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Early pubarche in girls associated with increased left ventricular mass
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Girls with signs of precocious pubarche were more likely to have an increase in left ventricular mass associated with androgens, total body fat and insulin resistance than their healthy peers, according to research in Clinical Endocrinology.
“The [left ventricular mass] increase, which may represent early adverse cardiac remodeling, was associated with androgens, [insulin resistance] and adiposity in the [precocious pubarche] group,” Fabíola Satler, of the division of endocrinology at Hospital de Clinicas de Porto Alegre, Brazil, and colleagues wrote. “This important finding sheds light on the presence of potential risk factors for cardiovascular disease starting in childhood.”
Satler and colleagues analyzed data from 35 girls aged 5 to 15 years referred to the outpatient gynecologic endocrinology clinic at the Hospital de Clinicas de Porto Alegre between January 2010 and June 2014 for precocious pubarche (mean age, 10 years; 26 white; mean age at pubarche, 5.8 years; Tanner hair stage, 3.49), along with 35 healthy, age-matched controls (mean age, 10 years; 23 white; mean age at pubarche, 9.9 years; Tanner hair stage, 2.03). Researchers measured BMI, waist circumference and pubertal development. All girls underwent echocardiography and an oral glucose tolerance test, as well as adrenocorticotropic hormone and gonadotrophin-releasing hormone tests to rule out 21-hydroxylase deficiency and central puberty.
There were 16 girls in the early pubarche group with overweight vs. eight girls in the control group; total body fat percentage also was higher in the early pubarche group. Early pubarche girls had a higher free androgen index vs. healthy controls (P = .005). After adjusting for total body fat, left ventricular mass was higher in the early group (97.31 g vs. 81.25 g) as well as late diastolic annular motion (5.66 cm/s vs. 5.09 cm/s).
Researchers found no differences between groups for homeostatic model assessment of insulin resistance (HOMA-IR), glucose and insulin area under the curve; however, the quantitative insulin-sensitivity check index (QUICKI) was significantly lower in early pubarche girls than in controls.
There were no differences in blood pressure, lipid profiles or insulin-like growth factor between groups, according to researchers.
“[Free androgen index] and total body fat were independent predictors of higher [left ventricular mass], and together with HOMA-IR contributed 72% of [left ventricular mass] variability in the [precocious pubarche] group,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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