"The Frequency of the Delay of Puberty and Various Developmental Disorders in Adolescents in Namangan and Jizzakh Regions of the Republic of Uzbekistan on the Data of Screening in 2021 Year"

Mavlonov UKh1, Urmanova Yu M2*, Aliyeva DA3 and Dalimova GA4 1Bukhara Regional Endocrinological Dispensary, RUZ, Bukhara 2Department of Endocrinology, Tashkent Pediatric Medical Institute, RUZ, Tashkent, Mirzo-Ulugbek 3Department of Neuroendocrinology, Acad. Yosh. Turakulova, RUZ, Tashkent, Mirzo-Ulugbek 4Endocrinology Department of the RSNPMC Endocrinology, Acad. Yosh. Turakulova, RUZ, Tashkent, Mirzo-Ulugbek


Introduction
The Delay of Puberty (DP) implies the absence of secondary sexual signs and relevant physical changes in boys and girls aged 14 years. The delay in sexual development in the boys implies the lack of an increase in the testicular volume (<4 ml) and if the length of the testicles do not reach 2.5 cm (<4 ml) at the age of 15 years. The main signs of the delay of sexual development in girls is the lack of Telarche and Adrenarche by the 13 years and the absence of Menarche by 15 years [1][2][3]. In accordance with the ICD-10, the delay of sexual development is highlighted as an independent endocrine disease. DP is one of the actual problems of endocrinology. Even though the frequency of the recovery of the DP among both sexes is the same, but boys are more often treated with complaints: 9: 1 [4,5]. At the same time, in modern literature there is not enough data in this area, there are no work and fully dedicated to the epidemiology of various forms of DP in boys and girls. There are many publications on separate only issues. There are no multicenter studies of DP in boys and girls in any foreign literature, nor in the near abroad over the past few decade.
According to the researchers, the frequency of the DP is from 0.4% to 9.8%, and over the past decades its increase is noted.
Such a variation of the frequency of the DP is associated with the lack of clear criteria for the age limits of the puberty and possible hyperdiagnosis. The role of the thyroid gland in the regulation of the reproductive function is clearly visible both in the norm and especially with its functional disorders by type of hyper and hypothyroidism. The excess T3 and T4 leads to an increase in the LH, suppressing the hormone ovulatory peak, the lack of lutein phase, the disorders of the menstrual cycle and infertility. With a shortage of thyroid hormones, the biosynthesis of FSH and LH decreases, the function of the genital glands is oppressed with all further manifestations of their insufficiency [6][7][8][9][10][11][12][13][14][15][16][17]. According to WHO estimates, about two billion people are at risk of iodine deficiency in the sense that these people get an insufficient amount of iodine with food and water, thus undergoing risk of developing diseases affecting the liberation of "brakes" of puberty may occur in several age windows between the fetus life and sexual ripening [11,13].
All of the above served as a reason for the present study.
The Purpose of the Study: is to study the frequency of the delay of Puberty and various developmental disorders in adolescents (boys and girls) in some regions of the Republic of Uzbekistan.

Material and Methods
We have been examined and surveyed in the framework of screening from all over the period from January 1, 2021 to April 1,

Results
An examination of 1023 adolescents contributed to the diagnosis of various forms of delay and violations of sexual development. Table 1 shows the distribution of inspected adolescents by age -the stages of Puberty by J. Tanner. In the history of inspected adolescents, there were many different risk factors, among which the leading place occupies neuroinfection, then viral hepatitis and in third place in frequency -chickenpox. Table 2 shows the frequency of the delays of puberty and various developmental disorders among 1023 adolescents. As can be seen from Table 2  Note: A -Namangan region, B -Jizzakh region, N is the number of patients in the region, ZP -the number of patients with the DP. Numerator -Boys, denominator -Girls