Serum vascular endothelial growth factor-A (VEGF-A) levels regarding pubertal stage and obesity in girls

초록

Objectives: Vascular endothelial growth factor-A (VEGF-A) is essential for normal growth plate morphogenesis and angiogenesis in adipose tissue. Childhood obesity may lead to early puberty in girls, however, it remains unclear whether early thelarche in overweight girls is related to central activation of the gonadotropin releasing hormone-gonadotropin axis. We assessed serum VEGF-A level regarding to pubertal stage and obesity in girls. Patients and Methods: Our previous study including normal puberty boys and girls showed that only pubertal girls showed significantly higher VEGF-A levels. Total 165 girls were classified as prepuberty (n=40), puberty with peak LH <5.0 IU/L (n=60), and puberty with peak LH ≥5.0 IU/L (n=65). Serum VEGF-A, sex hormone, gonadotropin level and bone age were analyzed according to pubertal state and overweight including obesity. We measured serum level of VEGF-A using ELISA kit. Results: Their chronological age were similar (7.8±1.2, 7.9±0.8, and 8.0±0.9 years, P=0.410). The mean VEGF-A level was higher in puberty girls (399.3±206.2, 633.5±473.0, 605.7±392.4 pg/mL, P = 0.009) and was significantly correlated with BMI SDS (r=0.191, P=0.014), weight SDS (r=0.202, P=0.009) and pubertal stage (r=0.224, P=0.004). When sub-analysis with the degree of obesity, VEGF-A level (802.2±556.0 pg/mL) was highest in overweight puberty girls with peak LH <5 IU/L and was significantly correlated with peak LH (r=0.397, p=0.044) and peak LH/FSH (r=0.409, P=0.038). Conclusions: Our study showed higher VEGF-A levels in overweight puberty girls. Obesity-associated VEGF-A rise may involve in the progression of precocious puberty. Further large-scale and longitudinal studies including boys related to pathophysiological mechanism are needed.