ESPE Abstracts

Background: In 2012, a phenomenon of early isolated gonadotropin-independent thelarche among contemporary girls was reported.

Objective and hypotheses: We wanted to evaluate whether a contemporary isolated early pubarche also exists. One way of looking into this is by investigating the age of pubarche in a group of girls with premature pubarche (PP) over time. If some girls had earlier pubarche, then, we would expect a subgroup (i.e. those younger than 8 years) of individuals with earlier pubarche to constitute a subgroup of individuals with PP.

Method: There were 268 girls with PP and without SGA referred between 1978 and 2013. 31 cases with precocious puberty and/or those given GnRH analogue treatment were excluded (n: 268−31=237). Of these 237 girls, seven had nonclassical CAH, one had ovarian tumour, one had adrenocortical carcinoma, one had SV CAH (n: 237−10=227). Of 227 girls, those with known pubarche age (n: 200) were grouped according to years of referral. 173 girls had serum DHEAS levels determined. Girls with PP and with increased serum levels of DHEAS for age were named as premature adrenarche (PA) and those without as idiopathic PP (IPP).

Results: Age of pubarche in 2006–2010 and 2011–2012 was significantly higher than in 1996–2000 (respectively P: 0.007 and 0.005). Age of pubarche after 2006 was significantly higher than that of before 2006 (P:0.001). (<1995 (n: 19) 5.82±1.49; 1996–2000 (n: 22) 5.19±1.89; 2001–2005 (n: 18) 5.54±3.12; 2006–2010 (n: 102) 6.48±1.45; 2011–2012 (n: 39) 6.72±0.97 years). Although there was no significant difference between pubarche age of PA subjects before and after 2006, there was a significant difference between pubarche age of IPP subjects before and after 2006 respectively (6.22±0.76; median 6.5, 6.63±1.51;median 7 years; P:0.004).

Conclusion: Our findings suggest that there might be a contemporary subgroup of individuals with earlier pubarche in our group of PP girls, especially indicated by the presence of a higher proportion of 7–8 years old girls with IPP after 2006 than before 2006.