hyper-insulinemia. In addition to estrogens, GH-IGF are important in accretion of bone mineral density (BMD) in puberty, and hypofunction may cause permanent low bone density. Growth hormone treatment of girls with Turner syndrome increases final height.