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Abstract
More than two decades of clinical studies have provided us with the opportunity to develop and implement criteria that distinguish three phases during pre-menarche ,paralleling rising levels of estrogens, namely 'pre-estrogenization' ,'onset of estrogenization' and 'full estrogenization'. The aim of this study was to examine the relationships between somatic features and levels of leptin ,neuropeptide Y (NPY) ,β-endorphin ,gonadotropin and estradiol in pubertal girls before menarche. Weight ,height ,body mass index (BMI) ,tertiary sex features ,estrogen-related changes in hymen ,fat and lean body mass were studied on a quarterly basis in 45 girls. At the same time ,ovarian and uterine dimensions were established sonographically and serum was obtained for the determination of leptin ,NPY ,β-endorphin, gonadotropin ,and estradiol levels. Onset of estrogenization in girls was marked by weight loss ,followed by an increase in total ,fat and lean body mass ,and pubertal acceleration of growth. At the time of full estrogenization ,lower NPY and β-endorphin levels were observed ,accompanied by an increase in gonadotropin secretion. Changes in leptin levels are consistent with a role of this hormone in metabolic signaling.