Correlation between ceramide and its metabolites and central precocious puberty: a cross-sectional study.

BACKGROUND: Emerging evidence suggests that ceramide (Cer) is implicated in obesity-associated central precocious puberty (CPP), potentially serving as a key mediator within hypothalamic pathways. This study investigated alterations in circulating Cer and its metabolites in CPP patients and explored their potential roles in CPP pathogenesis. METHODS: In this prospective cross-sectional study, 143 CPP patients and 140 healthy controls were enrolled. Clinical parameters, including gonadotropins, sex hormones, and Tanner stage, were assessed. Serum concentrations of total Cer, ceramide-1-phosphate (C1P), and sphingosine-1-phosphate (S1P) were quantified in a subset of 45 CPP patients and 30 controls. RESULTS: Circulating S1P levels were significantly elevated in children with CPP (P = 0.011). This association remained robust after adjustment for age and BMI (Model III). S1P was negatively correlated with total Cer (r = -0.321, P = 0.01) and mediated the association between Cer and CPP. Moreover, S1P showed significant interactions with BMI and serum 25-hydroxyvitamin D [25(OH)D], revealing a potential link between sphingolipid metabolism and pubertal regulation. CONCLUSION: Peripheral S1P levels were markedly increased in CPP patients. S1P, rather than Cer, may represent a more sensitive biomarker for CPP and participate in the complex metabolic interplay involving BMI, vitamin D status, and pubertal initiation.