ESPE Abstracts

Background: Premature pubarche is the appearance of pubic hair before 8 years in girls and 9 years in boys, being more frequent in girls. Current literature demonstrates associations between premature pubarche and metabolic and cardiovascular diseases.

Objective and hypotheses: To evaluate the frequency of cardiovascular disease risk factors in girls with isolated premature pubarche (IPP).

Method: Observational study using data from medical records of 41 girls with IPP aged 2–19 years attended at the Paediatric Outpatients Clinic of the University of Blumenau between 1999 and 2013. Excess weight (overweight and obesity according WHO criteria), blood pressure, low birth weight (<2.500 g), bone age (Greylich and Pyle), dyslipidaemia (total cholesterol >150 mg/dl or LDL-c >100 mg/dl or HDL-c <45 mg/dl or TGL >100 mg/dl), basal blood androgens levels (17-OH-progesterone, androstenedione, DHEA-S, and total testosterone), hyperinsulinism (basal insulin >15 mUI/l) and insulin resistance (HOMAR-IR >3.16) were analysed. The appearance of pubarche before 8 years without breast development was considered IPP. In the presence of advanced bone age (>1 year) and elevated basal blood androgens levels an adrenal stimulation test with exogenous ACTH was performed to ruled out congenital adrenal hyperplasia.

Results: The mean age at the first medical evaluation was 7.8±1.4 years. Excess weight was present in 42.1% (26.3% overweight and 15.8% obesity), elevated blood pressure in 17.3% and dyslipidaemia in 45.8%. Hyperinsulinism and insulin resistance were not observed. Nevertheless, the group with excess weight showed fasting insulin levels higher than excess weight group (7.3±4.2 vs 4.3±2.8; P<0.05). Bone age was advanced in 81.8%. Basal blood levels of 17-OH-progesterone, androstenedione, DHEA-S, and total testosterone were elevated in 48.6, 35.1, 32.4, and 37.2% respectively. Low birth weight ocurred in 13.1%.

Conclusions: Excess weight and dyslipidaemia were the most frequent cardiovascular disease risk factors observed. Almost 50% of the girls presented these clinical conditions.