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Early Breast Growth in Girls Aged 6 to 8 Years in the Current Environmental Context

Not Applicable
Recruiting
Conditions
Breast
Environmental Exposure
Puberty, Precocious
Interventions
Other: Environmental health measures
Registration Number
NCT06083415
Lead Sponsor
Lille Catholic University
Brief Summary

Various studies show an increase in the number of cases of early puberty in girls with breast development with a variable clinical presentation and evolution. This increasing phenomenon concerns girls between 6 and 8 years old. In a large number of cases, from 70 to 95% depending on the series, no medical cause is found and environmental factors are suspected to be involved.

Descriptive studies of these patients are scarce and not always provide an overview of all the parameters in line with the concept of the exposome.

The PENELOPE clinical trial will allow to analyze a large number of parameters, including the adipose tissue, its metabolism, the endocrine disruptors, and the epigenetic modifications, and to study the impact of environmental health measures in the evolution of these parameters.

The data from the analyses of the endocrine disruptors of the patients will be explored in parallel in experimental models (amphibians, murine, cellular) in order to test potential mechanistic hypotheses.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
50
Inclusion Criteria
  • Girls aged 6 to 8 years
  • Presenting a breast development (isolated or not)
  • Undergoing scheduled pediatric day hospital care (HDJ)
  • Who agree to participate in the study
  • Whose parents agree to their child's participation in the study
  • French speaking
  • Whose parents speak French
  • Affiliated to social security
Exclusion Criteria
  • Organic brain causes of precocious puberty: History of neurocerebral disease (malformations, developmental abnormalities)
  • Organic causes of precocious puberty: Mac Cune Albright syndrome, ovarian cyst or tumor and adrenal hyperplasia
  • History of chemotherapy or radiation therapy
  • Presenting with a communication disorder
  • Pregnancy
  • Persons under protective measures
  • Persons deprived of liberty for judicial or administrative reasons

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
6 to 8 years old girls, presenting with a breast flare-upEnvironmental health measuresGirls aged 6 to 8 years old with breast flare (isolated or not) and scheduled for pediatric day hospital stay
Primary Outcome Measures
NameTimeMethod
Change from baseline of the heightBaseline, 3 months, 6 months

This parameter will allow to describe the clinical evolution of the height after application of environmental health measures

Change from baseline of the size of the breast development measured by Magnetic Resonance ImagingBaseline, 3 months

This parameter will allow to describe the clinical evolution of breast development after application of environmental health measures

Change from baseline of the size of ovaries/uterus measured by Magnetic Resonance ImagingBaseline, 3 months,

This parameter will allow to describe the clinical evolution of ovaries and uterus after application of environmental health measures

Body mass index (BMI)Baseline, 3 months, 6 months

This parameter will allow to describe the clinical evolution of the BMI after application of environmental health measures

Change from baseline of the abdominal fat surface measured by Magnetic Resonance ImagingBaseline, 3 months

This parameter will allow to describe the clinical evolution of the abdominal fat surface after application of environmental health measures

Change from baseline of the weightBaseline, 3 months, 6 months

This parameter will allow to describe the clinical evolution of the weight after application of environmental health measures

Secondary Outcome Measures
NameTimeMethod
Thyroid Stimulating Hormone levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

FT4 (Free Thyroxine hormone) levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Degree of severity of teeth hypomineralisationBaseline, 3 months

The dree of severity is determine according to a scale: 1: \<30% of the tooth's enamel surface area visibly disrupted, 2: 31 to 49% of the tooth's enamel surface area visibly disrupted, 3: \>50% of the tooth's enamel surface area visibly disrupted

17 hydroxyprogesterone levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Sex Hormone-Binding Globulin levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Bone age determination by X rayChange from baseline at 90

Determination of bone age to determine the maturity of the child's skeletal system.

Tanner scaleChange from baseline at 90 and 180 days

The Tanner scale is a scale of physical development as children transition into adolescence and then adulthood. The scale defines physical measurements of development based on external primary and secondary sex characteristics.

Breast:

Tanner I: no glandular tissue Tanner II: breast bud forms, areola begins to widen Tanner III: breast begins to become more elevated, and extends beyond the borders of the areola, Tanner IV: increased breast sizing and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast Tanner V: breast reaches final adult size

Pubis hair:

Tanner I: no pubic hair Tanner II: small amount of long, downy hair Tanner III: hair becomes more coarse and curly, and begins to extend laterally Tanner IV: adult-like hair quality, extending across pubis but sparing medial thighs Tanner V: hair extends to medial surface of the thighs

Estradiol (E2) levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Measurement of endocrine disruptors in hairChange from baseline at 90 days

Describe the evolution of the amount of endocrine disruptors in hair after the implementation of environmental health measures. from 70 to 100 mg of hair will cut as close as possible to the scalp at the posterior vertex, and stored at room temperature to measure endocrine disruptors such as parabens, phthalates, bisphenols and pesticides.

Glycated hemoglobin (HbA1C) levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Glycemia levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Insulin-like Growth Factor-1 levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Follicle-stimulating hormone (FSH) levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Testosterone LevelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Dehydroepiandrosterone sulfate levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Androstenedione levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Leptine levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Luteinizing hormone (LH) levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Insulin levelChange from baseline at 90 days and 180 days

Blood test for determining the evolution of this parameter from baseline

Trial Locations

Locations (2)

Cabinet BLM

🇫🇷

Lambersart, Nord Pas De Calais, France

Saint Vincent hospital

🇫🇷

Lille, Nord Pas De Calais, France

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