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Evaluation of metabolic parameters and aortic elasticity in normotensive children with premature adrenarche
Eylem Topaktaş1, Elif Erolu2, Fatma Dursun3
1Department of Pediatrics, University of Health Sciences, Ümraniye Training and Research Hospital, Istanbul, Turkey.
Insights
Premature adrenarche is not directly linked to arterial stiffness. Instead, overweight status and metabolic factors like insulin resistance and dyslipidemia are key contributors to vascular changes.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Premature adrenarche (PA) may indicate intrauterine programming for metabolic syndrome.
- Metabolic syndrome is a risk factor for cardiovascular disease, including atherosclerosis, hypertension, and type 2 diabetes mellitus.
- PA has been linked to conditions like polycystic ovary syndrome.
Purpose of the Study:
- To evaluate metabolic parameters and aortic elasticity in patients with PA.
- To assess susceptibility to atherosclerosis in individuals with PA.
- To compare metabolic and cardiac parameters between overweight and non-overweight PA patient groups.
Main Methods:
- Seventy-three patients with PA underwent evaluation of metabolic parameters and aortic elasticity.
- A control group was used for comparison.
- Aortic elasticity was assessed using strain, distensibility, and stiffness index parameters.
- Patients were categorized into overweight and non-overweight groups for comparative analysis.
Main Results:
- No significant differences in biochemical or cardiac measurements were found between PA patients and controls.
- Overweight and non-overweight PA patient groups showed no significant differences in metabolic or cardiac parameters.
- A strong correlation was observed between the atherogenic index and insulin resistance.
- A positive correlation was found between cholesterol and triglyceride levels and ascending aortic stiffness.
Conclusions:
- Arterial stiffness appears primarily influenced by cholesterol and triglyceride levels.
- Being overweight and having a metabolic profile of insulin resistance and dyslipidemia are major factors affecting vascular structure.
- Increased androgens and PA itself may not be the primary drivers of arterial stiffness in these patients.
Objectives:
Premature adrenarche may be associated with an intrauterine programmed metabolic syndrome which should be considered as a warning sign for coronary heart disease due to accelerated atherosclerosis, hypertension, type 2 diabetes mellitus (DM), and polycystic ovary syndrome.
Methods:
Seventy-three patients with premature adrenarche were evaluated for metabolic parameters and aortic elasticity to evaluate the susceptibility to atherosclerosis and compared with a control group. The patients were examined in two groups as overweight and nonoverweight, and metabolic and cardiac parameters were also compared among these groups. Strain, distensibility, and stiffness index parameters were used to evaluate aortic elasticity.
Results:
Biochemical parameters and cardiac measurements were not statistically different between patients and controls. They also did not differ between patients with normal weight and overweight groups. Atherogenic index and insulin resistance were closely related and a positive correlation between cholesterol and triglyceride, and ascending aortic stiffness was found.
Conclusions:
The results may suggest that cholesterol and triglyceride-related arterial involvement is more involved in the pathogenesis of arterial stiffness. It can be considered that 'being overweight' or 'having metabolic profile characterized by insulin resistance and dyslipidemia' are the major coexisting factors influencing the vascular structure, rather than increased androgens and premature adrenarche itself.
