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

W. F. Paterson; S. F. Ahmed; L. Bath; M. D. C. Donaldson; R. Fleming; S. A. Greene; I. Hunter; C. J. H. Kelnar; A. Mayo; J. S. Schulga; D. Shapiro; P. J. Smail; A. M. Wallace

doi:10.1111/j.1365-2265.2009.03739.x

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

W. F. Paterson, S. F. Ahmed, L. Bath, M. D. C. Donaldson, R. Fleming, S. A. Greene, I. Hunter, C. J. H. Kelnar, A. Mayo, J. S. Schulga, D. Shapiro, P. J. Smail, A. M. Wallace

Research output: Contribution to journal › Article › peer-review

38 Citations (Scopus)

Abstract

Objective
To investigate the reported association between exaggerated adrenarche (EA) and reduced foetal growth and to identify possible risk factors for future morbidity in Scottish children with clinical features of EA.

Design
Three-year prospective study.

Measurements
Auxology, blood pressure (BP), biochemical analysis of blood and urine, pelvic ultrasound in girls.

Results
Fifty-two patients were recruited of whom one girl had nonclassical congenital adrenal hyperplasia (17-OHP 17 nmol/l) and one had insufficient blood for analysis. The final cohort comprised 42 girls of mean (SD) age 7 center dot 7 (0 center dot 99) and eight boys of 8 center dot 8 (0 center dot 67) years. Mean (SD) birth weight was 3 center dot 27 (0 center dot 49) and 3 center dot 10 (0 center dot 76) kg in girls and boys respectively. Height/weight SDS were 1 center dot 13/1 center dot 69 in girls and 1 center dot 69/1 center dot 88 in boys. Mean systolic/diastolic BP was 107 center dot 8/60 center dot 4 (50th-75th centile) in girls and 115 center dot 5/63 center dot 9 (75th-91st centile) in boys. Uterine and ovarian development was prepubertal. Median serum dehydroepiandrosterone sulphate (DHEAS) was 2 center dot 1 and 4 center dot 1 mu mol/l, androstenedione 3 center dot 1 and 3 center dot 8 nmol/l in girls and boys respectively, with DHEAS within the reference range/undetectable in 18/2 and androstenedione in 12/6 patients. Fasting insulin was 9 center dot 0 and 15 center dot 0 mU/l in girls and boys respectively, with concomitant low normal SHBG. Anti-Mullerian hormone (AMH) was 15 center dot 7 pmol/l in 27 girls, compared with 5 center dot 0 pmol/l in normal girls aged 5-8 years.

Conclusions
Our Scottish EA cohort showed female predominance, no evidence of reduced foetal growth, a tendency to overweight with commensurate mild hyperinsulinaemia and modest elevation of serum androgens in some patients. We have found raised AMH levels in the girls, indicating advanced ovarian follicular development.

Original language	English
Pages (from-to)	496-501
Number of pages	6
Journal	Clinical Endocrinology
Volume	72
Issue number	4
DOIs	https://doi.org/10.1111/j.1365-2265.2009.03739.x
Publication status	Published - Apr 2010

Keywords

POLYCYSTIC-OVARY-SYNDROME
PREMATURE ADRENARCHE
PRECOCIOUS PUBARCHE
NORMAL GIRLS
HYPERANDROGENISM
HORMONE
SERUM
HYPERINSULINEMIA
MENARCHE
GROWTH

Access to Document

10.1111/j.1365-2265.2009.03739.x

Cite this

Paterson, W. F., Ahmed, S. F., Bath, L., Donaldson, M. D. C., Fleming, R., Greene, S. A., Hunter, I., Kelnar, C. J. H., Mayo, A., Schulga, J. S., Shapiro, D., Smail, P. J., & Wallace, A. M. (2010). Exaggerated adrenarche in a cohort of Scottish children: clinical features and biochemistry. Clinical Endocrinology, 72(4), 496-501. https://doi.org/10.1111/j.1365-2265.2009.03739.x

@article{4e628bb471624a9a8e715f69ff789e49,

title = "Exaggerated adrenarche in a cohort of Scottish children: clinical features and biochemistry",

