Profiles of puberty markers in relation to clinical pubertal development in representative cohorts of healthy lean and obese children

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 596-621-Pediatric Endocrinology /Steroids and Puberty
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-607
Antje Körner*1, Roland Pfäffle1, Kathrin Dittrich1, Madlen Neef1, Antje Berthold1, Isabel Wagner1, Wieland Kiess1 and Jürgen Kratzsch2
1University of Leipzig, Dept. of Women´s & Child Health, Leipzig, Germany, 2Univ of Leipzig, Instit of Lab, Germany
Rationale: We aimed for a detailed investigation of dynamics in puberty and fertility markers and to provide reference ranges in relation to pubertal development for normal healthy children and adolescents. Considering that obesity may be accompanied by precipitated pubertal development and derangement in sex steroid balance, we compared sex steroid profiles between lean and obese children.

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

*Please take note of The Endocrine Society's News Embargo Policy at

Sources of Research Support: German Research Council DFG, KFO 152 “Atherobesity” (KO3512-1), IFB AdiposityDiseases ADI K7-10 to A.K. Laboratory analyses were performed and supported by Roche Diagnostics.