Hormonal Findings in African-American and Caribbean Hispanic Girls With Premature Adrenarche: Implications for Polycystic  Ovarian Syndrome

Banerjee, Swati; Raghavan, Susan; Wasserman, Ethan; Linder, Barbara; Saenger, Paul; DiMartino-Nardi, Joan

doi:10.1542/peds.102.3.e36

Cited by 35 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 60-min ACTH-stimulated hormonal profile of the subjects was compared to the normative data for healthy Tanner stage 2–3 pubertal children from Santo Domingo [21]. The ACTH-stimulated levels of 17-OHPreg, dehydroepiandrosterone, androstenedione, 17-OH progesterone, and testosterone were similar to the mean levels reported for normal girls in early puberty, as previously reported [3, 22]. …”

Section: Resultssupporting

confidence: 65%

See 1 more Smart Citation

Prediction Models for Insulin Resistance in Girls with Premature Adrenarche

et al. 2006

Self Cite

View full text Add to dashboard Cite

Aim: The purpose of this study was to develop an accurate regression model to predict insulin resistance in girls with premature adrenarche. Methods: The insulin sensitivity index was calculated from the frequently sampled intravenous glucose tolerance test with tolbutamide. Thirty-five prepubertal girls (23 Caribbean-Hispanic and 12 African-American; mean age 6.8 years) were studied. The insulin sensitivity index was compared to birth weight, body mass index (BMI), the presence of acanthosis nigricans (AN), insulin-like growth factor 1, insulin-like growth factor binding protein 1, sex hormone binding globulin, lipid profile, and adrenocorticotropic hormone stimulated androgens. Results: The best prediction models included birth weight, BMI, and AN (model 1: R² = 0.78) and BMI, AN, and serum 17-OH pregnenolone (model 2: R² = 0.76). When viewed as screening tests, a cutoff value <5.5 (premature adrenarche insulin resistance score) in both equations showed a sensitivity of 100% and a specificity of 85%. Conclusion: Born small for gestational age, premature adrenarche, obesity, AN, and higher serum 17-OH pregnenolone levels may confer negative, but independent, health risks.

show abstract

Section: Resultssupporting

confidence: 65%

“…Insulin-resistant girls with PA had significantly higher ACTH-stimulated androgen levels than their peers with a normal insulin sensitivity [3, 22]. In this study, ACTH-stimulated 17-OHPreg, an index of modest hyperandrogenism, was independently associated with insulin sensitivity [3].…”

Section: Discussionmentioning

confidence: 89%

Prediction Models for Insulin Resistance in Girls with Premature Adrenarche

et al. 2006

Self Cite

View full text Add to dashboard Cite

show abstract

“…Indeed, there is some inconsistency in the literature where PP is often used synonymously for PA. First, some of these studies only scored the onset of pubic hair growth but lack biochemical confirmation of increased adrenal androgen production. Second, equating the two terms would limit the attention to the development of pubic hair only, but ignore other signs of increased androgen action including adult-type body odour and oily hair and skin (23, 46,47,50,51). Conversely, some investigators have defined PA very strictly as the biochemical detection of a premature increase in circulating adrenal androgens irrespective of the clinical presentation (52).…”

Section: Pa: Definitions and Differential Diagnosismentioning

confidence: 99%

Premature adrenarche: novel lessons from early onset androgen excess

Idkowiak

Lavery

Dhir

et al. 2011

European Journal of Endocrinology

110

View full text Add to dashboard Cite

Adrenarche reflects the maturation of the adrenal zona reticularis resulting in increased secretion of the adrenal androgen precursor DHEA and its sulphate ester DHEAS. Premature adrenarche (PA) is defined by increased levels of DHEA and DHEAS before the age of 8 years in girls and 9 years in boys and the concurrent presence of signs of androgen action including adult-type body odour, oily skin and hair and pubic hair growth. PA is distinct from precocious puberty, which manifests with the development of secondary sexual characteristics including testicular growth and breast development. Idiopathic PA (IPA) has long been considered an extreme of normal variation, but emerging evidence links IPA to an increased risk of developing the metabolic syndrome (MS) and thus ultimately cardiovascular morbidity. Areas of controversy include the question whether IPA in girls is associated with a higher rate of progression to the polycystic ovary syndrome (PCOS) and whether low birth weight increases the risk of developing IPA. The recent discoveries of two novel monogenic causes of early onset androgen excess, apparent cortisone reductase deficiency and apparent DHEA sulphotransferase deficiency, support the notion that PA may represent a forerunner condition for PCOS. Future research including carefully designed longitudinal studies is required to address the apparent link between early onset androgen excess and the development of insulin resistance and the MS.

show abstract

“…In some individuals, particularly African-American (Banerjee et al, 1998) girls and children with low birthweight, adrenarche may begin early ('premature adrenarche', < 6 years of age) or progress with higher DHEA-S production and more abundant axillary and pubic hair growth than is typical ('exaggerated adrenarche'). Along with elevated age-adjusted DHEA-S production, children with exaggerated adrenarche may have slightly advanced bone age and accelerated linear growth.…”

Section: Premature Adrenarche and Exaggerated Adrenarchementioning

confidence: 99%

Adrenarche – physiology, biochemistry and human disease

Auchus¹,

Rainey

2003

Clinical Endocrinology

259

148

View full text Add to dashboard Cite

SummaryAdrenarche refers to the onset of dehydroepiandrosterone (DHEA) and DHEA-sulphate (DHEA-S) production from the adrenal zona reticularis that can be detected at around 6 years of age. The phenotypic result of adrenarche is pubarche or the development of axillary and pubic hair that occurs in both girls and boys at about age 8. The phenomenon of adrenarche is unique to human beings and to some Old World primates, and a reversal of adrenarche appears to occur in the ageing process. Premature and exaggerated adrenarche can be indicative of future onset of adult diseases, thus increasing the clinical relevance of adrenarche. The physiological triggers of adrenarche and the role(s) of DHEA-S remain speculative. However, the biochemical pathways that define adrenarche have been characterized in detail, and the appearance of key enzymes and cofactors in the adrenal zona reticularis track with the progression of adrenarche. This article reviews the clinical manifestations of adrenarche, the biochemistry of the enzymes involved in DHEA-S production, and the cell biology of the adrenal zona reticularis.Glucocorticoids and mineralocorticoids secreted by the adrenal glands are essential for the maintenance of vascular tone and carbohydrate metabolism or of blood volume and sodium balance, respectively. The testes and ovaries, by contrast, generate the sex steroids that are required for gametogenesis, secondary sexual characteristics and reproduction. However, the adrenal glands of adult human beings secrete generous quantities of the C 19 steroids dehydroepiandrosterone (DHEA) and DHEA-sulphate

show abstract

Hormonal Findings in African-American and Caribbean Hispanic Girls With Premature Adrenarche: Implications for Polycystic Ovarian Syndrome

Cited by 35 publications

References 29 publications

Prediction Models for Insulin Resistance in Girls with Premature Adrenarche

Prediction Models for Insulin Resistance in Girls with Premature Adrenarche

Premature adrenarche: novel lessons from early onset androgen excess

Adrenarche – physiology, biochemistry and human disease

Contact Info

Product

Resources

About