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Early adrenarche in normal prepubertal girls: a prospective longitudinal study
Ricardo Azziz1, Lisa A Farah, Carlos Moran
1Departments of Obstetrics and Gynecology and Medicine, The University ofAlabama at Birmingham, Birmingham, AL, USA. azzizr@cshs.org
Journal of Pediatric Endocrinology & Metabolism : JPEM
|October 28, 2004
Summary
The study found that dehydroepiandrosterone sulfate (DHEAS) levels increase in girls around age 6-7, preceding other hormonal changes of adrenarche. This rise in DHEAS is the earliest indicator of adrenarche.
Area of Science:
- Pediatric endocrinology
- Adolescent medicine
- Reproductive health
Background:
- Adrenarche, the maturation of the adrenal gland, involves increased production of adrenal androgens.
- Understanding the hormonal changes during prepuberty is crucial for identifying early signs of adrenarche.
Purpose of the Study:
- To investigate basal and ACTH-stimulated levels of key adrenal androgens and cortisol in healthy prepubertal girls.
- To determine the chronological onset of hormonal changes associated with adrenarche.
Main Methods:
- Yearly assessment of serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), and cortisol (F) in six girls aged 3.7-10.9 years.
- ACTH stimulation tests were performed to measure hormone responses.
Main Results:
- Dehydroepiandrosterone sulfate (DHEAS) levels showed a significant increase starting between 6.1-7.0 years of age.
- Dehydroepiandrosterone (DHEA) and androstenedione (A4) levels tended to increase later, around 9.1-10.0 years.
- No significant changes were observed in the stimulated increment of any hormone.
Conclusions:
- Elevated circulating DHEAS levels appear to be the initial marker of adrenarche in girls.
- This hormonal shift precedes observable clinical signs of adrenarche.