title: High growth rate of girls with precocious puberty exposed to estrogenic mycotoxins.
abstract: OBJECTIVE
  To test the hypothesis that human puberty timing can be advanced by environmental estrogen exposure.
  
  
  METHODS
  We analyzed serum mycoestrogen contamination via high-performance liquid chromatography (HPLC) in 32 girls affected by central precocious puberty (CPP) and in 31 healthy female control subjects. All 32 patients received triptorelin (TR) for more than 12 months after diagnosis.
  
  
  RESULTS
  Increased serum levels of zearalenone (ZEA; 933.7 +/- 200.3 pg/mL; 95% CI, 723.5-1143.9) and of its congener alpha-zearalenol (106.5 +/- 1.9 pg/mL; 95% CI, 104.5-108.5) contaminated 6 girls with CPP, who were from a bounded Tuscany area. At diagnosis, ZEA levels correlated with patient height (r = 0.906, P < .05) and weight (r = 0.887, P < .05), but not with bone age. In patients who were mycotoxin-positive, height (F = 4.192; P < .01), weight (F = 3.915; P < .01), and height velocity (F = 2.777, P < .05) were higher than patients who were mycotoxin-negative during 12-months TR treatment. Height correlated with weight both in patients who were mycotoxin-positive (r = 0.986, P < .001) and in patients who were mycotoxin-negative (r = 0.994, P < .001). Body mass index, bone age, and gonadal secretion was not different in patient groups before and during TR treatment (P > .05).
  
  
  CONCLUSIONS
  Mycoestrogenic zearalenone is suspected to be a triggering factor for CPP development in girls. Because of its chemical resemblance to some anabolic agents used in animal breeding, ZEA may also represent a growth promoter in exposed patients.
authors.affiliation: Department of Pediatrics, University of Pisa, Pisa, Italy. massart@med.unipi.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Massart
authors.forename: Valentina
authors.initials: V
authors.lastname: Meucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Saggese
authors.forename: Giulio
authors.initials: G
authors.lastname: Soldani
mesh_terms: D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D007558:Italy; D011629:Puberty, Precocious / Q000097:blood* / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D015025:Zearalenone / Q000009:adverse effects / Q000097:blood*; D015029:Zeranol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: C029659:zearalenol; D015025:Zearalenone; D015029:Zeranol