Endocrine Abstracts

Introduction: One tenth of children worldwide are obese and disturbance in pubertal progression is one of the unpleasant health consequences of adolescent obesity. Data on pubertal hormones in obese adolescents are scarce and contradictory.

Methods: This study was a cross-sectional, case-control study conducted on 120 participants; 60 randomly chosen obese adolescent males and 60 age and sex matched controls. All participants had measurements of their weight, height, waist circumference and calculation of their body mass index (BMI), waist height and waist hip ratios. Pubertal status was assessed by Tanner staging. Assessment for depression was carried out using the Center for Epidemiological Studies Depression Scale for Children (CES-DC), Children’s Depression Inventory (CDI), and Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Laboratory investigations included free testosterone (fT), estradiol, follicle stimulating hormone (FSH), and luteinising hormone (LH) measurement for all cases and controls.

Results: Obese adolescents had significantly lower testicular volumes, higher FSH, LH, fT, and estradiol compared to lean controls. fT correlated negatively in cases with the BMI (P<0.001), waist circumference (P=0.009), waist height ratio (P=0.003), waist SDS (P=0.017) and waist height ratio SDS (P=0.006). However, fT didn’t show any significant correlations with the aforementioned parameters in controls. Cases differed significantly from controls regarding the presence of depression, presence of depressive symptoms and absence of depression (P< 0.001 for each category). Comparison between presence and absence of depressive symptoms (according to the MINI KID module A) regarding the mean free testosterone level showed that the following symptoms were significantly different between cases and controls: feeling depressed (P=0.036), loss of interest (P=0.032), eating disorders (P=0.000), sleeping disorders (P=0.003), feeling restless (P=0.000), feeling tired (P=0.002), feeling guilty (P=0.000) and Suicidality (P=0.000).

Conclusion: In adolescent males, obesity was associated with lower testosterone levels which were associated with higher incidence of depression and depressive symptoms.