Early Breast Growth in Girls Aged 6 to 8 Years in the Current Environmental Context (PENELOPE)

Early Breast Growth in Girls Aged 6 to 8 Years in the Current Environmental Context: Clinical and Biological Parameters, Level of Impregnation With Endocrine Disruptors and Evaluation of the Impact of Environmental Health Measures

Various studies show an increase in the number of cases of early puberty in girls with breast development with a variable clinical presentation and evolution. This increasing phenomenon concerns girls between 6 and 8 years old. In a large number of cases, from 70 to 95% depending on the series, no medical cause is found and environmental factors are suspected to be involved. Descriptive studies of these patients are scarce and not always provide an overview of all the parameters in line with the concept of the exposome. The PENELOPE clinical trial will allow to analyze a large number of parameters, including the adipose tissue, its metabolism, the endocrine disruptors, and the epigenetic modifications, and to study the impact of environmental health measures in the evolution of these parameters. The data from the analyses of the endocrine disruptors of the patients will be explored in parallel in experimental models (amphibians, murine, cellular) in order to test potential mechanistic hypotheses.

Girls aged 6 to 8 years old with breast flare (isolated or not) and scheduled for pediatric day hospital stay

Magnetic Resonance Imaging (MRI), Blood tests, Determination of endocrine disruptors in hair, Urine tests, Bone age x ray

MRI will be used to confirm the presence of breast buds, to measure the size of the ovaries and uterus, as well as the fraction of fat mass (abdominal, subcutaneous, liver and bone marrow). The bood and urine tests will allow to measure different biological and metabolic parameters. The presence of endocrine disruptors will be determined in the hair. The bone age x ray will be estimate the maturity of the child's skeletal system.

This parameter will allow to describe the clinical evolution of breast development after application of environmental health measures

This parameter will allow to describe the clinical evolution of ovaries and uterus after application of environmental health measures

This parameter will allow to describe the clinical evolution of the abdominal fat surface after application of environmental health measures

This parameter will allow to describe the clinical evolution of the weight after application of environmental health measures

This parameter will allow to describe the clinical evolution of the height after application of environmental health measures

This parameter will allow to describe the clinical evolution of the BMI after application of environmental health measures

Describe the evolution of the amount of endocrine disruptors in hair after the implementation of environmental health measures. from 70 to 100 mg of hair will cut as close as possible to the scalp at the posterior vertex, and stored at room temperature to measure endocrine disruptors such as parabens, phthalates, bisphenols and pesticides.

The Tanner scale is a scale of physical development as children transition into adolescence and then adulthood. The scale defines physical measurements of development based on external primary and secondary sex characteristics. Breast: Tanner I: no glandular tissue Tanner II: breast bud forms, areola begins to widen Tanner III: breast begins to become more elevated, and extends beyond the borders of the areola, Tanner IV: increased breast sizing and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast Tanner V: breast reaches final adult size Pubis hair: Tanner I: no pubic hair Tanner II: small amount of long, downy hair Tanner III: hair becomes more coarse and curly, and begins to extend laterally Tanner IV: adult-like hair quality, extending across pubis but sparing medial thighs Tanner V: hair extends to medial surface of the thighs

The dree of severity is determine according to a scale: 1: <30% of the tooth's enamel surface area visibly disrupted, 2: 31 to 49% of the tooth's enamel surface area visibly disrupted, 3: >50% of the tooth's enamel surface area visibly disrupted

Inclusion Criteria: Girls aged 6 to 8 years Presenting a breast development (isolated or not) Undergoing scheduled pediatric day hospital care (HDJ) Who agree to participate in the study Whose parents agree to their child's participation in the study French speaking Whose parents speak French Affiliated to social security Exclusion Criteria: Organic brain causes of precocious puberty: History of neurocerebral disease (malformations, developmental abnormalities) Organic causes of precocious puberty: Mac Cune Albright syndrome, ovarian cyst or tumor and adrenal hyperplasia History of chemotherapy or radiation therapy Presenting with a communication disorder Pregnancy Persons under protective measures Persons deprived of liberty for judicial or administrative reasons