肥胖与中枢性性早熟关联性研究：从流行病学到机制探索的系统综述

Research on the Association between Obesity and Central Precocious Puberty: A Systematic Review from Epidemiology to Mechanism Exploration

摘要: 肥胖与中枢性性早熟的关联已成为儿科内分泌领域的研究热点。本文系统梳理了关于肥胖与性早熟关系的研究文献，从流行病学证据、机制探索、诊断挑战、干预策略四个维度对既有研究进行归纳与评述。研究发现，流行病学研究已确认肥胖是中枢性性早熟的重要危险因素，但其因果关系及具体机制仍在深入探索中；机制研究主要涉及肠道菌群–代谢物–性腺轴调控、下丘脑炎症通路、表观遗传修饰等方向；临床诊断方面，肥胖对传统诊断指标如GnRH激发试验峰值产生显著影响，亟需建立针对肥胖儿童的特异性诊断标准；干预研究则从生活方式干预、天然产物提取物到新型药物靶点，呈现出多元化的探索态势。未来研究需进一步整合多组学技术，深入探讨肥胖导致性早熟的分子机制，并开展大规模临床随机对照试验以验证干预措施的有效性。

Abstract: The association between obesity and central precocious puberty has become a research hotspot in the field of pediatric endocrinology. This article systematically reviews the literature on the relationship between obesity and precocious puberty, summarizing and discussing existing research from four dimensions: epidemiological evidence, mechanism exploration, diagnostic challenges, and intervention strategies. The study finds that epidemiological research has confirmed obesity as a significant risk factor for central precocious puberty, although its causal relationship and specific mechanisms require further in-depth exploration. Mechanistic studies primarily focus on areas such as the gut microbiota-metabolite-gonadal axis regulation, hypothalamic inflammatory pathways, and epigenetic modifications. In clinical diagnosis, obesity significantly impacts traditional diagnostic indicators, such as the peak value in GnRH stimulation tests, highlighting an urgent need to establish specific diagnostic criteria for obese children. Intervention research shows a trend of diversified exploration, ranging from lifestyle interventions and natural product extracts to novel drug targets. Future studies should further integrate multi-omics technologies to delve into the molecular mechanisms by which obesity leads to precocious puberty and conduct large-scale randomized controlled clinical trials to validate the effectiveness of intervention measures.