Introduction: There seems to be an undoubting, but still puzzling, relationship between obesity and premature adrenarche (PA).
Aim: To characterize a population of prepubertal girls with PA and to compare girls with a normal body mass index (BMI) with girls who are overweight or obese, in what regards gestational age and birth weight, age at the referral, clinical signs, anthropometry, bone age and hormone profile.
Methods: Cross sectional study that included 83 Caucasian prepubertal girls, with a mean age of 7.2±1.2 years, who were followed in the Pediatric Endocrinology outpatient clinic of a university hospital in Portugal because of PA.
Data regarding gestational age and birth weight were collected from the child's health card. Parents' height and maternal age at menarche were self-reported. Clinical files were also reviewed. All subjects included in the study underwent anthropometric and clinic evaluation by a trained observer. All of them underwent bone age evaluation (Greulich Pyle comparative method) and blood collection for DHEAS, androstenedione, total testosterone and 17-hydroxyprogesterone.
Girls were then divided in two groups, according to their BMI SD (World Health Organization criteria): 1) normal BMI (BMI≤+1 SD) (n=33); 2) overweight/obese (BMI >1SD) (n=50).
Results: Overweight or obese girls with PA had a slightly higher birth weight than normal-BMI PA girls (3075±545 vs 2707±834 grams; P=0.024; -0.05±0-8 vs -0.64±1.0 SD according to Fenton growth charts; P=0.005). No difference was found regarding gestational age, age of pubarche or maternal age at menarche.
Overweight or obese PA girls were taller (height SD 1.3±1.0 vs 0.4±1.1; P=0.008) and had a higher difference between height SD and target height SD (1.3±0.8 vs 0.6±1.1; P=0.006). No statistically significant differences were found in growth velocity or bone age advancement between groups.
Overweight or obese PA girls had higher levels of median total testosterone (0.045 vs 0 ng/mL; P=0.015) and median basal 17-hydroxyprogesterone (1.1 vs 1.0 ng/dL; P=0.041). No difference was found in DHEAS or androstenedione levels.
Conclusion: When compared with their normal-BMI PA peers, PA girls that are overweight or obese at prepuberty present higher levels of total testosterone and 17-hydroxyprogesterone. Therefore, we believe that obesity is a risk factor for hyperandrogenism since prepubertal years.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology