Background: Human health might be negatively affected by chemicals named as endocrine disrupters. Researchers showed that phthalates (bis-(2-ethylhexyl) phthalate (DEHP), mono-(2-ethylhexyl) phthalate (MEHP)) and bisphenol A (BPA) have an anti-androgenic and/or estrogenic effects. These endocrine disruptors are accused in occurrence and/or possible increase in unusual early puberty in girls in recent years.
Objective and hypotheses: The aim of this study is to measure urine BPA and plasma phthalate (MEHP and DEHP) levels in girls with idiopathic central puberty precocious (SPP) and peripheral puberty precocious (PPP) and compare them with healthy controls, in order to investigate possible role of them in occurrence of early puberty.
Method: This study was performed in Keçiören Training and Research Hospital, Clinic of Pediatric Endocrinology between August 2012 and July 2013, newly diagnosed SPP and PPP patients and non-obese healthy girls as control group.
Results: SPP, PPP and control groups mean ages were similar, as 7.4±0.61 (6.058.26); 7.4±0.68 (6.098.28), and 7.4±0.68 (6.018.33) years respectively. Basal FSH levels were similar in the SPP and PPP groups and significantly higher than the control group (P<0.0001). Basal LH levels had no significant difference between PPP and control groups (P>0.05). Basal estradiol levels were similar PPP and SPP groups and significantly higher than control group (P<0.0001). SEP group had higher LH levels at 20 and 40 min in LHRH test than PEP group (P<0.0001). At suprapubic pelvic ultrasonography; mean ovarian volume and uterine length of SPP were significantly higher than PPP group (respectively; P=0.007, and 0.0001). Urine BPA levels was measured similarly in SPP, PPP and control groups, within median levels of 10.15 (2.0850.22); 10.60 (2.4655.58), and 10.91 (2.9353.43) μg/g creatinine respectively (P>0.05). Mean plasma DEHP levels in SPP, PPP and control groups were 0.141±0.106 (0.0520.568); 0.110±0.027 (0.0590.188), and 0.095±0.036 (0.0550.166) μg/ml respectively; plasma MEHP levels were 0.207±0.089 (0.0560.397); 0.147±0.088 (0.0610.470), and 0.172±0.147 (0.0500.670) μg/ml respectively. Plasma DEHP and MEHP levels did not differ significantly between PPP and control groups (P>0.05), however in SPP group levels were significantly higher than PPP and control groups (respectively P=0.022 and P=0.018.
Conclusion: Our study showed that phthalates might be possible risk factor in etiology of precocious puberty while BPA effect might be limited impact. But more studies are necessary to confirm this theory.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology