Adrenarche is dissociated from gonadarche--studies in patients with Turner's syndrome

Twenty-two patients with gonadal dysgenesis (14 45,XO; median age 13.6 years; 8 mosaics, median age 12.3 years) were studied regarding their clinical onset of adrenarche (pubarche) and breast development. The latter was considered evidence of gonadarche. 1/22 showed breast development, stage 2; 9/22 had pubarche, stage 2-4. The 24h-urinary excretion of androsterone, etiocholanolone, dehydroepiandrosterone, 16 alpha- and 16 beta-dehydroepiandrosterone was studied in these patients by urinary capillary column gas chromatography profiling. The urinary steroid profiles of twenty-one healthy, normal girls (median age 10.4 years) served as controls. Dehydroepiandrosterone and its 16-hydroxylated derivatives were excreted in significantly greater amounts by the patients with Turner's syndrome as compared to normal girls. These findings support the hypothesis, that adrenarche is independent of gonadarche and proceeds even in instances of gonadal dysgenesis.