| Abstract | Pubertet definiramo kao razdoblje razvoja ljudske jedinke, i kao takav, on je obiljeţen
zamahom rasta, razvojem spolnih organa i sekundarnih spolnih osobina ĉime jedinka stiĉe
svoju sposobnost za reprodukciju. Zapoĉinje pulsatilnom sekrecijom GnRH koji pokreće
hipotalamus – hipofiza – gonadnu os. MeĊutim primarni mehanizam koji pokreće ovo
cjelokupno zbivanje i nadalje je nepoznat. Najpoznatiji sustav za procjenu pubertetskog
razvoja je stupnjevanje po Tanneru. U djevojĉica pubertet zapoĉinje rastom dojki, a ubrzo ga
slijedi pojava pubiĉne i aksilarne dlakavosti te kasnije pojava prve menstruacije. U djeĉaka
pubertet zapoĉinje povećanjem testisa, rastom penisa, pojavom pubiĉne i aksilarne dlakavosti
te brade. Dosadašnji podaci ukazuju na to da 95% djece ulazi u pubertet u predviĊenom
vremenskom razdoblju, za djevojĉice ono je u dobi od 8. – 13. godine, dok je za djeĉake u
dobi od 9,5 - 13,5 godina. Ostalih 5 % u pubertet ulazi ili prijevremeno ili kasno. Pubertet
definiramo preuranjenim ukoliko pojava kliniĉkih i hormonalnih znakova pubertetskog
razvoja u djevojĉica zapoĉne prije 8. godine, a u djeĉaka prije 9. godine ţivota. Ukoliko
pubertet u djevojĉica zapoĉne izmeĊu 8. i 10. godine, te u djeĉaka izmeĊu 9. i 11. godine
ţivota, radi se o ranom, ali ne i prijevremenom pubertetu. Prijevremeni pubertet najĉešće
nastaje ranom aktivacijom hipotalamus - hipofiza- gonadne osi i tada govorimo o centralnom,
gonadotropin ovisnom, potpunom ili pravom prijevremenom pubertetu. A ukoliko fiziĉke
promjene pokrenu spolni hormoni tada govorimo o perifernom, gonadotropin neovisnom,
nepotpunom ili laţnom prijevremenom pubertetu. Tako rani poĉetak puberteta moţe
prouzroĉiti probleme poput niske završne visine rasta te emocionalnog poremećaja. Najvaţniji
kriterij u donošenju odluke o uvoĊenju terapije GnRH analozima sama je progresija
pubertetskog razvoja. |
| Abstract (english) | Puberty is define as a period of the development of a human being, and like that it is marked
by the growth momentum, the development of sexual organs and the secondary sexual
characteristics, thus achieving the individual's ability to reproduce. It is initiated by the
pulsatile secretion of GnRH which triggers thehypothalamic - pituitary - ovarian axis.
However, the primary mechanism that triggers this overall phenomenon is still unknown. The
most well-known system for assessing puberty is the degree of Tanner. In a girl it begins with
breast growth, and soon is followed by the appearance of pubic and axillary hair and
subsequent appearance of the first menstrual period. In a boy, puberty begins with increasing
testicles, penis growth, pubic and axillary hair growth and hair on chin. Previous data suggest
that 95% of children enter puberty in the predicted time of that period, for girls it is between
the ages of 8 and 13, and for boys ages 9.5 to 13.5. The other 5% in puberty enter either
earlier or later. Puberty is defined as precocious puberty if the occurrence of clinical and
hormonal signs of puberty in girls begins before 8 years and in boys before 9 years of age. If
puberty begins in girls between 8 and 10, and in boys between the ages of 9 and 11, it is early
but not precocious puberty. Early puberty is most commonly caused by early activation of the
hypothalamic – pituitary - ovarian axis and then we are talking about central, gonadotropindependent,
complete or right precocious puberty. And if physical changes trigger sex
hormones then we talk about peripheral, gonadotropin independent, incomplete or false
precocious puberty. Such early puberty starts can cause problems such as low height growth
and emotional disturbance. The most important criterion in deciding to introduce GnRH
analogs therapy is the progression of puberty development. |
