The association between skeletal maturation and adrenal androgen levels in obese children and adolescents
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Purpose: This study aimed to investigate the association between skeletal maturation and adrenal androgen levels in obese children and adolescents. Methods: Fifty-three children and adolescents (aged 7–15 years) diagnosed as obese or overweight were investigated. Anthropometric measurements, bone age (BA) determination, serum biochemical analyses, and hormonal measurements were performed. The difference between BA and chronological age (BA–CA, dBACA) was calculated and used to represent the degree of advanced skeletal maturation. Results: Thirty-one subjects were classified into the obese group and 22 subjects into the overweight group. Insulin resistance as calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly higher in the obese group than in the overweight group (4.03±2.20 vs. 2.86±1.11, P=0.026). The skeletal maturation of the obese group was advanced, but the dBACA did not differ between the obese and overweight groups statistically (1.43±1.35 vs. 0.91±1.15, P=0.141). Serum dehydroepiandrosterone sulfate (DHEA-S) levels were significantly higher in subjects with dBACA>1 compared to those with dBACA≤1 (104.3±62.2 vs. 59.6±61.0, P=0.014). Correlation analyses demonstrated that dBACA was positively correlated with body mass index standard deviation scores (r=0.35, P=0.010), fasting insulin (r=0.36, P=0.009), HOMA-IR (r=0.30, P=0.031), and insulin-like growth factorbinding protein-3 (r=0.331, P=0.028). In multivariate linear regression analysis, HOMA-IR (P=0.026) and serum DHEA-S (P=0.032) were positively correlated with the degree of advanced skeletal maturation. Conclusion: Advanced skeletal maturation is associated with increased insulin resistance and elevated DHEA-S levels in obese children and adolescents.
Abstract
Purpose: This study aimed to investigate the association between skeletal maturation and adrenal androgen levels in obese children and adolescents. Methods: Fifty-three children and adolescents (aged 7–15 years) diagnosed as obese or overweight were investigated. Anthropometric measurements, bone age (BA) determination, serum biochemical analyses, and hormonal measurements were performed. The difference between BA and chronological age (BA–CA, dBACA) was calculated and used to represent the degree of advanced skeletal maturation. Results: Thirty-one subjects were classified into the obese group and 22 subjects into the overweight group. Insulin resistance as calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) was significantly higher in the obese group than in the overweight group (4.03±2.20 vs. 2.86±1.11, P=0.026). The skeletal maturation of the obese group was advanced, but the dBACA did not differ between the obese and overweight groups statistically (1.43±1.35 vs. 0.91±1.15, P=0.141). Serum dehydroepiandrosterone sulfate (DHEA-S) levels were significantly higher in subjects with dBACA>1 compared to those with dBACA≤1 (104.3±62.2 vs. 59.6±61.0, P=0.014). Correlation analyses demonstrated that dBACA was positively correlated with body mass index standard deviation scores (r=0.35, P=0.010), fasting insulin (r=0.36, P=0.009), HOMA-IR (r=0.30, P=0.031), and insulin-like growth factorbinding protein-3 (r=0.331, P=0.028). In multivariate linear regression analysis, HOMA-IR (P=0.026) and serum DHEA-S (P=0.032) were positively correlated with the degree of advanced skeletal maturation. Conclusion: Advanced skeletal maturation is associated with increased insulin resistance and elevated DHEA-S levels in obese children and adolescents.
참고문헌 (40)
- Daniels SR., "Complications of obesity in children and adolescents", Int J Obes (Lond), 33(Suppl 1), pp.S60~S65 (2009)
- Wabitsch M, "Overweight and obesity in European children: definition and diagnostic procedures, risk factors and consequences for later health outcome", Eur J Pediatr, 159(Suppl 1), pp.S8~S13 (2000)
- Aksglaede L, "Age at puberty and the emerging obesity epidemic", PLoS One, 4, pp.e8450~ (2009)
- Denzer C, "Pubertal development in obese children and adolescents", Int J Obes (Lond), 31, pp.1509~1519 (2007)
- Kleber M, "Obesity in children and adolescents: relationship to growth, pubarche, menarche, and voice break", J Pediatr Endocrinol Metab, 24, pp.125~130 (2011)
- Johnson W, "Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults", Int J Obes (Lond), 36, pp.535~541 (2012)
- Reinehr T, "Relationships of IGF-I and andrrogens to skeletal maturation in obese children and adolescents", J Pediatr Endocrinol Metab, 19, pp.1133~1140 (2006)
- Phillip M, "Growth without growth hormone", J Pediatr Endocrinol Metab, 15(Suppl 5), pp.1267~1272 (2002)
- Klein KO, "Effect of obesity on estradiol level, and its relationship to leptin, bone maturation, and bone mineral density in children", J Clin Endocrinol Metab, 83, pp.3469~3475 (1998)
- Reinehr T, "Cortisol and its relation to insulin resistance before and after weight loss in obese children", Horm Res, 62, pp.107~112 (2004)
- Björntorp P, "Neuroendocrine abnormalities in visceral obesity", Int J Obes Relat Metab Disord, 24(Suppl 2), pp.s80~s85 (2000)
- Reinehr T, "Androgens before and after weight loss in obese children", J Clin Endocrinol Metab, 90, pp.5588~5595 (2005)
- Sopher AB, "Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors", Obesity (Silver Spring), 19, pp.1259~1264 (2011)
- 문진수, "2007 한국 소아 청소년 성장도표 : 개발 과정과 전망", Korean Journal of Pediatrics, 51(1), pp.1~25 (2008), 대한소아과학회
- Garibaldi LR, "Nelson textbook of pediatrics", pp.2656~2662 (2016), Elsevier Saunders
- Marshall WA, "Variations in pattern of pubertal changes in girls", Arch Dis Child, 44, pp.291~303 (1969)
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)
- American Diabetes Association, "Management of dyslipidemia in children and adolescents with diabetes", Diabetes Care, 26, pp.2194~2197 (2003)
- Valerio G, "Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy", Nutr Metab Cardiovasc Dis, 16, pp.279~284 (2006)
- Greulich WW, "Radiographic atlas of skeletal development of the hand and wrist" (1959), Stanford University Press
- Russell DL, "The relation between skeletal maturation and adiposity in African American and Caucasian children", J Pediatr, 139, pp.844~848 (2001)
- Gascón F, "Sex hormone-binding globulin as a marker for hyperinsulinemia and", or insulin resistance in obese children, 2000, pp.143, 85~89
- Pintor C, "Adrenal androgens in obese boys before and after weight loss", Horm Metab Res, 16, pp.544~548 (1984)
- Silfen ME, "Early endocrine, metabolic, and sonographic characteristics of polycystic ovary syndrome (PCOS): comparison between nonobese and obese adolescents", J Clin Endocrinol Metab, 88, pp.4682~4688 (2003)
- Schlechter NL, "Evidence suggesting that the direct growth-promoting effect of growth hormone on cartilage in vivo is mediated by local production of somatomedin", Proc Natl Acad Sci U S A, 83, pp.7932~7934 (1986)
- Sjögren K, "Liver-derived insulin-like growth factor I (IGF-I) is the principal source of IGF-I in blood but is not required for postnatal body growth in mice", Proc Natl Acad Sci U S A, 96, pp.7088~7092 (1999)
- Wabitsch M, "Insulin-like growth factors and their binding proteins before and after weight loss and their associations with hormonal and metabolic parameters in obese adolescent girls", Int J Obes Relat Metab Disord, 20, pp.1073~1080 (1996)
- Wabitsch M, "The role of growth hormone", insulin-like growth factors in adipocyte differentiation, 1995, pp.44(10 Suppl 4), 45~49
- Harris DA, "Somatomedin-C in normal puberty and in true precocious puberty before and after treatment with a potent luteinizing hormone-releasing hormone agonist", J Clin Endocrinol Metab, 61, pp.152~159 (1985)
- Grumbach MM, "Williams textbook of endocrinology", pp.1115~1286 (2003), Saunders
- Savage MO, "Clinical features and endocrine status in patients with growth hormone insensitivity (Laron syndrome)", J Clin Endocrinol Metab, 77, pp.1465~1471 (1993)
- Remer T, "Role of nutritional status in the regulation of adrenarche", J Clin Endocrinol Metab, 84, pp.3936~3944 (1999)
- l'Allemand D, "Associations between body mass, leptin, IGF-I and circulating adrenal androgens in children with obesity and premature adrenarche", Eur J Endocrinol, 146, pp.537~543 (2002)
- Garn SM, "Nutrition, growth, development, and maturation: findings from the ten-state nutrition survey of 1968-1970", Pediatrics, 56, pp.306~319 (1970)
- Forest MG, "Pathophysiology of puberty", pp.137~155 (1980), Academic Press
- Reinehr T, "Steroid hormone profiles in prepubertal obese children before and after weight loss", J Clin Endocrinol Metab, 98, pp.E1022~E1030 (2013)
- Saenger P, "Premature adrenarche", J Endocrinol Invest, 24, pp.724~733 (2001)
- Biason-Lauber A, "Effect of leptin on CYP17 enzymatic activities in human adrenal cells: new insight in the onset of adrenarche", Endocrinology, 141, pp.1446~1454 (2000)
- Gingras S, "Multiple signal transduction pathways mediate interleukin-4-induced 3betahydroxysteroid dehydrogenase", Delta5-Delta4 isomerase in normal and tumoral target tissues, 2001, pp.76, 213~225
- Reinehr T, "Irisin and its relation to insulin resistance and puberty in obese children: a longitudinal analysis", J Clin Endocrinol Metab, 100, pp.2123~2130 (2015)
