ESPE Abstracts

Background and aim: Children with premature adrenarche (PA) have often tall stature, advanced bone maturation, and a tendency to be overweight. It has been speculated that PA may lead to unfavourable outcome, including obesity-related metabolic disturbances, but the data on long-term outcome of PA are insufficient. The aim of this work was to describe adult body composition in young females with a history of PA.

Subjects and design: This prospective case-control study included 30 PA and 42 control females who were mostly full-term and appropriate for gestational age -born. They were evaluated first at the median age of 7.6 years¹ and now at 18.1 years. Main outcome measures were body mass index (BMI), fat percentage, lean mass, and bone mineral density (BMD; areal at prepuberty and total body excluding the head at adulthood). Additionally, determinants for parameters of adult body composition were analysed using linear regression models.

Results: When compared to the controls at prepubertal age, the PA females had higher BMI standard deviation score (SDS), fat percentage, and lean mass, but areal BMDs (adjusted for body size) did not differ between the study groups¹. At adulthood, BMI, waist circumference (including waist-to-height and waist-to-hip ratio), and fat percentage were comparable between the study groups, but lean mass (P=0.001) and BMI-adjusted BMD SDS (P=0.008) were higher in the PA than control females. In all females of the present study, higher prepubertal height SDS and serum insulin concentration were determinants for higher adult lean mass and BMD.

Conclusion: PA seems to induce anabolic effects as adiposity-oriented childhood body composition alters during puberty towards higher adult lean mass and BMD. This modulation is mostly determined by advanced childhood growth and higher serum insulin concentrations, rather than adrenal androgen levels.

Reference

1. P, Jääskeläinen J, Saarinen A, Vanninen E, Mäkitie O, Voutilainen R. Body composition and bone mineral density in children with premature adrenarche and the association of LRP5 gene polymorphisms with bone mineral density. J Clin Endocrinol Metab. 2009; 94:4144-51.

Note to reviewers: Adult BMI and waist circumference data (on other aspects than in the present study) are also included in a manuscript which is currently submitted to journal.