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 5.08.5 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.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology