ESPE Abstracts (2015) 84 P-3-1130

Clinical Features and Pubertal Timing in Girls with Premature Adrenarche

Sevinc Celika, Heves Kirmizibekmezb, Rahime Gul Yesiltepe Mutlub & Feyza Yildiza


aClinics of Pediatrics, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey; bPediatric Endocrinology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey


Background: Premature adrenarche is defined as the development of axillary and/or pubic hair in association of the DHEA-S concentrations >108.4 nmol/l (40 μg/dl) before the age of eight in girls.

Objective and hypotheses: This retrospective study aimed to investigate the clinical presentation, metabolic status, growth velocity and pubertal timing of girls with premature adrenarche.

Method: Medical records of 117 patients were investigated. Pubertal onset was regarded as breast enlargement (Tanner stage-2) and/or elevation of baseline LH level to 1 mIU/ml or stimulated LH to 5 mIU/ml.

Results: Mean adrenarche age of 117 girls was 6.96±0.82 years. The complaint was pubic hair in 105 (%89.7), axillary hair in 63 (%53.8), adult type axillary odour in 31 (%26.5) patients. Prematurity (<37th week) was present in 17 (%14.5) patients while low birth weight (SGA) was present in 9 (%7.6). Hypertension was the most common (%62.6) finding in family history. Eighty-two patients had normal body mass index, while 17 (%14.7) had obesity, 15 (%12.9) had overweight and only two had under-nutrition. Mean DHEA-S level was 95.02 μg/dl and it was negatively correlated with birth weight and gestational age. Growth velocity, bone age, volumes of ovaries and uterus were positively correlated with height SDS, weight SDS and testosterone levels, indicating the effects of oestrogen which is produced by the aromatization of androgens. Puberty was started in 37 girls, mean age of pubertal timing was 8.28±0.95 and a significant decrease was found when compared with mean age in healthy population. Treatment with GnRH-analogue was needed in ten (%8.4) patients.

Conclusion: Pubertal timing was diminished in girls with premature adrenarche, suggesting the necessity of following patients in terms of puberty precocious and rapidly progressive puberty. Monitoring the growth and pubertal signs are important especially in premature and SGA children.

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