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.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology