Session: SAT 596-621-Pediatric Endocrinology /Steroids and Puberty
Poster Board SAT-607
Methods: We analyzed puberty markers in a cohort of 3000 children and adolescents aged 1.3 to 20.0 years with anthropometric and pubertal stage assessed by pediatricians. The cohort included 2332 children form a representative Caucasian pediatric population and 668 obese children. After exclusion of syndromal disease, contraceptional medication, extremes of BMI, and precocious/retarded pubertal development, we determined estradiol, progesterone, testosterone, LH, FSH, DHEAS, SHBG and prolactin by immunoassay in the remaining 2915 probands.
Results: In our representative normal cohorts, we saw an expected highly significant correlation of all hormonal markers with age and pubertal stage. Investigating the dynamics of parameters with pubertal development in depth revealed DHEAS was very similar between boys and girls. Besides sex specific differences in incremental increases for estradiol and testosterone, progesterone was very similar in absolute levels and slope during entire pubertal development in boys and girls. Boys had lower FSH levels at the beginning of puberty, but catched up with girls at pubertal stage 4. For LH we observed the most distinct increase with pubertal onset in boys and girls. Prolactin increased with puberty particularly in girls, while SHBG decreased with age more pronouncedly in boys.
Compared to normal lean children, DHEAS, progesterone and estradiol are pronouncedly lower in obese children, while SHBG, testosterone and in girls estradiol are higher. SHBG and albumin showed strongest correlations with BMI SDS in girls (r=-0.62, P<0.001) and boys (r=-0.54, P<0.001), and hence differences in free testosterone index were most evident between lean and obese children. The gonadotropins LH and FSH did not show clear differences between obese and lean children.
Conclusion: We provide reference ranges and describe dynamics for major puberty and fertility markers for normal, healthy children and adolescents across all pubertal stages. Obesity is accompanied by deranged peripheral sex steroid profiles.
Disclosure: AK: Clinical Researcher, Roche Diagnostics. Nothing to Disclose: RP, KD, MN, AB, IW, WK, JK
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