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.
|Girls PA+||Girls PA−|
|Age (years)||8.8 (95%CI; 7.99.3)||9.3 (95%CI; 9.19.6)|
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).
10 - 12 Sep 2016
European Society for Paediatric Endocrinology