Background: Premature adrenarche (PA),characterized by high concentrations of DHEAS,has been considered a benign condition until recently,where associations to increased metabolic risk and PCOS have arisen,which may depend on ethnic background and infancy weight gain.
Objective and hypotheses: To determine whether PA in girls determines:i)a different timing of pubertal events, and ii)a different pattern of Ovarian morphology/hormones and adrenal hormones.
Methods: Study set up in the Chilean Growth and Obesity Cohort Study (GOCS, n=1.190, 50% female) followed from 2006 (born in 20022003),PA was defined by DHEAS (RIA) >75th percentile for sex (F=42 microg/dl at age 6.8±0.6 yr). Annual clinical examination including Tanner assessment until 1 yr postmenarche and fasting blood sample for glycemia, insulin, lipid profile, adiponectin, IGF-I, LH, FSH, AMH, DHEAS, Adrostendione,17OH prog,T(androgens by LC-MS/MS). Mann-Whitney test was used to compare difference in the medians of high DHEAS group (HD) and normal DHEAS (ND). Logistic regression models to assess the relation between DHEAS and anthropometric, metabolic and gonadal hormones were adjusted by chronologic age at DHEAS sampling and BMI SDS. Results are summarized in the table as medians (*P<0.05 and **P<0.01). Girls with high DHEAS presented earlier breast and pubic hair (9.3 vs 9.8 yr) development, menarche (11.7 vs 12 yr) and higher BMI SDS throughout puberty. Time between B2 and menarche was similar as well as ovarian size 1 yr after menarche. HOMA-IR was only higher at B2 however HD group showed persistent mild hyperandrogenism.
|B2||ND||HD||B4 ND||HD||1yrpostM ND||HD|
Conclusion: In Chilean adolescents, PA is associated with earlier breast, pubic hair and menarche and higher BMI SDS throughout puberty. We believe our findings support that adrenarche is not a benign process and continuous follow-up of this cohort is a unique opportunity to address prospectively the interrelationships of PA, early growth and adiposity as determinants of ovarian function and metabolic risks.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology