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Published in: European Journal of Pediatrics 11/2018

01-11-2018 | Original Article

Body mass index at the presentation of premature adrenarche is associated with components of metabolic syndrome at puberty

Authors: Gamze Kaya, Zehra Yavas Abali, Firdevs Bas, Sukran Poyrazoglu, Feyza Darendeliler

Published in: European Journal of Pediatrics | Issue 11/2018

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Abstract

The aim of this study was to analyze the relationship between premature adrenarche (PA) and metabolic syndrome (MeS) parameters at presentation and during puberty. This study comprised 47 girls with PA. Age- and puberty-matched 22 healthy girls without PA were the control group. Patients were evaluated at admission (first evaluation) and later in puberty (second evaluation). Anthropometric measurements, lipid levels, and hormonal parameters were studied and oral glucose tolerance test was performed. Indices for insulin resistance (IR) were calculated. The study group was divided in subgroups according to body mass index (BMI) and compared with the control group. The age of the PA group at first evaluation was 8.0 ± 1.1 years; mean height SDS and BMI SDS were 0.4 ± 1.2 and 0.6 ± 0.9, respectively. Age of PA group at the second evaluation was 12.9 ± 2.4 years. Frequency of obesity and overweight was 14.9 and 23.4%. Dyslipidemia ratio was 28.3%. PA group had significantly higher BMI than controls. Mean insulin concentration was higher and mean glucose and FGIR were lower in PA group and also dyslipidemia ratio was 5.3 times higher in PA than controls (p = 0.040). In PA group, overweight/obese subjects had still higher BMI at second evaluation and also higher fasting glucose, insulin, HOMA-IR. However, PA children with exaggerated DHEAS concentrations compared to those without had similar BMI SDS, insulin sensitivity, and secretion indices and lipid profile at second evaluation. BMI SDS at first evaluation was positively correlated with HOMA-IR at puberty; however, there is no correlation between DHEAS at first evaluation and HOMA-IR at puberty.
Conclusion: BMI at adrenarche is more important than prepubertal adrogen concentrations such as DHEAS, while predicting the IR in puberty. Long-term follow-up of children supports the observation that PA per se may be related to IR; however, the risk increases with obesity.
What is Known:
• Premature adrenarche (PA) is receiving more attention as evidence emerges for a relation between early androgen excess and metabolic syndrome.
• The onset of the adrenal androgen production before 8 years in girls defined as PA. Pubarche, axillary hair, apocrine body odor, acne are typical phenotypic features of PA.
What is New:
• Body mass index at adrenarche is an important risk factor for development of insulin resistance in pubertal ages.
• Degree of dehydroepiandrosterone sulfate elevation was not shown as a risk factor for insulin resistance.
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Metadata
Title
Body mass index at the presentation of premature adrenarche is associated with components of metabolic syndrome at puberty
Authors
Gamze Kaya
Zehra Yavas Abali
Firdevs Bas
Sukran Poyrazoglu
Feyza Darendeliler
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics / Issue 11/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-018-3211-1

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