Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"Pancreatic Neuroendocrine Tumors in French VHL Mutation Carriers.","authors":"Marie Muller, Pascal Hammel, Anne Couvelard, Anne-Laure Védie, Jérôme Cros, Nelly Burnichon, Agathe Hercent, Alain Sauvanet, Stéphane Richard, Louis de Mestier","doi":"10.1210/clinem/dgae310","DOIUrl":"10.1210/clinem/dgae310","url":null,"abstract":"<p><strong>Context: </strong>Von Hippel-Lindau disease (VHL) is a rare, autosomal-dominant hereditary cancer-predisposition syndrome caused by germline pathogenic variants (PVs) in the VHL gene. It is associated with a high penetrance of benign and malignant vascular tumors in multiple organs, including pancreatic neuroendocrine tumors (PanNETs), whose long-term natural history is ill-known.</p><p><strong>Objective: </strong>The aim of this study was to identify prognostic factors associated with VHL-related PanNETs, notably the role of genotype-phenotype correlations.</p><p><strong>Methods: </strong>Patients with both documented germline PV in the VHL gene and PanNETs included in the French PREDIR database between 1995 and 2022 were included. The primary end point was the proportion of patients with PanNET-related metastases, and the secondary end point was overall survival (OS). Genotype/phenotype correlations were studied.</p><p><strong>Results: </strong>We included 121 patients with 259 PanNETs. Median age at diagnosis was 38 years. Median follow-up was 89.5 months. PanNET surgical resection was performed in 51 patients. Overall, 29 patients (24%) had metastases (5 synchronous, 10 metachronous), with a higher risk in case of larger PanNET size (P = .0089; best threshold 28 mm) and grade 2 PanNET (P = .048), and a pejorative prognostic impact (P = .043). Patients with PV in VHL exon 1 had larger PanNETs (P = .018), more often metastatic disease (48% vs 11.5%; P < .001) and a trend toward shorter OS (P = .16).</p><p><strong>Conclusion: </strong>The risk of metastases associated with VHL-related PanNETs remains low (24%) but increases with tumor size greater than 28 mm, higher grade, and in case of PV, located in VHL exon 1. These data might help improve the management of these patients, who should be referred to an expert center.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1160-e1166"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-terminal Pro-B-Type Natriuretic Peptide and Risk for Diabetes Mellitus and Metabolic Syndrome.","authors":"Charles D Nicoli, D Leann Long, Timothy B Plante, Suzanne E Judd, Leslie A McClure, April P Carson, Mary Cushman","doi":"10.1210/clinem/dgae301","DOIUrl":"10.1210/clinem/dgae301","url":null,"abstract":"<p><strong>Context: </strong>Natriuretic peptide concentrations are inversely associated with risk of diabetes mellitus and may be protective from metabolic dysfunction.</p><p><strong>Objective: </strong>We studied associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with incident diabetes, metabolic syndrome (MetS), and MetS components.</p><p><strong>Methods: </strong>A total of 2899 participants with baseline (2003-2007) and follow-up (2013-2016) examinations and baseline NT-proBNP measurement in the REasons for Geographic And Racial Differences in Stroke study. Logistic regression models were fitted to incident MetS, MetS components, and diabetes; covariates included demographics, risk and laboratory factors. Incident diabetes was defined as fasting glucose ≥126 mg/dL, random glucose ≥200 mg/dL, or use of insulin or hypoglycemic drugs at follow-up but not baseline. Incident MetS was defined as participants with ≥3 harmonized criteria at follow-up and <3 at baseline.