The effect of obesity in the pre-pubertal period on testis sizes

Introduction-aim: With the hypothesis that the increase in testicular volume (TV) determined by Prader orchidometry (PO) in obese boys aged <9 years without clinical and laboratory signs of puberty may have an effect on obesity-related local fat tissue increase, it was also determined by ultrasonography (US) in addition to TV measured with PO in obese children. It was aimed to determine the differences, if any, by comparing the determined TV, to determine the relationship with anthropometric data and body fat percentage, and to compare the obtained data with non-obese healthy boys. Material-method: The study included 60 boys aged 5-9 years who were defined as obese according to body mass index (BMI) without any other chronic disease followed in Farabi Hospital Pediatric Endocrinology Outpatient Clinic of Karadeniz Technical University and healthy 5-9 years old (pre-pubertal) without signs of puberty. 60 boys with normal BMI were included. Fat percentage results and clinical findings measured by anthropometry, bioimpedance analysis method, TVs determined by PO and US, as well as stretched penile length (PSL) of the obese and healthy control groups were evaluated. Results: VA, BMI and body fat percentage of the obese group were significantly higher than the control group. Although 6 (10%) of the obese group had TV ≥4 ml as measured by PO, no other pubertal finding was detected, and luteinizing hormone (LH) and total testosterone values were at pre-pubertal level. TV measured by PO was <4 ml in all controls. With both PO and US measurement of the obese group, right and left TV was significantly greater than the right and left TV of the control group. No significant correlation was found between BMI-standard deviation score (SDS) and BMI percentile, and TV measurements made with both PO and US in obese and controls. However, there was a positive correlation between body weight (VA) and VA percentile and TVs measured by both PO and US in both obese and controls there was also a positive correlation between VA-SDS and TV measured by US but no correlation was found between PO and TV measured. In the control group, there was no correlation between body fat percentage and TVs measured by PO, but there was a positive correlation with left TV measured by US. In the obese group, there was no significant correlation between fat percentage and TV measured by PO or US. Conclusion: In our study, for the first time in our country, both PO and US measurements of obese and healthy children between the ages of 5-9 were compared and TV percentiles were determined according to age groups. These percentile charts can be used especially in the pubertal assessment of obese people. In our study, the TV of the obese was found to be higher than the controls with both PO and US, and TV was greater with PO measurement than US measurements in both groups. While determining TV with PO, epididymis and scrotal skin are also measured. TV can be measured larger than it is with the increase in scrotal subcutaneous adipose tissue in obese children. Because of its practical use, PO is important in the diagnosis and follow-up of early puberty, but we recommend the evaluation of TV with US measurement to avoid an exaggerated diagnosis of precocious puberty, especially when PO measurement is found to be ≥4 ml in pre-pubertal obese patients.