Determination of Serum Di-(2-ethylhexyl) phthalate and Bisphenol A Level in Children with Idiopathic Central Precocious Puberty

Abstract

Purpose: Environmental endocrine disruptors may affect the endocrine system or sexual development in children. Several recent studies have focused on indoor and dietary pollutants such as di-(2-ethylhexyl) phthalate (DEHP), which is used as a plastic softener, and bisphenol A, which is used in food-packaging materials. Despite the accumulation of data and the substantial arguments implicatinf these pollutants in endocrinal disorders, no clear evidence has been established yet. Thus, we assessed the serum levels of DEHP and bisphenol A in patients diagnosed with idiopathic central precocious puberty (CPP) to estimate the possible environmental hazards associated with increasing number of cases of precocious puberty.

Methods: The study included 30 patients (29 girls and 1 boy) with idiopathic CPP and 30 normal control children who visited the pediatric endocrinology clinic. CPP was diagnosed on the basis of clinical & hormonal tests, including the gonadotropin-releasing hormone-stimulation test. The serum DEHP and bisphenol A levels were analyzed by gas chromatography/mass spectrometry.

Results: The mean chronological ages (CA) in the idiopathic CPP and control groups were similar (8.6±0.9 vs. 7.8±1.1 years). However, the overall growth stage in the CPP group was advanced. The CPP group had a significantly higher height SDS (1.3±1.0 vs. -0.4±1.1, P?0.005) and weight SDS (1.3±1.3 vs. -0.2±1.3, P?0.005) than the control group. Bone age was significantly more advanced in the CPP group than in the control group (BA-CA:14.6±9.4 months vs. 0.8±15.3 months, P?0.005). While the serum bisphenol A levels were not significantly different between the groups (11.2±10.3 vs.16.2±12.5 ng/mL), the DEHP levels were significantly higher in the CPP group than in the control group (159.01±92.78 vs. 103.55±92.98 ng/mL, P?0.05).

Conclusion: This study suggests that DEHP, one of most commonly used plasticizers, may be an etiologic factor for precocious puberty