title: Sex steroids in relation to sexual and skeletal maturation in obese male adolescents.
abstract: BACKGROUND
  Childhood obesity is associated with an accelerated skeletal maturation. However, data concerning pubertal development and sex steroid levels in obese adolescents are scarce and contrasting.
  
  
  OBJECTIVE
  To study sex steroids in relation to sexual and skeletal maturation and to serum prostate specific antigen (PSA), as a marker of androgen activity, in obese boys from early to late adolescence.
  
  
  METHODS
  Ninety obese boys (aged 10-19 y) at the start of a residential obesity treatment program and 90 age-matched controls were studied cross-sectionally. Pubertal status was assessed according to the Tanner method. Skeletal age was determined by an x-ray of the left hand. Morning concentrations of total testosterone (TT) and estradiol (E2) were measured by liquid chromatography-tandem mass spectrometry, free T (FT) was measured by equilibrium dialysis, and LH, FSH, SHBG, and PSA were measured by immunoassays.
  
  
  RESULTS
  Genital staging was comparable between the obese and nonobese groups, whereas skeletal bone advancement (mean, 1 y) was present in early and midadolescence in the obese males. Although both median SHBG and TT concentrations were significantly (P < .001) lower in obese subjects during mid and late puberty, median FT, LH, FSH, and PSA levels were comparable to those of controls. In contrast, serum E2 concentrations were significantly (P < .001) higher in the obese group at all pubertal stages.
  
  
  CONCLUSIONS
  Obese boys have lower circulating SHBG and TT, but similar FT concentrations during mid and late puberty in parallel with a normal pubertal progression and serum PSA levels. Our data indicate that in obese boys, serum FT concentration is a better marker of androgen activity than TT. On the other hand, skeletal maturation and E2 were increased from the beginning of puberty, suggesting a significant contribution of hyperestrogenemia in the advancement of skeletal maturation in obese boys.
authors.affiliation: Department of Endocrinology (S.V., Y.T., E.V.C., J.D.S., J.M.K.), Unit for Osteoporosis and Metabolic Bone Diseases (S.V., Y.T., J.M.K.), Department of Pediatric Endocrinology (S.V., J.D.S.), and Department of Hormonology (T.F.), Ghent University Hospital, 9000 Ghent, Belgium; Zeepreventorium (M.V.H., P.D.), 8420 De Haan, Belgium; Department of Radiology (N.H.), Ghent University Hospital, 9000 Ghent, Belgium; and Departments of Radiology (C.E., F.V.) and Pediatric Endocrinology (I.R., J.D.S.), University Hospital Brussels, B-1090 Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Vandewalle
authors.forename: Y
authors.initials: Y
authors.lastname: Taes
authors.forename: T
authors.initials: T
authors.lastname: Fiers
authors.forename: M
authors.initials: M
authors.lastname: Van Helvoirt
authors.forename: P
authors.initials: P
authors.lastname: Debode
authors.forename: N
authors.initials: N
authors.lastname: Herregods
authors.forename: C
authors.initials: C
authors.lastname: Ernst
authors.forename: E
authors.initials: E
authors.lastname: Van Caenegem
authors.forename: I
authors.initials: I
authors.lastname: Roggen
authors.forename: F
authors.initials: F
authors.lastname: Verhelle
authors.forename: J
authors.initials: J
authors.lastname: De Schepper
authors.forename: J M
authors.initials: JM
authors.lastname: Kaufman
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000365:Age Determination by Skeleton; D001846:Bone Development; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D009929:Organ Size; D063766:Pediatric Obesity / Q000097:blood* / Q000503:physiopathology*; D012741:Sexual Maturation; D013737:Testis / Q000254:growth & development
chemical_list: D012739:Gonadal Steroid Hormones