Biopsychological and Cognitive Differences in Children With Premature vs On-Time Adrenarche

Abstract

Background: Puberty consists of 2 components: gonadarche and adrenarche. Both components have distinct endocrine changes. Adrenarche has virtually been ignored with respect to examining hormone-behavior relations. Objectives: To provide descriptive biological and behavioral information on children with premature adrenarche (PA) and to examine differences in biological, psychological, and cognitive variables of children with PA and a healthy comparison group of children with ontime adrenarche. Design: Descriptive pilot study. Setting: A consecutive sample of patients was recruited from pediatric endocrine clinics; comparison children were recruited from the community. Participants: Children aged 6 to 9 years. Mean (±SD) age of children with PA (n = 9) was 7.8 (±1.3) years; of children with on-time adrenarche (n = 20), 8.0 (±1.2) years. Methods and Measures: Serum and saliva samples were collected for measurement of hormone concentrations. Questionnaires, tests, and interviews were completed by children and parents. Results: Compared with the on-time group, the PA group had significantly higher concentrations of adrenal androgens, estradiol, thyrotropin, and cortisol. By parent report on the Diagnostic Interview Schedule for Children, 4 children (44%) met diagnostic criteria for psychological disorders (primarily anxiety disorders). The PA group also had more self-reported depression and parent-reported behavior problems and lower scores on various intelligence tests. Conclusions: Although PA is considered a normal variation of pubertal development that warrants no medical intervention, PA presents with significant psychosocial problems. Children with PA may need psychological evaluation and follow-up. Future studies should confirm these findings with a larger sample and examine the long-term ramifications of this early presenting abnormality.

Differences in Endocrine Parameters and Psychopathology in Girls with Premature Adrenarche versus On-time Adrenarche

“…No significant group differences were noted in cortisol indices, differing from an earlier study 15 and our current hypothesis. Regulation of the corticotroph may be no different in PA compared to on-time girls.…”

“…Girls with PA also may be at risk for psychosocial problems 15 . The purpose of this study was two-fold.…”

A Cross-Sectional Study of Dehydroepiandrosterone Sulfate in Prepubertal Children with Myelomeningocele

“…Basal DHEAS serum levels (SDS values) in female (□) and male (●) MMC patients compared to reference data [19]. Lines represent –2 and +2 SD of reference data.…”

“…3 a SDS values of basal DHEAS serum levels in 13 MMC patients with isolated pubarche (Tanner stage PH 2–4; B1 or testes volume ≤3 ml); lines represent –2 and +2 SD of reference data [19]. b SDS values of basal DHEAS serum levels in 41 prepubertal MMC patients (Tanner stage PH 1; B1 or testes volume ≤3 ml); lines represent +2 and –2 SD of reference data [19]. □ = Females; ● = males. …”

“…Isolated premature activation of adrenarche is generally assessed as a benign condition [12]. However, transient acceleration of bone maturation [13], increased incidence of functional ovarian hyperandrogenism, insulin resistance and dyslipidemia in further life [14, 15, 17, 18]as well as psychosocial problems [19]have been documented. Isolated early or premature adrenarche is observed in MMC patients, but limited data are available in the literature.…”