ESPE Abstracts (2018) 89 P-P1-021

Higher Dehydroepiandrosterone Levels in Prepubertal Children Born Very Preterm

Veronica Mericqa, Alejandro Martinez-Aguayob, German Iñigueza, Helena Poggib, Ivonne D’Apremontc,d, Rosario Moorec, Monica Arancibiab,e, Hernan Garciab, Soledad Peredof, Claudia Trincadoc, Sofia Sifaquic, Jose Tomas Ossac, Carlos Fardellag, Cristian Carvajalg, Carmen Campinog, Rene Baudrandg, Sandra Solarih & Fidel Allendeh

aInstitute of Maternal and Child Research, University of Chile, Santiago de Chile, Chile; bEndocrinology Unit, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile; cDivision of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago de Chile, Chile; dComplejo Asistencial Hospital Dr. Sotero del Rio, Santiago de Chile, Chile; eServicio de Pediatría, Hospital Higueras, Talcahuano, Chile; fNephrology Unit, Division of Pediatrics, School of Mediien, Pontificia Universidad Católica de Chil, Santiago de Chile, Chile; gEndocrinology Department, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago de Chile, Chile; hDepartment of Clinical Laboratories, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile

Objective: To evaluate the impact of gestational age and birthweight on dehydroepiandrosterone and dehydroepiandrosterone-sulfate (DHEA and DHEA-S) in children born very preterm (VPT) appropriate for gestational age (GA) compared to children born at term (T).

Methods: We recorded anthropometric parameters in 72 VPT (<32 GA) and 41 T (≥ 38 GA) aged 5.0–8.5 years. Birthweight standard deviation scores (BW-SDS) were calculated using INTERGROWTH-21st standards and Body Mass Index (BMI) percentile according to WHO references. Fasting insulin and Insulin-like Growth Factor 1 (IGF-1) were measured by automated immunoassay, and DHEA, DHEA-S and cortisol by mass spectrometry (LC-MS/MS).

Results: (mean and SD): VPT (n=72, females =26, GA =29±2 weeks) and T (n=41, females=23, GA=38±1 week) had similar age (6.6±0.9 vs 6.7±1.0 years; P=0.543), abdominal circumference (58.5±7.4 vs 58.5±7.1 cm; P=0.982), BMI % (59±32 vs 64±29; P=0.476 and BW-SDS (0.4±1.03 vs 0.52±0.72 SDS; P=0.512). In VPT higher DHEA concentrations (6.70±3.97 vs 4.44±2.14 nmol/l; P=0.001) and higher DHEA/cortisol ratios (0.034±0.020 vs 0.023±0.013; P=0.003) were observed compared to T, but not for cortisol (P=0.517) and DHEA-S (P=0.107). When separated by sex, DHEA concentrations and DHEA/cortisol ratio were higher in VPT females than males (6.4±3.2 vs 4.2±1.7 nmol/l, P=0.005, and 0.033±0.014 vs 0.023±0.013, P=0.019, respectively). In VPT males these parameters trended to be higher compared to terms but not statistically different (6.9±3.2 vs 4.7±1.7 nmol/l; P=0.058 and 0.035±0.023 vs 0.023±0.012; P=0.051). GA was inversely associated to DHEA in both sexes (females, r=−0.375; P<0.001, males r=−0.260; P<0.001). This association persisted after controlling by age at the sampling time. On the other hand, no association were observed between DHEA with BW-SDS, BMI percentile, abdominal circumference, Insulin and IGF1.

Conclusions: Higher DHEA concentrations were observed in children who were born very preterm, especially in females, independently of birthweight, chronological age, BMI and abdominal circumference. Lower gestational age could determine a higher activity of the reticulata which could contribute to an earlier pubertal maturation. FONDECYT 1140447 and 1160836.