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Estrogenic mycotoxins linked to precocious puberty in girls

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Central precocious puberty development in girls may be triggered by mycoestrogenic zearalenone, a potent estrogenic metabolite, according to study results recently published in The Journal of Pediatrics.

Researchers from the University of Pisa in Italy analyzed serum mycoestrogen contamination in 32 girls affected by central precocious puberty and 31 controls to determine whether or not environmental estrogen exposure can advance human puberty timing. Those with central precocious puberty were assigned triptorelin for longer than 12 months post-diagnosis.

Six girls were contaminated with increased serum levels of zearalenone (933.7±200.3 pg/mL; 95% CI, 723.5-1,143.9) and its counterpart a-zearalenol (106.5±1.9 pg/mL; 95% CI, 104.5-108.5).

During the 12-month treatment, mycotoxin-positive patients had greater height (P<.01), weight (P<.01) and height velocity (P<.05) than those mycotoxin-negative patients. In both mycotoxin-positive and mycotoxin-negative patients, height correlated with weight (P<.001).

Due to its resemblance to anabolic growth agents used in animal breeding, zearalenone may support faster growth in exposed patients, the researchers concluded. – by Stacey L. Adams

J Pediatr. 2007; doi:10.1016/j.jpeds.2007.10.020.

There is a fair amount of mechanistic data in the animal literature suggesting that endocrine disruptors alter pubertal progression. They also suggest that they alter risk for obesity, and they may even alter neurocognitive development, so this is a big issue. The problem is that all of the data in humans is cross-sectional, like this study. This makes it somewhat difficult to determine whether or not there is really causation here, or whether it is sort of going along for the ride. Because the human data is not mechanistic or prospective, it is subject to ambiguity. These endocrine disruptors are usually lipid soluble, so simply having higher plasma volume could be more of a reflection of adiposity than it is a cause of puberty. The role of endocrine disruptors in human disease is definitely cause for alarm and concern; unfortunately, this paper does not add to or alleviate any of those concerns.

– Robert Lustig, MD

Professor of Clinical Pediatrics, Division of Endocrinology at the University of California, San Francisco