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Sexual Differentiation and Disorders · Journal article
Frontiers in Endocrinology · August 18, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study of 1,252 children demonstrates that circulating DHEA-S significantly mediates the association between obesity (BMI SDS) and advanced bone age, accounting for a substantial proportion of the effect in boys ≤9 years and girls ≥8 years. The findings identify adrenal androgen activity as a potential endocrine mechanism linking childhood obesity to accelerated skeletal maturation, but the causal pathway remains inferred from cross-sectional associations rather than prospective or interventional data.
Retrospective single-center cohort study with mediation analysis. 1,252 children aged 4–12 years from a single center; no other eligibility criteria specified in the abstract.. Intervention: None; observational study of existing associations between adiposity, adrenal androgens, and bone maturation. n = 1,252. Single center (location not specified in provided text).
BMI SDS and DHEA-S were independently associated with BA/CA ratio (p<0.05) In boys <9 years, DHEA-S showed good discriminative performance for advanced maturation with AUC=0.817 DHEA-S mediated the BMI-BA/CA association in boys ≤9 years (β=0.512, p=0.024) and girls ≥8 years (β=0.377, p=0.003)
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Clinicians should recognize that adrenal androgen activity may explain part of the accelerated skeletal maturation observed in obese children, particularly in younger boys, suggesting a potential endocrine target; however, the clinical consequences of advanced bone age in this population and whether DHEA-S modification alters outcomes remain unknown. The age- and sex-specific patterns warrant further prospective investigation before any therapeutic implications can be considered.
A well-designed retrospective cohort study with adequate sample size demonstrating a plausible mechanistic pathway (DHEA-S mediation) between obesity and advanced bone age, but limited by single-center design, cross-sectional analysis, and surrogate endpoint (bone age ratio rather than clinical outcomes).
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that adrenal androgen activity may explain part of the accelerated skeletal maturation observed in obese children, particularly in younger boys, suggesting a potential endocrine target; however, the clinical consequences of advanced bone age in this population and whether DHEA-S modification alters outcomes remain unknown. The age- and sex-specific patterns warrant further prospective investigation before any therapeutic implications can be considered.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Childhood obesity is associated with advanced bone age (BA), but the underlying endocrine mechanisms remain unclear. We investigated the mediating role of dehydroepiandrosterone sulfate (DHEA-S) in the relationship between adiposity and skeletal maturation. Methods This retrospective study included 1,252 children aged 4–12 years from a single center. Skeletal maturation was assessed using the BA-to-chronological age (CA) ratio. Advanced maturation was defined as BA/CA 1.1. Mediation analysis was performed to evaluate whether DHEA-S explains the association between BMI SDS and skeletal maturation. Results Body mass index standard deviation score (BMI SDS) and DHEA-S were independently associated with the BA/CA ratio (p 0.05). In boys younger than 9 years, DHEA-S demonstrated good discriminative performance for advanced maturation (Area under the curve = 0.817). Mediation analysis showed that DHEA-S significantly mediated the association between BMI and BA/CA in boys 9 years (β = 0.512, p = 0.024) and in girls ≥ 8 years (β = 0.377, p = 0.003). In young boys, the direct effect of BMI became non-significant after inclusion of DHEA-S, consistent with substantial mediation by adrenal androgens. Conclusions Adrenal androgen activity, reflected by DHEA-S, represents a significant endocrine pathway linking obesity to accelerated skeletal maturation. The magnitude of this mediation varies by age and sex, highlighting developmentally specific windows of endocrine-metabolic interaction in growing children.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.