Association of Serum Vascular Endothelial Growth Factor-A With Pubertal Stage by Sex and Its Relationship With Precocious Puberty in Girls

Background: Vascular endothelial growth factor-A (VEGF-A) is essential for normal growth plate morphogenesis, including blood vessel invasion and cartilage remodeling. We assessed serum VEGF-A levels according to pubertal stage by sex and investigated their relationship with precocious puberty. Methods: Our study included 180 children aged 6–15 years (153 children with normal puberty [92 boys and 61 girls] and 27 girls with precocious puberty). Clinical and biochemical characteristics according to prepubertal stages were compared in boys and girls, respectively. Serum VEGF-A and leptin levels were performed across Tanner stages. Results: Mean VEGF-A levels were similar among boys and girls with normal puberty (433.7 ± 326.1 pg/mL vs. 483.9 ± 390.5 pg/mL). There was no significant difference in the VEGF-A levels between prepubertal and pubertal boys. VEGF-A levels were significantly higher in pubertal girls than in prepubertal girls (595.9 ± 405.4 pg/mL vs. 264.2 ± 138.0 pg/mL, P < 0.001) and were positively correlated with bone age advancement, Tanner stage, and estradiol level. There was no association between the VEGF-A levels and the body mass index standard deviation scores in either sex. VEGF-A levels were significantly higher in girls with precocious puberty than in prepubertal girls of the same age. Conclusion: Our study showed sex-related differences in VEGF-A levels according to the pubertal stage. Therefore, VEGF-A may be involved in the progression of precocious puberty.