Ultrasonographic assessment of pubertal breast development in obese children: compliance with the clinic
-
Özge Yüce
and
Derya Sevinç
Abstract
Background:
The aim of the study was to determine the compliance with the clinical and ultrasonographic staging of pubertal breast development in obese children.
Methods:
Fifty-two obese children with Tanner stage 2 and stage 3 breast development accompanied by at least one pubertal clinical finding were included in the study. The staging of breast development was also performed according to the ultrasonographic morphostructural appearance. The subjects were then divided into subgroups according to their clinical and ultrasonographic breast stages. The stages given by both methods were compared for consistency with the hormonal values and other radiological (uterus long diameter, ovary sizes) findings.
Results:
The correlation between the clinical and ultrasonographic staging of pubertal breast development was determined to be weak (r=0.19). Estradiol levels, uterus long diameter and ovary sizes were significantly increased when the ultrasonographic stage increased among the subjects with clinically similar breast development stage. However, no statistical difference was determined in these parameters among the subjects with ultrasonographically similar but clinically different breast development.
Conclusions:
It was shown that the ultrasonographic staging of breast development could provide more accurate and objective data due to the possible mistakes caused in the breast development staging of obese children by their adipose tissue.
Author contributions: Authors contributions: Concept – ÖY; Design – ÖY, DS; Supervision – ÖY; Resource – ÖY; Materials – ÖY; Data Collection and/or Processing – ÖY, DS; Analysis and/or Interpretation – ÖY; Literature Search – ÖY; Writing – ÖY; Critical Reviews – ÖY, DS. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Sperling, MA. Pediatric endocrinology. Amsterdam: Elsevier Health Sciences, 2014.Search in Google Scholar
2. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.10.1136/adc.44.235.291Search in Google Scholar
3. Bruni V, Dei M, Deligeoroglou E, Innocenti P, Antonio M, et al. Breast development in adolescent girls. Adolesc Pediatr Gynecol 1990;3:201–5.10.1016/S0932-8610(19)80037-3Search in Google Scholar
4. Cacciari E, Milani S, Balsamo A, Spada E, Bona G, et al. Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr). J Endocrinol Invest 2006;29:581–593.10.1007/BF03344156Search in Google Scholar
5. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, et al. Body mass index references for Turkish children. Acta Paediatr 2006;95:194–8.10.1080/08035250500334738Search in Google Scholar
6. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660–7.10.2471/BLT.07.043497Search in Google Scholar
7. Pyle SI, Waterhouse AM, Greulich WW. Attributes of the radiographic standard of reference for the National Health Examination Survey. Am J Phys Anthropol 1971;35:331–7.10.1002/ajpa.1330350306Search in Google Scholar
8. Klein KO, Larmore KA, de Lancey E, Brown JM, Considine RV, et al. Effect of obesity on estradiol level, and its relationship to leptin, bone maturation, and bone mineral density in children. J Clin Endocrinol Metab 1998;83:3469–75.10.1210/jcem.83.10.5204Search in Google Scholar
9. de Groot CJ, van den Berg A, Ballieux BE, Kroon HM, Rings EH, et al. Determinants of advanced bone age in childhood obesity. Horm Res Paediatr 2017;87:254–63.10.1159/000467393Search in Google Scholar
10. Dunkel L, Sorva R, Voutilainen R. Low levels of sex hormone—binding globulin in obese children. J Pediatr 1985;107(1):95–7.10.1016/S0022-3476(85)80623-5Search in Google Scholar
11. Garcia CJ, Espinoza A, Dinamarca V, Navarro O, Daneman A, et al. Breast US in children and adolescents. Radio Graph 2000;20:1605–12.10.1148/radiographics.20.6.g00nv171605Search in Google Scholar PubMed
12. Youn I, Park SH, Lim IS, Kim SJ. Ultrasound assessment of breast development: distinction between premature thelarche and precocious puberty. Am J Roentgenol 2015;204(3):620–4.10.2214/AJR.14.12565Search in Google Scholar PubMed
13. Calcaterra V, Sampaolo P, Klersy C, Larizza D, Alfei A, et al. Utility of breast ultrasonography in the diagnostic work-up of precocious puberty and proposal of a prognostic index for identifying girls with rapidly progressive central precocious puberty. Ultrasound Obstet Gynecol 2009;33:85–91.10.1002/uog.6271Search in Google Scholar PubMed
©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- The role of corticosteroid-binding globulin in the evaluation of adrenal insufficiency
- Original Articles
- Association of sodium intake with insulin resistance in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey 2010
- Decrease in serum chemerin through aerobic exercise plus dieting and its association with mitigation of cardio-metabolic risk in obese female adolescents
- Ultrasonographic assessment of pubertal breast development in obese children: compliance with the clinic
- Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents
- Association of cord blood ghrelin, leptin and insulin concentrations in term newborns with anthropometric parameters at birth
- Management of thyrotoxicosis in children and adolescents: 35 years’ experience in 304 patients
- Clinical and cytogenetic features of 516 patients with suspected Turner syndrome – a single-center experience
- Response to growth hormone treatment in very young patients with growth hormone deficiencies and mini-puberty
- Reference centile curves for wrist circumference for Indian children aged 3–18 years
- Comparison between two inhibin B ELISA assays in 46,XY testicular disorders of sex development (DSD) with normal testosterone secretion
- Genetic mutations associated with neonatal diabetes mellitus in Omani patients
- Four novel mutations of the BCKDHA, BCKDHB and DBT genes in Iranian patients with maple syrup urine disease
- Improved medical-alert ID ownership and utilization in youth with congenital adrenal hyperplasia following a parent educational intervention
- Letter to the Editor
- Identification of five mutations in a patient with galactose metabolic disorders
- Case Reports
- Partial androgen insensitivity syndrome due to somatic mosaicism of the androgen receptor
- Vaginal bleeding and a giant ovarian cyst in an infant with 21-hydroxylase deficiency
- Insulin-mediated pseudoacromegaly: a report of two pediatric patients
- Novel compound heterozygous variants in the LHCGR gene identified in a subject with Leydig cell hypoplasia type 1
Articles in the same Issue
- Frontmatter
- Review
- The role of corticosteroid-binding globulin in the evaluation of adrenal insufficiency
- Original Articles
- Association of sodium intake with insulin resistance in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey 2010
- Decrease in serum chemerin through aerobic exercise plus dieting and its association with mitigation of cardio-metabolic risk in obese female adolescents
- Ultrasonographic assessment of pubertal breast development in obese children: compliance with the clinic
- Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents
- Association of cord blood ghrelin, leptin and insulin concentrations in term newborns with anthropometric parameters at birth
- Management of thyrotoxicosis in children and adolescents: 35 years’ experience in 304 patients
- Clinical and cytogenetic features of 516 patients with suspected Turner syndrome – a single-center experience
- Response to growth hormone treatment in very young patients with growth hormone deficiencies and mini-puberty
- Reference centile curves for wrist circumference for Indian children aged 3–18 years
- Comparison between two inhibin B ELISA assays in 46,XY testicular disorders of sex development (DSD) with normal testosterone secretion
- Genetic mutations associated with neonatal diabetes mellitus in Omani patients
- Four novel mutations of the BCKDHA, BCKDHB and DBT genes in Iranian patients with maple syrup urine disease
- Improved medical-alert ID ownership and utilization in youth with congenital adrenal hyperplasia following a parent educational intervention
- Letter to the Editor
- Identification of five mutations in a patient with galactose metabolic disorders
- Case Reports
- Partial androgen insensitivity syndrome due to somatic mosaicism of the androgen receptor
- Vaginal bleeding and a giant ovarian cyst in an infant with 21-hydroxylase deficiency
- Insulin-mediated pseudoacromegaly: a report of two pediatric patients
- Novel compound heterozygous variants in the LHCGR gene identified in a subject with Leydig cell hypoplasia type 1