</p><p><strong>Results: </strong>A total of 310 participants (2364 at risk) developed diabetes and 361 (2059 at risk) developed MetS over a mean 9.4 years of follow-up. NT-proBNP was inversely associated with odds of incident diabetes (fully adjusted OR per SD higher log NT-proBNP 0.80, 95% CI 0.69-0.93) and MetS in the highest vs lowest quartile only (fully adjusted OR 0.59, 95% CI 0.37-0.92); the linear association with incident MetS was not statistically significant. NT-proBNP was inversely associated with incident dysglycemia in all models (fully adjusted OR per SD log NT-proBNP 0.65, 95% CI 0.53-0.79), but not with other MetS components. Effect modification by sex, race, age, or body mass index was not observed.</p><p><strong>Conclusion: </strong>NT-proBNP was inversely associated with odds of diabetes, MetS, and the MetS dysglycemia component. The metabolic implications of B-type natriuretic peptides appear important for glycemic homeostasis.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1185-e1193"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Incorporating Molecular Testing Improve the Accuracy of Newborn Screening for Congenital Adrenal Hyperplasia?","authors":"Kyriakie Sarafoglou, Amy Gaviglio, Carrie Wolf, Cindy P Lorentz, Aida Lteif, Jennifer Kyllo, Gretchen Radloff, Zachary Detwiler, Carla D Cuthbert, James S Hodges, Scott D Grosse, Christopher N Greene, Suzanne Cordovado","doi":"10.1210/clinem/dgae297","DOIUrl":"10.1210/clinem/dgae297","url":null,"abstract":"<p><strong>Context: </strong>Single-tier newborn screening (NBS) for congenital adrenal hyperplasia (CAH) using 17-hydroxyprogesterone (17OHP) measured by fluoroimmunoassay (FIA) in samples collected at 24 to 48 hours produces a high false-positive rate (FPR). Second-tier steroid testing can reduce the FPR and has been widely implemented.</p><p><strong>Objective: </strong>We investigated the accuracy of an alternative multitier CAH NBS protocol that incorporates molecular testing of the CYP21A2 gene and reduces the first-tier 17OHP cutoff to minimize missed cases.</p><p><strong>Methods: </strong>We create a Minnesota-specific CYP21A2 pathogenic variants panel; developed a rapid, high-throughput multiplex, allele-specific-primer-extension assay; and performed a 1-year retrospective analysis of Minnesota NBS results comparing metrics between a conventional steroid-based 2-tier protocol and a molecular-based multitier NBS protocol, applied post hoc.</p><p><strong>Results: </strong>CYP21A2 gene sequencing of 103 Minnesota families resulted in a Minnesota-specific panel of 21 pathogenic variants. The Centers for Disease Control and Prevention created a molecular assay with 100% accuracy and reproducibility. Two-tier steroid-based screening of 68 659 live births during 2015 resulted in 2 false negatives (FNs), 91 FPs, and 1 true positive (TP). A 3-tier protocol with a lower first-tier steroid cutoff, second-tier 21-variant CYP21A2 panel, and third-tier CYP21A2 sequencing would have resulted in 0 FNs, 52 FPs, and 3 TPs.</p><p><strong>Conclusion: </strong>Incorporation of molecular testing could improve the accuracy of CAH NBS, although some distinct challenges of molecular testing may need to be considered before implementation by NBS programs.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1194-e1203"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Metreleptin in Patients With Generalized Lipodystrophy Before vs After the Onset of Severe Metabolic Disease.","authors":"Maiah Brush, Sungyoung Auh, Elaine Cochran, Rebecca Tuska, Christopher Koh, David E Kleiner, Marissa Lightbourne, Rebecca J Brown","doi":"10.1210/clinem/dgae335","DOIUrl":"10.1210/clinem/dgae335","url":null,"abstract":"<p><strong>Context: </strong>Leptin replacement therapy with metreleptin improves metabolic abnormalities in patients with generalized lipodystrophy (GLD).</p><p><strong>Objective: </strong>Determine how timing of metreleptin initiation in the clinical course of GLD affects long-term metabolic health.</p><p><strong>Methods: </strong>Retrospective analysis of patients ≥6 months old with congenital (n = 47) or acquired (n = 16) GLD treated with metreleptin at the National Institutes of Health since 2001. Least squares means for glycated hemoglobin (HbA1c), insulin area under the curve from oral glucose tolerance tests, triglycerides, urine protein excretion, platelets, transaminases, and aspartate aminotransferase (AST) to Platelet Ratio Index for early and late treatment groups, defined by baseline metabolic health, were analyzed during median 72 (24-108) months' follow-up.</p><p><strong>Results: </strong>Compared to late groups, early groups based on metabolic status had higher mean ± SEM insulin area under the curve (20 831 ± 1 vs 11 948 ± 1), lower HbA1c (5.3 ± 0.3 vs 6.8 ± 0.3%), triglycerides (101 ± 1 vs 193 ± 1 mg/dL), urine protein excretion (85 ± 1.5 vs 404 ± 1.4 mg/24 h), alanine aminotransferase (30 ± 1 vs 53 ± 1 U/L), AST (23 ± 1 vs 40 ± 1 U/L), and AST to Platelet Ratio Index (0.22 ± 1.3 vs 0.78 ± 1.3), and higher platelets (257 ± 24 vs 152 ± 28 K/µL) during follow-up (P < .05). Compared to patients ≥6 years old at baseline, patients <6 years had lower HbA1c (4.5 ± 0.5 vs 6.4 ± 0.2%) and higher AST (40 ± 1vs 23 ± 1 U/L) during follow (P < .05).</p><p><strong>Conclusion: </strong>Patients with GLD who initiated metreleptin before the onset of severe metabolic complications had better long-term control of diabetes, proteinuria, and hypertriglyceridemia. Early treatment may also result is less severe progression of liver fibrosis, but further histological studies are needed to determine the effects of metreleptin therapy on liver disease.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1051-e1061"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Houston We Have a Problem….\": Raising the Quality and Authenticity of Manuscripts Submitted to JCEM.","authors":"Paul M Stewart","doi":"10.1210/clinem/dgaf036","DOIUrl":"10.1210/clinem/dgaf036","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"901-902"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Lateralization Index of Adrenal Venous Sampling for Surgical Indication in Primary Aldosteronism.","authors":"Hiroki Kobayashi, Yoshihiro Nakamura, Masanori Abe, Oskar Ragnarsson, Eleftheria Gkaniatsa, Marianne Aa Grytaas, Kristian Løvås, Norio Wada, Takamasa Ichijo, Daniel A Heinrich, William Drake, Sam O'Toole, Tomaz Kocjan, Darko Kastelan, Ivana Kraljevic, Koichi Yamamoto, Mika Tsuiki, Simon Kloock, Ulrich Dischinger, Mirko Parasiliti-Caprino, Gruber Sven, Ariadni Spyroglou, Raluca Maria Furnica, Francesco Fallo, Giuseppe Maiolino, Mitsuhiro Kometani, Vin-Cent Wu, Felix Beuschlein, Martin Reincke, Mitsuhide Naruse","doi":"10.1210/clinem/dgae336","DOIUrl":"10.1210/clinem/dgae336","url":null,"abstract":"<p><strong>Context: </strong>Clinical practice guidelines recommend the lateralization index (LI) as the standard for determining surgical eligibility in primary aldosteronism (PA).</p><p><strong>Objective: </strong>Our goal was to identify the optimal LI cutoffs in adrenal venous sampling (AVS) for diagnosing PA that is amenable to surgical cure.</p><p><strong>Methods: </strong>We conducted a retrospective international cohort study across 16 institutions in 11 countries, including 1550 patients with PA who underwent AVS, with and/or without adrenocorticotropin (ACTH) stimulation. The establishment of optimal cutoffs was informed by a survey of 82 patients with PA in Japan, aimed at determining the LI cutoff aligned with patient expectations for a surgical cure rate.</p><p><strong>Results: </strong>The survey revealed that a median cure rate expectation of 80% would motivate patients with PA towards undergoing adrenalectomy. The optimal LI cutoffs achieving an adjusted positive predictive value (PPV) of 80% were identified as 3.8 for unstimulated AVS and 3.4 for ACTH-stimulated AVS. Furthermore, a contralateral ratio of less than 0.4 and the detection of an adrenal nodule on computed tomography imaging were identified as independent predictors of surgically curable PA. Incorporating these factors with the optimal LI cutoffs, the adjusted PPV increased to 96.6% for unstimulated AVS and 89.6% for ACTH-stimulated AVS. No clear differences in predictive ability between unstimulated and ACTH-stimulated LI were found.</p><p><strong>Conclusion: </strong>The present study clarified the optimal LI cutoffs for without and with ACTH stimulation. The presence of contralateral suppression and adrenal nodule on CT imaging seems to provide additional available information besides LI for surgical indication.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1084-e1093"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Study on Central Precocious Puberty: Molecular and Clinical Analyses in 90 Patients.","authors":"Hiromune Narusawa, Tomoe Ogawa, Hideaki Yagasaki, Keisuke Nagasaki, Tatsuki Urakawa, Tomohiro Saito, Shun Soneda, Saori Kinjo, Shinichiro Sano, Mitsukazu Mamada, Shintaro Terashita, Sumito Dateki, Satoshi Narumi, Yasuhiro Naiki, Reiko Horikawa, Tsutomu Ogata, Maki Fukami, Masayo Kagami","doi":"10.1210/clinem/dgae666","DOIUrl":"10.1210/clinem/dgae666","url":null,"abstract":"<p><strong>Context: </strong>Defects in MKRN3, DLK1, KISS1, and KISS1R and some disorders, such as Temple syndrome (TS14), cause central precocious puberty (CPP). Recently, pathogenic variants (PVs) in MECP2 have been reported to be associated with CPP.</p><p><strong>Objective: </strong>We aimed to clarify the contribution of (epi)genetic abnormalities to CPP and clinical and hormonal features in each etiology.</p><p><strong>Methods: </strong>We conducted targeted sequencing for MKRN3, DLK1, MECP2, KISS1, and KISS1R and methylation analysis for screening of imprinting disorders such as TS14 associated with CPP in 90 patients with CPP (no history of brain injuries and negative brain magnetic resonance imaging) and collected their clinical and laboratory data. We measured serum DLK1 levels in 3 patients with TS14 and serum MKRN3 levels in 2 patients with MKRN3 genetic defects, together with some etiology-unknown patients with CPP and controls.</p><p><strong>Results: </strong>We detected 8 patients with TS14 (6, epimutation; 1, mosaic maternal uniparental disomy chromosome 14; 1, microdeletion) and 3 patients with MKRN3 genetic defects (1, PV; 1, 13-bp deletion in the 5'-untranslated region [5'-UTR]; 1, microdeletion) with family histories of paternal early puberty. There were no patients with PVs identified in MECP2, KISS1, or KISS1R. We confirmed low serum MKRN3 level in the patient with a deletion in 5'-UTR. The median height at initial evaluation of TS14 patients was lower than that of all patients. Six patients with TS14 were born small for gestational age (SGA).</p><p><strong>Conclusion: </strong>(Epi)genetic causes were identified in 12.2% of patients with CPP at our center. For patients with CPP born SGA or together with family histories of paternal early puberty, (epi)genetic testing for TS14 and MKRN3 genetic defects should be considered.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"1023-1036"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of Molecular Testing for Thyroid Nodules With Indeterminate Cytology.","authors":"Sara Ahmadi, Jennifer A Sipos","doi":"10.1210/clinem/dgae470","DOIUrl":"10.1210/clinem/dgae470","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e1280-e1281"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonpronuclear- and Monopronuclear-derived Blastocysts Do Not Impair Subsequent Perinatal and Maternal Outcomes.","authors":"Qiuyu Xu, Xiaoyan Mao, Jie Zhang, Ling Wu","doi":"10.1210/clinem/dgae375","DOIUrl":"10.1210/clinem/dgae375","url":null,"abstract":"<p><strong>Context: </strong>The routine clinical practice is to prioritize the transfer of blastocysts derived from 2 pronuclei (2PN) embryos if they are available. For women who only have blastocysts resulting from nonpronuclear (0PN) and monopronuclear (1PN) embryos, whether to transfer these embryos or discard them has been an ongoing debate over the years.</p><p><strong>Objective: </strong>To investigate the perinatal and obstetric outcomes following the transfer of vitrified-warmed single blastocysts derived from 0PN and 1PN zygotes.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>University-affiliated in vitro fertilization center.</p><p><strong>Patient(s): </strong>This study included singletons born to women who had undergone 0PN and 1PN vitrified-warmed single blastocyst transfers, compared to those resulting from 2PN vitrified-warmed single blastocyst transfers from 2012 to 2021.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measure(s): </strong>Perinatal and obstetric outcomes.</p><p><strong>Result(s): </strong>A total of 7284 women were included in the final analysis. Of these, 386, 316, and 6582 cycles resulted from 0PN-, 1PN-, and 2PN-derived blastocysts transfer, respectively. The rates of clinical pregnancy, miscarriage, and live birth were similar across the study cohorts in both unadjusted and adjusted analyses. When comparing the 0PN and 2PN groups, no differences were found in birth outcomes after adjusting for confounders. Similarly, maternal complications and mode of delivery were comparable between these 2 study cohorts. Birth parameters were also similar between the 1PN and 2PN blastocyst groups, except for more male births in the 1PN cohort. Furthermore, a comparison between the 1PN and 2PN groups did not reveal any significant differences in maternal outcomes.</p><p><strong>Conclusion: </strong>The current study showed that the transfer of 0PN and 1PN blastocysts did not compromise reproductive outcomes or increase maternal and perinatal complications. This information is valuable for clinicians to counsel couples effectively and guide them in making informed decisions.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e953-e961"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Stress Trajectories Are Associated With Puberty Timing: Findings From a 7-Year Cohort in Chongqing, China.","authors":"Shudan Liu, Yangxue Zhou, Di Wu, Yu Tian, Jie Luo, Jie Zhang, Wenhe Wang, Ge Yan, Qin Liu","doi":"10.1210/clinem/dgae378","DOIUrl":"10.1210/clinem/dgae378","url":null,"abstract":"<p><strong>Context: </strong>Evidence for the associations between psychosocial stress PS related exposures and puberty timing are inconclusive. The PS of children has rarely been evaluated through repeated measurements.</p><p><strong>Objective: </strong>To evaluate the associations between PS trajectories and pubertal outcomes of girls and boys in a Chinese cohort (2015-2022).</p><p><strong>Methods: </strong>Pubertal outcomes of 732 girls and 688 boys were physically examined every 6 months. Stressful life events were repeatedly assessed 7 times. A group-based trajectory model was fitted for the optimum trajectories of total PS and PS from 5 sources. A Cox model adjusted for age, body mass index, and socioeconomic factors was used to evaluate the association.</p><p><strong>Results: </strong>Compared with the \"low, gradual decline\" trajectory, the \"moderate, gradual decline\" trajectory of total PS was associated with late menarche (hazard ratio [HR] 0.816, 95% CI 0.677-0.983), late pubic hair development (HR 0.729, 95% CI 0.609-0.872), and late axillary hair development (HR 0.803, 95% CI 0.661-0.975) in girls. Girls following the \"high, rise then decline\" trajectory of PS from family life demonstrated delayed axillary hair development (HR 0.752, 95% CI 0.571-0.990). For boys, the \"high, rise then decline\" trajectory of PS from academic adaptation (HR 0.670, 95% CI 0.476-0.945) and life adaptation (HR 0.642, 95% CI 0.445-0.925) was associated with late axillary hair development. Boys in the \"moderate, gradual decline\" trajectory of PS from peer relationships was at risk of early testicular development (HR 1.353, 95% CI 1.108-1.653).</p><p><strong>Conclusion: </strong>Chronic PS may be associated with delayed onset of several pubertal signs in both girls and boys. It may also accelerate testicular development of boys, indicating its varying impact on pubertal timing during early and later stages.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e945-e952"},"PeriodicalIF":5.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}