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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">arthyper</journal-id><journal-title-group><journal-title xml:lang="ru">Артериальная гипертензия</journal-title><trans-title-group xml:lang="en"><trans-title>"Arterial’naya Gipertenziya" ("Arterial Hypertension")</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-419X</issn><issn pub-type="epub">2411-8524</issn><publisher><publisher-name>Antihypertensive League</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18705/1607-419X-2013-19-3-227-236</article-id><article-id custom-type="elpub" pub-id-type="custom">arthyper-141</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛЕКЦИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LECTURE</subject></subj-group></article-categories><title-group><article-title>СТАРТ ПУБЕРТАТА — ИЗВЕСТНОЕ И НОВОЕ</article-title><trans-title-group xml:lang="en"><trans-title>THE TIMING OF PUBERTY: WELL-KNOWN AND NEW ISSUES</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никитина</surname><given-names>И. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikitina</surname><given-names>I. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Никитина И.Л. — Доктор  медицинских наук, заведующая научно-исследовательской лабораторией детской эндокринологии Института эндокринологии ФЦСКЭ им. В.А. Алмазова.</p><p>Контактная информация: ФГБУ «Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова» Министерства здравоохранения Российской Федерации, ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341. Тел.: 8 (931) 224–22–38. E-mail: nikitina0901@gmail.com (Никитина Ирина Леоровна).</p></bio><bio xml:lang="en"><p>Corresponding author: Almazov Federal Heart, Blood and Endocrinology Centre, 2 Akkuratov st., St Petersburg, Russia, 197341. Phone: 8 (931) 224–22–38. E-mail: nikitina0901@gmail.com (Irina L. Nikitina, MD, PhD, the Head of the Research Laboratory of Pediatric Endocrinology at Institution of Endocrinology at Almazov Federal Heart, Blood and Endocrinology Centre).</p></bio><email xlink:type="simple">nikitina0901@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова, Санкт-Петербург</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov Federal Heart, Blood and Endocrinology Centre, St Petersburg</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>28</day><month>06</month><year>2013</year></pub-date><volume>19</volume><issue>3</issue><fpage>227</fpage><lpage>236</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Никитина И.Л., 2013</copyright-statement><copyright-year>2013</copyright-year><copyright-holder xml:lang="ru">Никитина И.Л.</copyright-holder><copyright-holder xml:lang="en">Nikitina I.L.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://htn.almazovcentre.ru/jour/article/view/141">https://htn.almazovcentre.ru/jour/article/view/141</self-uri><abstract><p>Пубертат можно определить как комплекс последовательных биологических событий, реализующихся  прогрессированием половых признаков, или характеристик, имеющих конечной целью формирование  полноценной репродуктивной функции. Известно, что ключевая роль в инициации пубертата у млеко- питающих принадлежит регулирующей функции гипоталамо-гипофизарно-гонадной оси. Многолетние  тренды свидетельствуют о значительном снижении возраста старта пубертата в большей степени у девочек,  в меньшей — у мальчиков. В течение последних десятилетий отмечается более высокая скорость снижения  возраста телархе по сравнению с менархе у девочек, при этом у части из них установлен «гонадотропин- независимый феномен» телархе, обусловленный повышением биодоступности либо чувствительности к  эстрогенам. В целом полученные данные не позволяют изменять референсный диапазон физиологического  старта пубертата. Событием последнего десятилетия является установление иерархической структуры  генов-регуляторов активации гонадостата, последовательная экспрессия которых координирует меж-нейрональные и глиа-нейрональные взаимодействия, имеющие конечной целью повышение импульсной  секреции гонадотропин-рилизинг гормона. Эпигенетические механизмы воздействия (метилирование  ДНК, деацетилирование гистонов) играют значимую роль в транскрипционной активности генов и в  целом определяют пластичность функционирования данной сети. Изучается ключевая роль системы кис- спептинов в регуляции половой дифференцировки мозга, синхронизации процессов полового развития у  подростков и функционирования репродуктивной системы на протяжении всей последующей жизни.</p></abstract><trans-abstract xml:lang="en"><p>Puberty is an important developmental milestone. It can be considered as a complex sequence of biological  events leading to progressive maturation of sexual characteristics ultimately leading to attainment of full  reproductive capacity. The decline in age at puberty in the general population has been paralleled by an increase  in the number of girls referred for evaluation of precocious puberty (PP). The recent pubertal trends have resulted in a concomitant lowering of the lower limit of normality of the pubertal onset. However, evidence suggests that  age at the gonadotropin and sex steroid surges have not changed. Thus, it looks as if an increasing proportion of  contemporary early pubertal girls may experience isolated gonadotropinindependent thelarche rather than central  PP, which may not be discernible on pubertal examination alone. Thus, the population-based limits of normality  srapid progressive PP as well as intracranial and other underlying pathology. The initiation of mammalian puberty  requires an increased pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This  increase is brought about by changes in transsynaptic and glial-neuronal communication. Coordination of these  cellular interactions likely requires the participation of sets of genes hierarchically arranged within functionally  connected networks. The role of kisspeptins in the control of GnRH neurons and the transmission of the regulatory  actions of key signals, such as sex steroids, metabolic hormones and environmental cues, has been recently  studied, point out that the Kiss1 system is an indispensable player of the brain sexual differentiation during early  periods of maturation and the timing of puberty onset.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>пубертат</kwd><kwd>гонадотропин-рилизинг гормон</kwd><kwd>тренды пубертата</kwd><kwd>метилирование ДНК</kwd></kwd-group><kwd-group xml:lang="en"><kwd>кисспептины</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Parent A.S., Teilmann G., Juul A. et al. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration // Endocrinol. 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