ESPE Abstracts

Introduction: Endocrino disruptors (EDs) are substances that interfere with hormonal function. The long list of EDs includes multiple natural compounds and numerous synthetic chemicals such as bisphenol A (BPA). BPA is present in plastics used in common products (Packaging, bottles, toys, digital media, etc). Several studies have shown its ability to alter the regulation of developmentally relevant genes, inhibit the synthesis of sex hormones and induce the proliferation of cancer cells in sex organs. In addition, the environmental exposure is associated with reproductive and behavioral abnormalities.

Objectives: To determine the urinary concentration of BPA (UBPA) in children between 5 and 12 years with variants of puberty (PP) or gynecomastia. To assess a possible association between the presence of elevated UBPA levels and the clinic studied.

Material and Methods: We randomly studied 35 children who consulted for PP variants and/or gynecomastia in a Pediatric Endocrinology Section (03/2020-06/2021). UBPA was determined in the first morning urine using the solid-phase extraction as a method of sample preparation, gas chromatography to separate compounds, and mass spectrometry for the UBPA detection and quantification. Hormonal studies and tumour markers were also carried out. Personal and family history and clinical manifestations were collected. The hospital ethics committee approved this study and participants and their legal representatives signed informed consent.

Results: 31 UBPA determinations of the 35 initially recruited patients (19 girls and 12 boys) were validated: 6 children with gynecomastia and 25 cases with PP variants [pubarche (12), thelarche (8), early puberty (2), adrenarche (1), menarche (1) and true PP (1)]. Only one child with gynecomastia reported regular use of a possible hormone disruptor (tea tree). Hormonal results were normal in all cases except in a 7-year-old girl with true PP. In two cases (6.5%) the levels of UBPA were elevated (gynecomastia and early puberty in a girl). No relationship was found between the UBPA levels and diagnosis or hormonal variables. No association was found between UBPA levels and home area or personal background.

Comments: The small sample size does not allow us to establish associations between UBPA and variants of PP and/or gynecomastia, but the extrapolation of 6.5% of children exposed to the general population may be significant. The high presence of EDs in our environment requires large and well-designed studies to assess its exposure and consequences in the pediatric age group.