Sexual precocity after immigration from developing countries to Belgium: evidence of previous exposure to organochlorine pesticides

Abstract

In a retrospective auxological study of 145 patients seen in Belgium during a 9-year period for treatment of precocious puberty, 28% appeared to be foreign children (39 girls, one boy) who immigrated 4 to 5 years earlier from 22 developing countries, without any link to a particular ethnic or country background. The patients were either adopted (n = 28) or non-adopted (n = 12), the latter having normal weight and height at immigration and starting early puberty without evidence of earlier deprivation. This led to the hypothesis that the mechanism of precocious puberty might involve previous exposure to oestrogenic endocrine disrupters. A toxicological plasma screening for eight pesticides detected p,p'-DDE, which is derived from the organochlorine pesticide DDT. Median p,p'-DDE concentrations were respectively 1.20 and 1.04 ng/ml in foreign adopted (n = 15) and non-adopted (n = 11) girls with precocious puberty, while 13 out of 15 Belgian native girls with idiopathic or organic precocious puberty showed undetectable concentrations (<0.1 ng/ml). A possible relationship between transient exposure to endocrine disrupters and sexual precocity is suggested, and deserves further studies in immigrant children with non-advanced puberty.

Early Onset of Puberty: Tracking Genetic and Environmental Factors

“…The differences in country of origin were unlikely to bias the findings, because in these studies the average menarcheal age was advanced in comparison with data from the foster countries as well as from the countries of origin [5]. In addition to the cohort studies of foreign adopted children, additional evidence of early pubertal timing was provided by the observation of sexual precocity in individual foreign adopted patients described as an entity in Italy [15] and in France [16] or in comparison with the whole group of patients seen for central precocious puberty in Copenhagen [17] and in Belgium [18]. In this latter country, foreign migrating children represented 28% of patients seen with central precocious puberty, accounting for an 80-fold increased risk of sexual precocity in comparison with native Belgian children [18].…”

“…In addition to the cohort studies of foreign adopted children, additional evidence of early pubertal timing was provided by the observation of sexual precocity in individual foreign adopted patients described as an entity in Italy [15] and in France [16] or in comparison with the whole group of patients seen for central precocious puberty in Copenhagen [17] and in Belgium [18]. In this latter country, foreign migrating children represented 28% of patients seen with central precocious puberty, accounting for an 80-fold increased risk of sexual precocity in comparison with native Belgian children [18]. The migrating children came from different ethnic and national backgrounds and were migrating either for international adoption or together with their original family and without any history of deprivation.…”

“…DDT, although banned in the US and western Europe, is still in use in developing countries and behaves as an oestrogen agonist or androgen antagonist [21, 22]. A pathophysiological mechanism of precocious puberty in these children has been proposed [5, 18] and is schematically depicted in figure 2: DDT, like oestradiol [23, 24], is able to promote hypothalamic maturation, exerting an inhibitory effect at the pituitary level that is most effective in prepubertal individuals. This prevents the gonadal manifestation of hypothalamic effects and signs of sexual maturation.…”

Early Puberty in Adopted Children

“…Compared to an incidence of about 1/10,000 for idiopathic CPP, in Belgium 20–25% of children with CPP were adopted from developing countries [22, 23]. Together with other data from Belgium, the incidence of precocious puberty in adopted children was estimated to be 0.8–1.8% [24]. However, the fact that adopted children may be under more cautious medical control may cause overestimation of these figures.…”

Epigenetic control of endocrine disrupting chemicals on gynecological disease: Focused on phthalates

“…Precocious puberty Rat Mouse DDT [6] PBA [7] DDT metabolites [8] PBB [9] Premature thelarche Phthalates and metabolites [10], phytoestrogen [11] Disturbed lactation Rodents Atarzine [12] DDE (DDT metabolites) [12] Breast abnormalities/cancer Rat Mice Dioxin [13], BPA [14] BPA [15] PCB [16] PCOS, HPO axis Sheep Rat BPA [17], MXC [17], Sluge [18] PCBs [19] AGEs [20] Fertility and fecundity Mice DES [21] Organochloride chemicals [5], pesticides [12] DES, diethylstilbesterol; DEHP, Di( …”