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Kinder- und Jugendmedizin 2023; 23(01): 19-26
DOI: 10.1055/a-1971-8578
Schwerpunkt

Pubertätsentwicklung und Adipositas

Pubertal development and obesity
Robert Stein
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Elena Sergeyev
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Eric Göpel
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Anette Stoltze
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Julia Gesing
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Roland Pfäffle
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Antje Körner
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
,
Wieland Kiess
1   Klinik und Poliklinik für Kinder und Jugendliche, Universitätsklinikum Leipzig AöR
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ZUSAMMENFASSUNG

Die Beurteilung der Pubertätsentwicklung sowie Übergewicht und Adipositas sind tagtäglicher Bestandteil der pädiatrischen Praxis. Dabei beeinflussen sich Pubertätsentwicklung und Adipositas wechselseitig. Während Mädchen mit Adipositas häufig eine Pubertätsakzeleration aufweisen, sind die Daten bei Jungen weniger eindeutig. Möglicherweise verursacht Übergewicht hier eine Pubertätsbeschleunigung und Adipositas eine Pubertätsverzögerung. Leicht erhöhte Androgenspiegel bei Mädchen sowie leicht erhöhte Östrogenspiegel bei Jungen und eine präpubertäre Wachstumsakzeleration bei beiden Geschlechtern sind häufige Phänomene bei Kindern mit Adipositas. Die Ursachen sind multifaktoriell. Hierbei spielt das Fettgewebe eine entscheidende Rolle, sowohl durch die zentrale Aktivierung der Hypothalamus-Hypophysen-Gonadenachse über Leptin und Kisspeptin als auch durch periphere Effekte, wie beispielweise die Umwandlung von Androgenen zu Östrogen. Syndrome, welche sowohl Störungen der Pubertätsentwicklung als auch Adipositas umfassen, dürfen bei der klinischen Einschätzung nicht übersehen werden. Zur Einschätzung der altersgerechten Pubertätsentwicklung bei Kindern und Jugendlichen mit Adipositas kann in Kenntnis der typischen Veränderungen und Warnzeichen in den meisten Fällen jedoch auf weitere Diagnostik verzichtet und der Verlauf vorerst beobachtet werden.

ABSTRACT

Suspected disorders of pubertal development as well as overweight and obesity belong to every pediatrician’s routine. Hereby, both diseases interfere with each other. Girls with obesity show accelerated pubertal development, on the contrary, this trend is less consistent in boys. Overweight may lead to an earlier pubertal timing in boys, whereas obesity causes pubertal delay. Elevated androgen levels are common in girls with obesity, elevated estradiol levels are common in boys with obesity, both sexes show accelerated growth during the prepubertal period. Causes are multifactorial. Adipose tissue plays a crucial role by mediating central activation of the hypothalamus-pituitary-gonadal axis through leptin and kisspeptin, as well as by peripheral effects through conversion of androgens to estrogen. Syndromes, which comprise altered pubertal development as well as obesity should not be dismissed. To evaluate pubertal timing in adolescents with obesity, further diagnostic testing is often not necessary, if typical alterations and red flags are taken under consideration carefully.

Schlüsselwörter

Pubertätsentwicklung - kindliche Adipositas - Pubertas präcox - Pubertas tarda

Keywords

Pubertal development - childhood obesity - precocious puberty - delayed puberty


Publication History

Article published online:
24 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG,
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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