Background: Premature adrenarche (PA) has been associated to increased metabolic risk. Areas of controversy regarding associated co-morbidities are precocious pubarche, PCOS and lower birth weight, which may depend on ethnic background.
Objective and hypotheses: To describe the risk of precocious thelarche (PT, <8 years), pubarche (PP, <8 years F, <9 years M) and gonadarche (PG, <9 years) in children with premature adrenarche.
Method: A longitudinal Chilean cohort (~20% indigenous/Mapuche origin) the Growth and Obesity Cohort Study (GOCS, n=1052, 49.9%F) followed from 2006 (born in 2002), PA defined by DHEAS (RIA) >75th percentile for each gender (45.1 M, 42.0 F μg/dl at age 6.8±0.6 years) and annual clinical examination including Tanner and pubarche assessment. Logistic regression models adjusted by age and BMI assessed the relation between DHEAS and premature thelarche, gonadarche and pubarche.
Results: At age of DHEAS determination, overweight/obesity (O/OW) was present in 43.6% M, 42.2% F. We found a 18.2% of PT, 8.8% PG and 15.2% (M) and 1.3% (F) PP; any precocious event were observed in 20.9% of M, and 19.2% of girls. In Girls with PA, we observed a 2.5 OR of PT (P<0.001), but they did not have an increased risk of PP. In boys with PA, a 1.3 OR of PG (ns), and PP was less frequent in those with PA (10% vs 18%, P<0.001) but difference was no longer significant after adjustment. The OR (only adjusted by age) between PA and PT, PG and PP was not different in obese or non-obese children.
Conclusion: In Chilean adolescents, precocious events of pubertal development were, in line with worldwide secular trend of earlier sexual maturations. PA was only associated with PT continuous follow-up of this cohort is a unique opportunity to address prospectively the interrelationships of PA, early growth, adiposity as determinants of gonadarche, pubertal rate and sequence progression and ovarian function.
Funding: FONDECYT 1140447 and 1120326.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology