High Growth Rate of Girls with Precocious Puberty Exposed to Estrogenic Mycotoxins

• Published in: The Journal of pediatrics Vol. 152; no. 5; pp. 690 - 695.e1
• Main Authors: Massart, Francesco, Meucci, Valentina, Saggese, Giuseppe, Soldani, Giulio
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2008; Elsevier
• Subjects: Biological and medical sciences; Case-Control Studies; Child; Cohort Studies; Environmental Exposure - adverse effects; Epidemiology; Female; General aspects; Gynecology. Andrology. Obstetrics; Humans; Italy; Medical sciences; Pediatrics; Puberal and climacteric disorders (male and female); Puberty, Precocious - blood; Puberty, Precocious - etiology; Puberty, Precocious - therapy; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Zearalenone - adverse effects; Zearalenone - blood; Zeranol - adverse effects; Zeranol - analogs & derivatives; Zeranol - blood; Italy; α-ZOL; β-ZAL; CPP; DDE; Ht; HV; α-ZAL; β-ZOL; E 2; ZEA; GnRH; Wt; CA; HPG; HPLC; TR; BA; BMI; Hypothalamic-pituitary-gonadal; Zearalenone; Body mass index; α-zearalanol; 17β-estradiol; Height; α-zearalenol; β-zearalenol; β-zearalanol; Dichloro-diphenyl-dichloro ethylene; Gonadatropin-releasing hormone; High-performance liquid chromatography; Weight; Bone age; Chronological age; Height velocity; Triptorelin; Central precocious puberty; Endocrinopathy; Human; Toxin; Pediatrics; Growth; Mycotoxin; Female; Child; Epidemiology; Precocious puberty
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2007.10.020

To test the hypothesis that human puberty timing can be advanced by environmental estrogen exposure. 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. Increased serum levels of zearalenone (ZEA; 933.7 ± 200.3 pg/mL; 95% CI, 723.5-1143.9) and of its congener α-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). 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.