ESPE Abstracts

Background: Early timing of puberty is associated with worse cardiometabolic health in adulthood. Furthermore, birth weight (BW) is recognized to have implications for pubertal development and cardiometabolic risk factors. The study aimed to examine the independent association between birth size, dehydroepiandrosterone sulfate (DHEAS) and cardiometabolic risk factors in idiopathic central precocious puberty (ICPP) girls.

Methods: A total of 445 patients with newly diagnosed ICPP were selected and categorized into 80 small (SGA), 311 appropriate (AGA), and 54 large (LGA) for gestational age, according to the BW percentile. Anthropometric measures, sex hormonal levels, DHEAS, insulin-like growth factor 1 (IGF-1), blood pressure, laboratory cardiometabolic profile and a total cardiometabolic risk z-score were recorded. General linear models and logistic regression models were respectively used to evaluate the associations of birth size, DHEAS and cardiometabolic health, by primarily adjustment for age, body mass index standard deviation score (BMI SDS), Tanner stage, preterm delivery, delivery mode as well as feeding patterns in infancy.

Results: SGA showed increased risk of hypo-high density lipoprotein-cholesterolemia (hypo-HDL-C) than AGA (25.0% vs 13.9%, adjusted OR: 2.45, 95%CI: 1.26-4.73). Interestingly, compared with AGA, LGA was associated with a higher cardiometabolic risk z-score (adjusted OR: 2.03, 95% CI: 1.08-4.23), however, no significant difference in terms of non-obesity cardiometabolic risk z-score. Furthermore, LGA was lower in serum triglyceride and triglyceride/high-density lipoprotein cholesterol than AGA (adjusted mean difference standard deviation: -0.39, -0.30). Serum DHEAS was higher in SGA than AGA, which may partly explain the advanced pubic hair growth of SGA (P=0.004). In multiple linear regression, lower BW SDS and higher BMI SDS predicted higher DHEAS. Remarkably, IGF-1 SDS included reduced the magnitude of the BMI SDS effect by 47.6%. In addition, a negative correlation was observed between serum triglyceride and DHEAS independently of BW SDS, BMI SDS and IGF-1 SDS.

Conclusion: ICPP girls born SGA more likely exhibited hypo-HDL-C and born LGA presented with metabolic healthy obesity, characterized by higher BMI SDS with an adequate metabolic profile. Higher DHEAS was not associated with increased cardiometabolic risk excluding the impact of birth size and current state of nutrition in ICPP girls.