ESPE Abstracts (2019) 92 P2-23

"Girls with Idiopathic Premature Adrenarche Achieve Normal Adult Height"

Franciso Javier Mejorado-Molano1, Pilar Pérez-Segura2, Isabel Gómez-Aragón3, Rosa Collado-Valiente3, Ana Gómez-Neo3, Teresa Gavela-Pérez2, Leandro Soriano-Guillén2


1Hospital Universitario del Henares., Madrid, Spain. 2Unidad de Endocrinología Infantil. Hospital Universitario Fundación Jiménez Díaz. Universidad Autónoma de Madrid., Madrid, Spain. 3Hospital de Día. Hospital Universitario Fundación Jiménez Díaz., Madrid, Spain


Introduction: Studies about pubertal onset and the menarcheal age in girls with the antecedent of idiopathic premature adrenarche (IPA) are limited and with discordant results. For these reasons, we created a cohort of girls with the diagnosis of IPA. The objectives of our study were: a) to know the age of pubertal onset; b) to evaluate menarcheal age; c) to determine the growth rate in the first two years after the IPA diagnosis; d) to collect adult height data in these girls.

Material and Methods: IPA girls cohort with the following inclusion criteria: appearance of pubic and/or axillary hair before 8 years old after excluding other pathologies causing hyperandrogenism as ovarian or adrenal tumours (detected by ultrasound) and congenital adrenal hyperplasia (evaluated by ACTH stimulation test). We planned a follow-up of these patients from their diagnosis until reaching adult height, collecting anthropometric and pubertal development data through visits every six months.

Results: This cohort was composed of 81 girls with IPA, whose average age at diagnosis was 7.54 years (7.26 - 7.82). At that time, the mean difference between their bone and chronological age was 0.90 years (0.72 - 1.08). Their mean height was +1.59 SDS (1.38 - 1.80), significantly greater than the target height which was +0.30 SDS (0.09 - 0.52) (p <0.001). The growth rate in the first two years after diagnosis was +1.36 SDS (0.98 - 1.75) for the first year and +1.62 SDS (1.06 - 2.18) for the second year, respectively. The mean age of progressive thelarche appearance (Tanner II stage) was 9.62 years (9.38 - 9.86), with a mean menarcheal age of 11.50 years (11.18 - 11.83). The mean of menarcheal age of their mothers was 12.14 years (11.83 - 12.46), significantly higher (p 0.04). At the time of this study, 34 girls (42% of the cohort) reached an average final height of +0.72 SDS (0.38 - 1.05), significantly higher than the predicted adult height at diagnosis [+0.24 SDS (-0.03 - 0.52), p 0.02] and slightly higher, but not reporting significant differences with their target height [+0.3 SDS (0.09 - 0.52)].

Conclusions: Our cohort of girls with IPA shows advanced pubertal development compared to its mothers but this finding does not seem to affect their adult height.

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