Objective: To evaluate metabolic syndrome parameters in children with premature adrenarche (PA) during presentation in prepuberty and afterwards in puberty.
Methods: 54 (48 femals, six males) patients (mean age 12.5±2.4 years) diagnosed with PA and followed until puberty were included in our study; as the control group 28(22 females, six males) (age, sex, puberty matched) healthy children (mean age 13.5±2.2 years) were taken. CAH was ruled out in all PA children. Anthropometric measurements, lipid levels, hormonal parameters, adipocytokines (adiponectin, leptin, ghrelin, visfatin, resistin, RBP-4, TNF-α, IL-6) were evaluated and OGTT was done. Pelvic US (female) and Carotid Doppler US were performed in all patients. Different indices for insulin resistance (IR) were calculated. In PA children, prepubertal and pubertal results and also pubertal PA and control cases were compared.
Results: In PA cases; onset of adrenarche was 7.0±0.9 years, onset of puberty was 9.7±0.8 in girls, 10.7±0.9 in boys and menarcheal age was 11.8±0.9 years. Mean BMI SDS was normal in PA at presentation and in puberty but was significantly higher than the controls. Waist circumference (WC) SDS was significantly higher in pubertal PA than the controls. IR parameters were higher in puberty in PA than in prepuberty and higher than the controls. At first presentation, 25.9% of the patients had IR and 15.4% had dyslipidemia; during the study 63% had IR, 11.1% had impaired glucose tolerance, 3.7% had diabetes, 27.5% had dyslipidemia and PCOS was present in 33.3%. Lipid profiles, except for cholesterol, and adipocytokine levels were similar between the groups. Carotid Intima-media thickness was positively correlated with BMI SDS (r=0.281; P=0.043) and WC (r=0.287; P=0.043). The most important factors for the development of IR in pubertal PA were WC SDS, birth weight and exaggerated adrenarche.
Conclusion: Hyperinsulinaemia is common in children with PA in prepuberty and increases with age especially with increasing BMI, even within normal ranges, and WC.
Funding: This work was supported by Scientific Research Projects: Istanbul University (42752).
01 Oct 2015 - 03 Oct 2015