Abstract
Background: It has been speculated that premature adrenarche (PA) could lead to unfavorable outcome, including shorter adult stature, but longitudinal follow-up data are insufficient.Methods: This prospective case-control study included 30 PA and 42 control females who were born mostly full-term and appropriate for gestational age. They were examined first at the median age of 7.6 years and now at 18.1 years. Main outcome measures were height, body mass index (BMI), age at menarche, and serum dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) concentrations.Results: The PA and control females had comparable mean (standard deviation) adult height [167.2 (6.8) vs. 164.5 (5.1) cm, P = 0.059] and median (25th–75th percentiles) BMI [22.8 (21.1–28.9) vs. 21.6 (19.8–24.3) kg/m2, P = 0.068, respectively]. Adult heights were comparable with the mid-parental heights in both study groups. The PA females were taller than the controls until the age of 12 years and they lacked a distinct pubertal growth spurt. Serum DHEAS and IGF-1 concentrations did not differ between the PA and control groups at the age of 18 years. Median (range) age at menarche was significantly lower in the PA than control females [11.5 (9.5–15.0) vs. 13.0 (10.0–15.0), P = 0.001].Conclusions: Although PA girls have advanced growth and earlier pubertal development together with a tendency to be more overweight, their height, BMI, and serum DHEAS and IGF-1 concentrations are comparable to those of their peers at the age of 18 years. Our findings indicate a benign outcome of PA in appropriate for gestational age -born females concerning adult height and adrenal androgen secretion.
Highlights
Premature adrenarche (PA) is defined by increased levels of adrenal androgens before the age of 8 years in girls together with the presence of some hyperandrogenic clinical signs including adulttype body odor, comedones, acne, greasiness of hair and skin, and axillary or pubic hair [1, 2]
In our case-control cohort, mostly appropriate for gestational age (AGA)-born PA females had higher pubertal height and body mass index (BMI), and a higher percentage of them had reached menarche by the age of 12 years [20]. In this follow-up study, we evaluated females with a history of PA at the age of 18 years and aimed to investigate the following: (a) whether these currently young adult females have had earlier timing of menarche; (b) whether they have remained taller and more overweight than their peers or (c) if they have reduced adult height; and (d) whether they still manifest with exaggerated serum dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) concentrations
The mean adult heights were close to the corrected mid-parental height (cMPH) in both study groups
Summary
This prospective case-control study included 30 PA and 42 control females who were born mostly full-term and appropriate for gestational age. They were examined first at the median age of 7.6 years and at 18.1 years. Main outcome measures were height, body mass index (BMI), age at menarche, and serum dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) concentrations
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