ESPE Abstracts

Background: Premature adrenarche (PA) has been linked with early pubertal development, but only few longitudinal studies on PA girls and boys born appropriate for gestational age (AGA) have been reported.

Objective: Our objective was to study growth and pubertal development in PA children, and to explore which factors in prepuberty predict early menarche in girls.

Methods: PA (n=43, 36 girls) and control children (n=63, 52 girls) had been examined at the mean age of 7.6 years. Their parental pubertal timing, growth, pubertal signs, serum DHEAS, androstenedione, IGF-1, and insulin concentrations had been recorded. The current visit at the mean age of 12.1 years (95% CI 12.0–12.2) included pubertal and anthropometric assessment. Factors predicting early menarche were analysed with a logistic regression analysis.

Results: The PA girls but not the boys were taller and heavier than the controls (160.1 vs. 153.3 cm, P<0.001; 154.9 vs. 153.8 cm, NS; BMI 21.6 vs. 19.2 kg/m², P<0.01; 23.5 vs. 21.7 kg/m², NS; respectively). The same percentage of the PA and control boys were at Tanner genital stage ≥2 (43 vs. 46%, NS). A higher proportion of the PA than control girls had reached menarche (64 vs. 26%, P<0.001). In a univariate logistic regression model, having a history of PA, earlier maternal menarche, higher childhood BMI, serum DHEAS, androstenedione, IGF-1, and insulin concentrations, were all associated with the appearance of early menarche. However, in a multivariate stepwise forward model, only the history of PA, earlier maternal menarche, and higher IGF-1 were significantly associated with early menarche.

Conclusions: AGA-born PA girls have advanced pubertal development and linear growth, and they are slightly heavier than control girls still at 12 years of age. In boys, larger cohorts need to be evaluated. Prepubertal IGF-1 and the history of PA are strong predictors of earlier timing of menarche.