ESPE Abstracts

Context: Premature adrenarche (PA) could pose an increased risk of obesity and metabolic derangements in adolescence and early adulthood. However, little is known about the body composition of children with PA and its association to the development of adverse metabolic outcomes.

Aim: To describe the body composition of children with PA and explore the interaction between PA and metabolic syndrome components.

Methods: This observational study was conducted in a tertiary center. The study group comprised of 88 children with PA (14 males) and 88 consecutive healthy sex- and age- matched subjects with normal growth and puberty served as their controls. Body composition was measured using bioelectrical impedance analysis (BIA, Tanita MC-780 MA and GMON Professional Software), and muscle-to-fat ratio (MFR) z-scores were calculated. The relationship between parent-offspring MFR was assessed using Spearman correlation. Logistic regression model was applied to determine whether MFR z-scores and metabolic syndrome components were associated with PA. The models were adjusted for sex, socioeconomic position index, family history of metabolic syndrome components, perinatal characteristics, and MFR z-scores.

Results: Subjects with PA had a median age [IQR] of 7.95 years [7.3, 8.7] at BIA and mean HOMA-IR of 2.4 ± 1.3. Subjects with PA had higher median BMI z-scores (0.46 [-0.25, 1.23] vs. -0.06 [-0.92, 0.84], P=0.004) and higher median fat percentage (24.9 [21.8, 27.2] vs. 22.3 [20.2, 28.1], P=0.012) compared to controls; with no significant differences in MFR z-scores, blood pressure percentiles and lipid profiles between the groups. In the control group, significant correlations between parents' MFR and offspring's MFR z-scores were observed (father-child: r= 0.549, P=0.015; mother-child: r= 0.410, P=0.010), no significant correlations were found in the PA group. In the logistic regression models, MFR z-score was not significant, however, subjects with PA had higher odds for family history of metabolic syndrome components OR 2.29 [1.19, 4.42], P=0.013; no other significant variables were found.

Conclusions: Our research indicates that pediatric patients with PA exhibit an unfavorable body composition, as evidenced by higher BMI z-scores and fat percentages than healthy matched controls. Additionally, while heritable body composition traits were observed in healthy children, they were not present in those with PA, which suggests that environmental factors play a greater role in this particular group. These findings highlight the importance of early intervention and lifestyle modifications to prevent the development of metabolic complications in children with PA.