Abstract：OBJECTIVE: To investigate the clinical status and natural course of premature thelarche (PT) in infants under 2 years of age and to analyze the predictive factors for regression of thelarche. METHODS: The clinical and laboratory data of 863 infants under 2 years of age, who visited the department of endocrinology in our hospital due to PT between October 2009 and September 2010, were analyzed. A a longitudinal follow-up study was performed. RESULTS: Of the infants under 2 years of age with isolated PT, 89.3% showed a regression before the age of 3 years (mean 17±5.6 months), 10.7% had recurrent or persistent thelarche, with no regression after the age of 3 years, and some even developed into central precocious puberty. The independent predictive factors for regression of thelarche were Tanner stage at the first visit and whether baseline estradiol level had increased. CONCLUSIONS: PT in infants under 2 years of age is not rare in the clinical setting, and it usually runs a self-limited course, subsiding before the age of 3 years. However, regular follow-ups should be performed for infants aged over 2 years with persistent thelarche.
WANG Ying-Min,LIANG Li,FANG Yan-Lan et al. A clinical follow-up study of premature thelarche in infants under two years of age[J]. CJCP, 2013, 15(4): 285-288.
［3］Curfman AL, Reljanovic SM, McNelis KM, Dong TT, Lewis SA, Jackson LW,et al. Premature thelarche in infants and toddlers: prevalence, natural history and environmental determinants［J］. Pediatr Adolesc Gynecol, 2011, 24(6):338-341.
［4］Atay Z, Turan S, Guran T, Furman A, Bereket A. The prevalence and risk factors of premature thelarche and pubarche in 4-to 8-year-old girls［J］. Acta Paediatr, 2012, 101(2):e71-e75.
［5］Marshall WA, Tanner JM. Growth and physiological development during adolescence［J］. Annu Rev Med, 1968, 19:283.
［6］Elmlinger MW, Kuhnel W, Ranke MB. Reference ranges for serum concentrations of lutropin (LH), follitropin (FSH), estradiol (E2), prolactin, progesterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), cortisol and ferritin in neonates, children and young adults［J］. Clin Chem Lab Med, 2002, 40(11):1151-1160.
［8］Ma HM, Du ML, Luo XP, Chen SK, Liu L, Chen RM, et al. Onset of breast and pubic hair development and menses in urban chinese girls［J］. Pediatrics, 2009, 124(2): 269-277.
［9］Aks glaede L, Srensen K, Petersen JH, Skakkebaek NE, Juul A. Recent decline in age at breast development: the Copenhagen Puberty Study［J］. Pediatrics, 2009, 123(5):932-939.
［11］Crofton PM, Evans NE, Wardhaugh B, Groome NP, Kelnar CJ. Evidence for increased ovarian follicular activity in girls with premature thelarche［J］. Clin Endocrinol (Oxf), 2005,62(2): 205-209.
［12］Chou YY, Huang PC, Lee CC, Wu MH, Lin SJ. Phthalate exposure in girls during early puberty［J］. J Pediatr Endocrinol Metab, 2009, 22(1): 69-77.
［13］Jurewicz J, Hanke W. Exposure to phthalates: reproductive outcome and children health. A review of epidemiological studies［J］. Int J Occup Med Environ Health, 2011, 24(2): 115-141.
［14］Massart F, Saggese G. Oestrogenic mycotoxin exposures and precocious pubertal development［J］. Int J Androl, 2010, 33(2): 369-376.
［15］Weng YI, Hsu PY, Liyanarachchi S, Liu J, Deatherage DE, Huang YW, et al. Epigenetic influences of low-dose bisphenol A in primary human breast epithelial cells［J］.Toxicol Appl Pharmacol, 2010, 248(2): 111-121.
［16］Fortes EM, Malerba MI, Luchini PD, Sugawara EK, Sumodjo L, Ribeiro Neto LM, et al. High intake of phytoestrogens and precocious thelarche: case report with a possible correlation［J］. Arq Bras Endocrinol Metabol, 2007, 51(3): 500-503.
［17］Klein KO, Mericq V, Brown-Dawson JM, Larmore KA, Cabezas P, Cortinez A. Estrogen levels in girls with premature thelarche compared with normal prepubertal girls as determined by an ultrasensitive recombinant cell bioassay［J］. J Pediatr,1999, 134(2): 190-192.
［18］de Vries L, Guz-Mark A, Lazar L, Reches A, Phillip M. Premature thelarche: age at presentation affects clinical course but not clinical characteristics or risk to progress to precocious puberty［J］. J Pediatr, 2010, 156(3): 466-471.
［19］Zhu SY, Du ML, Huang TT. An analysis of predictive factors for the conversion from premature thelarche into complete central precocious puberty［J］. J Pediatr Endocrinol Metab, 2008, 21（6）:533-538.
