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.
| Girls PA+ | Girls PA− | |
| Age (years) | 8.8 (95%CI; 7.9–9.3) | 9.3 (95%CI; 9.1–9.6) |
| Height_SDS | 0.3±0.9** | 0.05±1.0 |
| BMI_SDS | 1.1±1.1** | 0.8±1.1 |
| 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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