MKRN3 mutations represent the most common genetic cause of central precocious puberty (CPP) but associations between genotype and clinical features have not been extensively explored. This systematic review and meta-analysis investigated genotype-phenotype associations and prevalence of MKRN3 mutations in CPP. The search was conducted in seven electronic databases (Cochrane, EMBASE, LILACS, LIVIVO, PubMed, Scopus, and Web of Science) for articles published until 4 September 2018. Studies evaluating MKRN3 mutations in patients with CPP were considered eligible. A total of 22 studies, studying 880 subjects with CPP, fulfilled the inclusion criteria. Eighty-nine subjects (76 girls) were identified as harboring MKRN3 mutations. Girls, compared with boys, exhibited earlier age at pubertal onset (median, 6.0 years; range, 3.0 to 7.0 vs 8.5 years; range, 5.9 to 9.0; P < 0.001), and higher basal FSH levels (median, 4.3 IU/L; range, 0.7 to 13.94 IU/L vs 2.45 IU/L; range, 0.8 to 13.70 IU/L; P = 0.003), and bone age advancement ( Δ BA; median, 2.3 years; range, −0.9 to 5.2 vs 1.2 years; range, 0.0 to 2.3; P = 0.01). Additional dysmorphisms were uncommon. A total of 14 studies evaluating 857 patients were included for quantitative analysis, with a pooled overall mutation prevalence of 9.0% (95% CI, 0.04 to 0.15). Subgroup analysis showed that prevalence estimates were higher in males, familial cases, and in non-Asian countries. In conclusion, MKRN3 mutations are associated with nonsyndromic CPP and manifest in a sex-dimorphic manner, with girls being affected earlier. They represent a common cause of CPP in western countries, especially in boys and familial cases.

O sistema endocrinológico vitamina D é constituído por um grupo de moléculas secosteroides derivadas do 7-deidrocolesterol, incluindo a forma ativa 1,25-diidroxi-vitamina D (1,25(OH)2D), seus precursores e metabólitos, sua proteína transportadora (DBP), seu receptor nuclear (VDR) e as enzimas do complexo do citocromo P450 envolvidas nos processos de ativação e inativação dessas moléculas. Os efeitos biológicos da 1,25(OH)2D são mediados pelo VDR, um fator de transcrição ativado por ligante, presente em quase todas as células humanas, e que pertence à família de receptores nucleares. Além dos clássicos papéis de reguladora do metabolismo do cálcio e da saúde óssea, as evidências sugerem que a 1,25(OH)2D module direta ou indiretamente cerca de 3% do genoma humano, participando do controle de funções essenciais à manutenção da homeostase sistêmica, tais como crescimento, diferenciação e apoptose celular, regulação dos sistemas imunológico, cardiovascular e musculoesquelético, e no metabolismo da insulina. Pela influência crítica que esse sistema exerce em vários processos do equilíbrio metabólico sistêmico, é importante que os ensaios laboratoriais utilizados para sua avaliação apresentem alta acurácia e reprodutibilidade, permitindo que sejam estabelecidos pontos de corte que, além de serem consensualmente aceitos, expressem adequadamente o grau de reserva de vitamina D do organismo e reflitam os respectivos impactos clínico-metabólicos na saúde global do indivíduo.

This distinctive phenotype can only be explained by the combined deficiency of functionally important selenoproteins and pinpoints the clinical relevance of selenoproteins and selenium economy in human development.

Children with OI presented cortical bone alterations after PAM treatment. Both MCW and the FD of the cortical bone were higher in children with OI after PAM treatment. It is argued that cortical bone should be considered for analyzing patients with OI, as well as to monitor the progress of PAM treatment.