Background: Childhood obesity is associated with advanced bone age (BA), leading to an altered growth pattern. Previous results of studies suggest that androgens, estrogens, sex hormone binding globulin (SHBG) and insulin are responsible for this phenomenon, but results are contradictory and might be biased by confounders.
Objective and hypotheses: To investigate the independent effects of estrogens, androgens, SHBG and insulin parameters on BA advancement in children and adolescents with obesity.
Method: We performed a correlation analysis of BA standard deviation score (SDS) with androgens, oestrogens and indicators of insulin secretion derived from oral glucose tolerance testing, in a group of obese children and in subgroups according to sex and pubertal status. For oestradiol, testosterone, SHBG and dihydroepiandrosterone sulphate (DHEAS) we calculated age and sex specific SDS. A multivariate analysis was performed to investigate which parameters were independently predictive of BA SDS.
Results: In this cohort (n=101; 47% female; 56% pubertal; mean age 10.9 years; mean BA 11.8 years; mean BMI SDS 3.4 kg/m2), BMI SDS was significantly correlated to BA SDS (r=0.55, P<0.001). In a regression analysis in the total cohort (B=0.27, P<0.001), as well as in females (B=0.34, P=0.042), males (B=0.31, P=0.006) and pubertal children (B=0.32, P=0.046), DHEAS showed a positive, independent association with BA SDS. In prepubertal children, SHBG showed an independent negative association with BA SDS (B=−0.41, P=0.013). No association with insulin, insulin resistance or insulin secretion was found.
Conclusion: Increased DHEAS has a central role in advanced BA in obese children.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology