medwireNews: Measures of obesity are significantly associated with increased androgen production in children, even in the absence of physical signs of puberty, researchers report.
“Given recent trends for increasing levels of childhood overweight and obesity, the association between anthropometric measures and androgen levels may lead to increased incidence of early or premature adrenarche and long-term changes in growth and health”, they write in the Archives of Disease in Childhood.
The study from Anne-Lise Goddings (UCL Great Ormond Street Institute of Child Health, London, UK) and colleagues included 1151 children aged 8 or 9 years from the Australian Childhood to Adolescence Transition Study.
The team found that four anthropometric measures – height, weight, BMI and waist circumference – were significantly and positively associated with higher androgen concentrations in this cohort, after accounting for age, sex and socioeconomic status.
Based on BMI standard deviation scores (SDS), 18.6% of girls and 14.6% of boys were overweight, and a corresponding 7.2% and 6.7% were obese.
Salivary levels of testosterone and dehydroepiandrosterone (DHEA) were a respective 27% and 43% higher in the overweight children relative to those with a healthy BMI, whereas DHEA-sulphate (DHEA-S) levels did not significantly differ. Levels of all three androgens were significantly elevated in the obese versus the healthy-weight children, by 39%, 74% and 76%, respectively, and all associations were again independent of age, sex, and socioeconomic status.
Likewise, BMI SDS significantly increased across rising tertiles of androgen levels, with 51.3% of obese children being in the highest tertile, compared with 24.1% of non-obese participants.
“The 9% of participants who were overweight or obese and in the high androgen group could represent a group with potentially high future cardiometabolic risk”, say the researchers.
“Previous studies have shown that children with premature adrenarche and raised DHEA-S have raised cardiometabolic risk markers, but that this association may be explained by raised BMI, emphasising that this group of young people may be particularly suitable for targeted interventions to manage weight gain and obesity.”
Only 19.1% of girls and 7.9% of boys had parent-reported physical signs of puberty, and these children were, on the whole, more likely to be in the top androgen tertiles.
“Using a large, community-based population, this study emphasises that there is an association between body composition and circulating levels of adrenarcheal hormones, even in the absence of perceived physical markers of adrenarche”, the researchers conclude.
By Eleanor McDermid
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Arch Dis Child 2021; doi:10.1136/archdischild-2020-319341