Reference values for serum dehydroepiandrosterone‐sulphate in healthy children and adolescents with emphasis on the age of adrenarche and pubarche

Abstract

We established reference data of serum DHEA-S levels in a large group of children. Currently, adrenarche (DHEA-S>108·4 nmol/l) starts 1 year earlier in boys but higher DHEA-S levels are needed for transition from P1 to P2 in boys.

Expanding the developmental boundaries of etiologic effects: The role of adrenarche in genetic influences on disordered eating in males.

“…Boys were considered to be in adrenarche if they were in middle childhood or pre-adolescence (ages 6-12) and were of pre-pubertal status (i.e., no secondary sex characteristics; PDS score = 1). Rather than grouping all adrenarcheal boys together, these adrenarcheal twins were split into three age groups (i.e., ages 6-7 vs. 8-9 vs. 10-12) in order to capture the progression of adrenarcheal development and age-related increases in adrenal androgens (Guran et al, 2015). Indeed, extant data indicate substantial increases (of large effect sizes) in adrenal androgen concentrations across middle childhood; mean adrenal hormone levels are relatively similar from ages 4-5 versus age 6-7 ( d = .11) and then substantially increase from ages 6-7 to ages 8-9 ( d = 1.29), ages 9-11, ( d = 1.57), ages 11-13 ( d = 1.54), and ages 13-18 ( d = 3.40) (see Guran et al, 2015).…”

“…Nonetheless, one important caveat is that prior studies have only examined males that were age ten or older, yet genetic effects on disordered eating may emerge earlier in boys, such as during adrenarche – the first phase of puberty that begins during middle childhood (Dorn, Dahl, Woodward, & Biro, 2006; Guran et al, 2015). Adrenarche occurs in both boys and girls and is marked by the “awakening” of the adrenal glands and a rise in adrenal androgens, including androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone-sulphate (Dorn et al, 2006; Patton & Viner, 2007; Styne & Grumbach, 2008).…”

“…Adrenarche occurs in both boys and girls and is marked by the “awakening” of the adrenal glands and a rise in adrenal androgens, including androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone-sulphate (Dorn et al, 2006; Patton & Viner, 2007; Styne & Grumbach, 2008). These adrenal androgens begin to rise around age 6, they typically hit the concentration threshold for adrenarche onset around age 8, and they steadily increase with advancing age until young adulthood (e.g., ~age 20; Guran et al, 2015; Ilondo et al, 1982; Kelner & Brook, 1983). Adrenarcheal changes precede the activation of gonadarche – a phase marked by dramatic increases in gonadal androgens in boys, predominantly testosterone (Dorn et al, 2006; Styne & Grumbach, 2008; Patton & Viner, 2007), that is traditionally conceptualized as puberty (Dorn et al, 2006; Dorn & Biro, 2011).…”

Association between dehydroepiandrosterone-sulfate and attention in long-term survivors of childhood acute lymphoblastic leukemia treated with only chemotherapy

“…As in the general population, male survivors had overall higher DHEAS levels than female survivors. A majority of the survivors had DHEAS levels that were within the normal reference range, though 8/35 (22%) male and 4/34 (12%) female survivors had DHEAS levels that were below age-, sex- and Tanner Stage-based clinical reference for healthy children and adolescents (Elmlinger et al, 2002; Guran et al, 2015). Age was positively correlated with DHEAS level in both male (rsp=0.81, P <0.0001) and female (rsp=0.61, P <0.0001) survivors.…”

“…Because male survivors have higher physiologic DHEAS levels in comparison with female survivors, they may be more dependent upon DHEAS function, and we speculate that they may be more vulnerable to partial adrenal deficiencies than female survivors (Guran et al, 2015). Moreover, male survivors at the bottom DHEAS tertile had much worse attention scores than female survivors from the bottom tertile, thus suggesting that male survivors may be more sensitive to the effects of low DHEAS levels.…”