High DHEAS levels linked to more advanced pubertal development in girls, but not boys
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Girls with higher dehydroepiandrosterone sulfate levels at age 7 years are more likely to have more advanced pubertal development at age 10 and 13 years than those with lower levels, according to study findings.
“In girls, but not in boys, higher DHEA sulfate levels at the age of 7 were associated with a higher risk of being more sexually mature between the ages of 10 and 13 years,” Rita Santos‐Silva, MD, an endocrinologist in the pediatric endocrinology unit, department of pediatrics at the University Hospital Center of São João in Portugal, and colleagues wrote in a study published in Clinical Endocrinology. “We also found that higher DHEA sulfate levels at age 7 years was associated with a younger age at menarche.”
Researchers analyzed data from 603 children enrolled as part of a prospective birth cohort in the metropolitan area of Porto, Portugal, in 2005 and 2006. Children who completed follow-up visits at age 7, 10 and 13 years and had serum DHEA sulfate (DHEAS) measured at age 7 years were included. At birth, data on gestation, delivery and newborn characteristics were collected. Physical examinations were completed at all follow-up visits. Sexual development evaluations, including breast and pubic hair changes in girls, and genital and pubic hair changes in boys, were conducted at age 10 and 13 years. Participants were grouped according to more or less advanced sexual maturation based on gestational age, birth weight and maternal age at menarche; age and BMI at all three follow-up visits; and menarche status at age 10 and 13 years.
Of the study cohort, 58.8% of girls and 48.3% of boys were placed in the more advanced sexual maturation group. More advanced sexual maturation was associated with a greater height and weight at all three follow-ups for girls, and the percentage of girls who reached menarche at age 10 and 13 years was higher in the more advanced sexual maturation group. Boys who were more sexually mature had a higher BMI than less sexually mature boys at all three follow-ups and were taller at age 10 and 13 years.
Girls with a higher BMI z score (OR = 2.2; 95% CI, 1.7-3; P < .01) and higher DHEAS levels (OR = 1.5; 95% CI, 1.1-2.3; P = .036) were more likely to have more advanced pubertal development at age 10 and 13 years than those with a lower BMI z score and lower DHEAS levels. Boys with a higher BMI z score were more likely to be more sexually mature than those with a lower BMI z score, (OR = 1.2; 95% CI, 1-1.5; P = .047), but no difference in DHEAS levels was observed.
“Increased BMI at age 7, but not higher DHEAS, was associated with a higher chance of being more sexually mature. However, we must be careful when analyzing our findings in boys,” the researchers wrote. “Puberty occurs in boys around 2 years later than in girls, and between 10 and 13 years old, many boys are prepubescent, despite boys in our cohort seeming to have a relatively fast tempo of their pubertal maturation.”
By age 13 years, 83.4% of girls had reached menarche. Higher DHEAS levels were associated with a younger age at menarche (beta = –0.119; 95% CI, –0.438 to –0.02; P = .013).
“The age of 13 years does not allow complete evaluation of later pubertal development,” the researchers wrote about the study’s limitations. “This is particularly relevant for boys, but also some girls have not yet reached menarche at age 13, making it impossible to relate DHEAS with age at menarche properly. However, this will not affect our major conclusions. As we continue to follow this cohort, we may carry on further investigation in different age ranges.”
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