ESPE Abstracts (2016) 86 RFC7.8

ESPE2016 Rapid Free Communications Gonads & DSD (8 abstracts)

Premature Adrenarche in Girls at Pubertal Onset is Associated with High Androgens, but Lower AMH Concentrations

Paulina M Merino a , Ana Pereira b , German Iniguez a , Camila Corvalan b & Veronica Mericq a

aInstitute of Maternal and Child Research (IDIMI), University of Chile, Santiago, Chile; bInstitute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile

Background: Premature adrenarche (PA) has been considered a benign condition. Recently, associations with increase androgen levels and PCOS have arisen.

Objective: To determine whether PA in children at pubertal onset (TII) determines a different timing of pubertal events and a different pattern of ovarian and adrenal hormones.

Methods: A total of 583 girls from the longitudinal cohort (Growth and Obesity Cohort Study, born 2002) were followed twice a year with a clinical evaluation, and at TII a complete hormonal profile (androstenedione, 17OHprogesterone, testosterone and AMH). PA was defined by DHEAS >42.0 μg/dl at 6.8±0.6 yr (RIA). Statistics: Generalized linear models were used to assess the relation between PA and hormonal profile, adjusting by chronologic age at DHEAS sampling, HOMA and BMI.

Results: At TII, girls who developed PA (PA+) were slightly younger (by interval censoring, Turnbull), taller and had higher BMI_SDS. In addition they displayed higher androstenedione, higher testosterone and lower AMH levels. No differences were observed in gonadotrophins, estradiol, 17OHprogesterone and SHBG levels.

Table 1.
Girls PA+Girls PA−
Age (years) 8.8 (95%CI; 7.9–9.3)9.3 (95%CI; 9.1–9.6)
Androstenedione (ng/ml)0.3±0.2**0.26±0.1
Testosterone (ng/ml)0.08±0.05*0.06±0.04
AMH (ng/ml)3.5±2.1**4.4±2.5
*P<0.05; **P<0.01.

Conclusions: Girls with history of PA initiated their puberty at an earlier age. At this stage of puberty (TII) they also showed a mild hyperandrogenism in concert with lower concentrations of AMH. Continuous follow-up of this cohort is a unique opportunity to address prospectively the interrelationships of PA and PCOS development which does not appear possible at this stage (Fondecyt 1140447 & 1120326, WCRF:2010/245).

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