Predicted Adult Height Remained Normal in Children With Premature Adrenarche Despite Advanced Bone Age

Aetiological factors affecting the phenotype of adrenarche are largely unknown. This study investigated the phenotypic variability of premature adrenarche.

In this cross-sectional retrospective registry study, data on 91 mainly Caucasian children diagnosed with premature adrenarche were retrieved from patient records. Hormonal and growth-related variables were analysed, and the data were further divided into subgroups to explore variations in different phenotypes of premature adrenarche.

We studied 91 children with premature adrenarche (23% boys) with median ages of 7.5 years (range 4.5-8.9) for boys and 6.8 years (4.3-8.0) for girls. They displayed increased height and weight, elevated androgen levels, and clinical signs of androgen action. Bone age was advanced by approximately 1 year, with overweight children showing more advanced bone age and linear growth. Adult heights predicted with bone age were comparable to mean parental heights. Girls with more advanced bone age had higher dehydroepiandrosterone sulfate (DHEAS) levels. Interestingly, early (< 6 years) diagnosed children exhibited higher height standard deviation scores but lower DHEAS levels compared to those diagnosed later (≥ 6 years).

Despite advanced bone age, predicted adult heights remained normal in premature adrenarche. Subgroup differences suggested the heterogeneity of aetiological factors in premature adrenarche.