Abstract
Premature adrenarche (PA) has been linked to early thelarche and menarche, but longitudinal data on growth and pubertal development after PA are insufficient. Growth and pubertal development of mostly full-term and appropriate for gestational age-born 43 PA (36 girls) and 63 control children (52 girls) were analyzed prospectively. Children examined first at the mean age of 7.6 years were reexamined at the mean age of 12.0 years. The PA girls but not the boys were taller and had higher body mass index (BMI) than the controls. A higher proportion of the PA than control girls had reached menarche, while the same percentage of the PA and control boys were at Tanner genital stage ≥2. The PA girls with premature pubarche (PP) were taller but not heavier and had more often reached menarche by the age of 12 years than the PA girls without PP. The PA girls with menarche had lower birth length (BL) and higher prepubertal insulin-like growth factor 1 (IGF-1) concentrations compared with non-menarcheal PA girls. In logistic regression analyses for all girls, lower BL standard deviation score, earlier maternal menarche, and higher prepubertal IGF-1 were independently associated with menarche. At 12 years of age, the PA girls had higher BMI, advanced linear growth, and accelerated pubertal development with earlier menarche than the control girls. The PA girls with PP were taller and had earlier menarche than the PA girls without PP. Lower BL and higher prepubertal IGF-1 concentration were predictive factors for menarche by the age of 12 years.
Highlights
In adrenarche, developing adrenocortical zona reticularis produces increasing amounts of adrenal androgen precursors, mostly dehydroepiandrosterone sulfate (DHEAS)
The girls with premature adrenarche (PA) were taller than their peers with higher serum insulin-like growth factor 1 (IGF-1) concentrations [14]. In this follow-up study, we examined whether the anthropometric differences found in prepuberty persist until adolescence and if PA is associated with advanced pubertal development at 12 years of age
Gestational age, birth weight, and age at baseline or follow-up visit did not differ between the PA and control girls (Table 1)
Summary
In adrenarche, developing adrenocortical zona reticularis produces increasing amounts of adrenal androgen precursors, mostly dehydroepiandrosterone sulfate (DHEAS). Increasing androgenic activity leads to clinical signs: adult-type body odor, oily hair and skin, comedones/acne, and axillary and pubic hair. Together with elevated DHEAS concentrations, are seen before the Abbreviations: AGA, appropriate for gestational age; BL, birth length; BMI, body mass index; cMPH, corrected mid-parental height; DHEAS, dehydroepiandrosterone sulfate; IGF-1, insulin-like growth factor 1; PA, premature adrenarche; PP, premature pubarche; SGA, small for gestational age; SDS, standard deviation score. Growth and Puberty after PA age of 8 years in a girl or 9 years in a boy, adrenarche is regarded as premature [reviewed in Ref. In Finland, the prevalence of premature adrenarche (PA) is 8.6% in girls and 1.8% in boys [3]. Premature adrenarche (PA) has been linked to early thelarche and menarche, but longitudinal data on growth and pubertal development after PA are insufficient
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