Exaggerated adrenarche and hyperinsulinism in adolescent girls born small for gestational age

Serum dehydroepiandrosterone-sulfate (DHEAS) is a classic marker for adrenarche and, subsequently, for the individual hormonal milieu. We have tested the hypothesis that prenatal growth reduction is followed by exaggerated adrenarche. Serum DHEAS, androstenedione and insulin concentrations were determined together with fasting glycemia in matched populations of asymptomatic, non-obese, post-menarcheal girls (mean age 14 yr) who were born either with a strictly appropriate weight for gestational age (AGA) or small for gestational age (SGA). When compared to AGA girls, the SGA girls had identical glucose levels, higher values for insulin and androstenedione (p<0.01), and a two-fold rise of DHEAS concentrations (p<0.0001). In conclusion, girls with prenatal growth reduction were found to be prone to develop, besides hyperinsulinism, a variant of exaggerated adrenarche. It remains to be verified whether the exaggerated adrenarche in adolescence is followed by adrenal hyperandrogenism throughout adulthood and senescence.