Exaggerated adrenarche in a cohort of Scottish children: clinical features and biochemistry

Paterson, W. F.; Ahmed, S. Faisal; Bath, Louise; Donaldson, Malcolm; Fleming, Richard; Greene, Stephen A.; Hunter, Iain Andrew; Kelnar, C. J. H.; Mayo, Amalia; Schulga, John; Shapiro, David; Smail, P J; Wallace, Andrew M.

doi:10.1111/j.1365-2265.2009.03739.x

Cited by 39 publications

(40 citation statements)

References 32 publications

(71 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Few longitudinal studies of adrenal function in children exist, and these are primarily based on very few subjects (21) or urinary samples (22,23). In addition, some studies based on longitudinally collected serum samples from patients with exaggerated adrenarche exist (24). To our knowledge, this is the only longitudinal study with repetitive collection of serum samples based on healthy children.…”

Section: Discussionmentioning

confidence: 98%

The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition

Mouritsen

Aksglæde

Soerensen

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Background: Pubertal onset is usually defined by breast development in girls and testicular growth in boys. Pubarche is defined as the attainment of pubic hair and is considered as a sign of pubertal transition. Pubarche is preceded by a gradual increase in production of adrenal androgens, DHEA and D4-androstenedione (Adione), a process termed adrenarche. Objective: To study the natural course of pubertal transition and the associations with adrenarche, body fat, and linear growth. Design and methods: A longitudinal study of 179 healthy children (89 girls) with higher socioeconomic background examined every 6 months for 5 years. Pubic hair stage, breast stage, genital stage, testicular volume (TV), height, weight, and four skinfolds were measured. Results: In girls, median age (25th and 75th percentiles) at thelarche (B2C) was 10.1 years (9.3-10.9). In boys, median age at attaining a TV O3 ml was 11.5 years (10.9-12.0). Median age at pubarche (PH2C) was 10.9 years (10.3-11.4) in girls and 11.6 years (10.8-12.4) in boys. Only 6.8% (4/59) of the girls and 24.6% (15/61) of the boys developed pubic hair as the first isolated sign of puberty. Serum DHEAS and Adione increased with age, although the increase in Adione was most pronounced in girls. No associations between early age at thelarche/testicular growth and increased body fat (BMI and sum of four skinfolds) were observed. Conclusion: Danish children rarely experience pubarche as the first sign of puberty. No associations between age at pubertal onset and body composition were found. Circulating levels of Adione, but not DHEAS, increased with the onset of puberty, although with large interindividual variability.

show abstract

Section: Discussionmentioning

confidence: 98%

The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition

Mouritsen

Aksglæde

Soerensen

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…By contrast, in Finnish girls with IPA, evidence of insulin resistance was identified using the OGTT, but no alterations in lipid metabolism or blood pressure were found (56). Similarly, in recent studies from Greece, Andalusia and Scotland girls with IPA had normal lipid profiles (55,89,90).…”

Section: Metabolic Risk Factors In Pamentioning

confidence: 97%

“…French, Finnish and Scottish girls presenting with PP did not have significantly lower birth weight than controls (55,56,116) (Table 4). Moreover, data from Finnish and British birth cohort studies indicate no correlation between the occurrence of PCOS and low birth weight (117,118).…”

Section: Low Birth Weight and Early Onset Androgen Excessmentioning

confidence: 99%

“…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). The additional use of the term 'exaggerated adrenarche' has created further confusion, as it has been used to describe adrenal androgen levels above the pubertal range in children of pre-pubertal age (53,54) but also as a definition for the presence of exaggerated clinical features of androgen action associated with physiological, normal-timed adrenarche (55).…”

