Puberte Prekokslu Kız Çocuklarında Oksidan-Antioksidan Denge: Vaka Kontrol Çalışması
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Köksal T.Oxidant-antioxidant balance in girls with puberty precocious: a case-control study. Hacettepe University Graduate School of Health Sciences, Social Pediatrics Program, Doctora Thesis, Ankara, 2021. It has been shown in studies that the puberty age has shifted earlier in recent years. Precocious puberty (PP) has multiple genetic, environmental and hormonal causes. Studies show that the disruption of the oxidant-antioxidant balance in the human body plays a role in the development of many diseases. In our study, we investigated the oxidant-antioxidant balance status in girls with PP. Therefore, oxidant-antioxidant balance was studied in 107 children who came to Ankara Pediatrics, Hematology, Oncology Training and Research Hospital Endocrine and General Pediatrics outpatient clinic. 58 of the children included in the study were PP cases and 49 were control cases from the same age group. Physical examination and anthropometric measurements of the patients were performed. Birth weight and gestational week, vitamin usage, smoking exposure, parental age, height and body weight were recorded. Thyroid stimulating hormone (TSH), thyroxine (T4), Estrogen, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, bone age and pelvic ultrasonography (USG) information of the patients were obtained from their files. Oxidant and antioxidant parameters were studied after the serum samples of the patients who had written consent from their families were completed. Puberty in PP cases started with thelarche in 98.3%, pubarche in 27.6% and menarche in 3.4%. Pubertal changes were detected in pelvic USG in 48.3% of the cases. Decapeptil (triptorelin acetate) was started in 41.4% of PP cases. In PP cases, mean maternal and paternal ages at birth were younger than control cases (p <0.001 and p = 0.007, respectively). Mean mother and father height values were shorter in PP cases compared to the control group (p = 0.002 and p = 0.025, respectively). Body mass index (BMI) of the parents was similar in both groups. Body mass index z score for age (BAZ) and body weight z score (WAZ) for age were significantly higher in children with PP than in the control group (p = 0.007 and p = 0.013, respectively). In the results we obtained, total oxidant level (TOS) and oxidative stress index (OSI) were found to be significantly higher in control cases than PP cases (p = 0.001, p <0.001). When both groups are compared, total antioxidant level (TAS), myeloperoxidase (MPO), catalase (KAT), superoxide dismutase (SOD), total thiol (TTL), native thiol (NTL), Disulfide, Disulfide / NTL, Disulfide / TTL, There was no statistically significant difference in NTL / TTL values. However, TSH and FSH values were significantly higher in PP cases compared to the control group (p = 0.017, p = 0.002). Free T4 value was found to be significantly lower in PP cases compared to the control group (p <0.001). Although the mean hemoglobin values of the PP group was lower than the control group (p = 0.049), the anemia rates were similar (p = 0.205). As a result, low TOS and OSI in PP cases may be related to the high estrogen levels in these patients. Studies showing the relationship between maternal age and PP can be conducted in the coming years.