Section: Pa: Definitions and Differential Diagnosismentioning

confidence: 99%

“…Distinct conditions manifesting PA include milder and nonclassic variants of congenital adrenal hyperplasia (CAH) that have been diagnosed in 0-40% of children with PP (51,(61)(62)(63)(64)(65), depending on the pre-selection bias applied to the studied cohorts. Baseline blood sampling for measurement of DHEAS, androstenedione, 17a-hydroxyprogesterone (17OHP), testosterone, and sex hormone binding globulin (SHBG) will be generally sufficient to confirm increased adrenal androgens and to differentiate between IPA, CAH, and virilising tumours (55,61). Other causes potentially underlying a presentation with PA are summarised in Table 1.…”

Section: Pa: Definitions and Differential Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

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

Association of Birth Weight, Childhood Body Mass Index, and Height With Risk of Hidradenitis Suppurativa

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE There is a lack of evidence on the association of birth weight, childhood body mass index (BMI), change in BMI during childhood, and childhood height with subsequent risks of hidradenitis suppurativa (HS) in adulthood.OBJECTIVE To investigate the association of birth weight, childhood BMI, change in BMI during childhood, and childhood height with subsequent risks of HS in adulthood in a large Danish population-based cohort. DESIGN, SETTING, AND PARTICIPANTSThis cohort study included 347 200 schoolchildren from the Copenhagen School Health Records Register born from 1930 to 1996 who were linked to the Danish National Patient Register of hospital discharge diagnoses to identify cases of HS. Birth weight was reported by parents or guardians, whereas childhood weight and height were measured by school physicians or nurses at ages 7 through 13 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% CIs. Statistical analysis was performed from February 20, 2019, to May 15, 2019. MAIN OUTCOMES AND MEASURESA diagnosis of HS as recorded in the Danish National Patient Register. RESULTS Among the 347 200 children included in the study (175 750 boys) during the follow-up period from 1977 to 2017, 1037 individuals (677 females; median age at diagnosis, 39 years [range, 15-73 years]) received a diagnosis of HS. A nonlinear (U-shaped) association was found between birth weight and HS, such that both the lightest (2.00-2.75 kg; HR, 1.36 [95% CI, 1.10-1.68]) and the heaviest babies (4.26-5.50 kg; HR, 1.39 [95% CI, 1.01-1.93]) had increased risks of HS compared with normal-weight babies (3.26-3.75 kg; P = .04 for deviation from linearity). The risk of HS increased significantly with increasing BMI z score at each age from 7 to 13 years, from an HR of 1.32 (95% CI, 1.24-1.40) per BMI z score at 7 years of age to an HR of 1.50 (95% CI, 1.40-1.61) per BMI z score at 13 years of age. Compared with children with a normal weight at 7 and 13 years of age, those with a normal weight at 7 years of age and overweight at 13 years of age had a significantly increased risk of HS (HR, 2.11 [95% CI, 1.63-2.74]) and children with persistent overweight at both ages also had an increased risk of HS (HR, 2.61 [95% CI, 2.02-3.38]). Children with overweight at 7 years of age but with normal weight at 13 years of age did not have a significantly increased risk of HS (HR, 1.05 [95% CI, 0.67-1.67]). Childhood height at all ages was not associated with risk of HS (children at 7 years had an HR of 1.00 [95% CI, 0.94-1.07], and those 13 years had an HR of 1.06 [95% CI, 0.99-1.13], per z score).CONCLUSIONS AND RELEVANCE This cohort study found that both the lightest and heaviest babies had increased risks of HS. Childhood BMI was positively and significantly associated with risk of HS development in adulthood. These findings suggest that returning to normal weight before puberty reduces risks of HS to levels observed in children who were never overweight. Childhood height was not associated with risk of HS.

show abstract

Exaggerated adrenarche in a cohort of Scottish children: clinical features and biochemistry

Cited by 39 publications

References 32 publications

The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition

The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition

Premature adrenarche: novel lessons from early onset androgen excess

Association of Birth Weight, Childhood Body Mass Index, and Height With Risk of Hidradenitis Suppurativa

Contact Info

Product

Resources

About