abstract = "Objective To investigate the reported association between exaggerated adrenarche (EA) and reduced foetal growth and to identify possible risk factors for future morbidity in Scottish children with clinical features of EA. Design Three-year prospective study. Measurements Auxology, blood pressure (BP), biochemical analysis of blood and urine, pelvic ultrasound in girls. Results Fifty-two patients were recruited of whom one girl had nonclassical congenital adrenal hyperplasia (17-OHP 17 nmol/l) and one had insufficient blood for analysis. The final cohort comprised 42 girls of mean (SD) age 7 center dot 7 (0 center dot 99) and eight boys of 8 center dot 8 (0 center dot 67) years. Mean (SD) birth weight was 3 center dot 27 (0 center dot 49) and 3 center dot 10 (0 center dot 76) kg in girls and boys respectively. Height/weight SDS were 1 center dot 13/1 center dot 69 in girls and 1 center dot 69/1 center dot 88 in boys. Mean systolic/diastolic BP was 107 center dot 8/60 center dot 4 (50th-75th centile) in girls and 115 center dot 5/63 center dot 9 (75th-91st centile) in boys. Uterine and ovarian development was prepubertal. Median serum dehydroepiandrosterone sulphate (DHEAS) was 2 center dot 1 and 4 center dot 1 mu mol/l, androstenedione 3 center dot 1 and 3 center dot 8 nmol/l in girls and boys respectively, with DHEAS within the reference range/undetectable in 18/2 and androstenedione in 12/6 patients. Fasting insulin was 9 center dot 0 and 15 center dot 0 mU/l in girls and boys respectively, with concomitant low normal SHBG. Anti-Mullerian hormone (AMH) was 15 center dot 7 pmol/l in 27 girls, compared with 5 center dot 0 pmol/l in normal girls aged 5-8 years. Conclusions Our Scottish EA cohort showed female predominance, no evidence of reduced foetal growth, a tendency to overweight with commensurate mild hyperinsulinaemia and modest elevation of serum androgens in some patients. We have found raised AMH levels in the girls, indicating advanced ovarian follicular development.",

keywords = "POLYCYSTIC-OVARY-SYNDROME, PREMATURE ADRENARCHE, PRECOCIOUS PUBARCHE, NORMAL GIRLS, HYPERANDROGENISM, HORMONE, SERUM, HYPERINSULINEMIA, MENARCHE, GROWTH",

author = "Paterson, {W. F.} and Ahmed, {S. F.} and L. Bath and Donaldson, {M. D. C.} and R. Fleming and Greene, {S. A.} and I. Hunter and Kelnar, {C. J. H.} and A. Mayo and Schulga, {J. S.} and D. Shapiro and Smail, {P. J.} and Wallace, {A. M.}",

year = "2010",

month = apr,

doi = "10.1111/j.1365-2265.2009.03739.x",

language = "English",

volume = "72",

pages = "496--501",

journal = "Clinical Endocrinology",

issn = "0300-0664",

publisher = "Wiley",

number = "4",

}

TY - JOUR

T1 - Exaggerated adrenarche in a cohort of Scottish children

T2 - clinical features and biochemistry

AU - Paterson, W. F.

AU - Ahmed, S. F.

AU - Bath, L.

AU - Donaldson, M. D. C.

AU - Fleming, R.

AU - Greene, S. A.

AU - Hunter, I.

AU - Kelnar, C. J. H.

AU - Mayo, A.

AU - Schulga, J. S.

AU - Shapiro, D.

AU - Smail, P. J.

AU - Wallace, A. M.

PY - 2010/4

Y1 - 2010/4

N2 - Objective To investigate the reported association between exaggerated adrenarche (EA) and reduced foetal growth and to identify possible risk factors for future morbidity in Scottish children with clinical features of EA. Design Three-year prospective study. Measurements Auxology, blood pressure (BP), biochemical analysis of blood and urine, pelvic ultrasound in girls. Results Fifty-two patients were recruited of whom one girl had nonclassical congenital adrenal hyperplasia (17-OHP 17 nmol/l) and one had insufficient blood for analysis. The final cohort comprised 42 girls of mean (SD) age 7 center dot 7 (0 center dot 99) and eight boys of 8 center dot 8 (0 center dot 67) years. Mean (SD) birth weight was 3 center dot 27 (0 center dot 49) and 3 center dot 10 (0 center dot 76) kg in girls and boys respectively. Height/weight SDS were 1 center dot 13/1 center dot 69 in girls and 1 center dot 69/1 center dot 88 in boys. Mean systolic/diastolic BP was 107 center dot 8/60 center dot 4 (50th-75th centile) in girls and 115 center dot 5/63 center dot 9 (75th-91st centile) in boys. Uterine and ovarian development was prepubertal. Median serum dehydroepiandrosterone sulphate (DHEAS) was 2 center dot 1 and 4 center dot 1 mu mol/l, androstenedione 3 center dot 1 and 3 center dot 8 nmol/l in girls and boys respectively, with DHEAS within the reference range/undetectable in 18/2 and androstenedione in 12/6 patients. Fasting insulin was 9 center dot 0 and 15 center dot 0 mU/l in girls and boys respectively, with concomitant low normal SHBG. Anti-Mullerian hormone (AMH) was 15 center dot 7 pmol/l in 27 girls, compared with 5 center dot 0 pmol/l in normal girls aged 5-8 years. Conclusions Our Scottish EA cohort showed female predominance, no evidence of reduced foetal growth, a tendency to overweight with commensurate mild hyperinsulinaemia and modest elevation of serum androgens in some patients. We have found raised AMH levels in the girls, indicating advanced ovarian follicular development.

AB - Objective To investigate the reported association between exaggerated adrenarche (EA) and reduced foetal growth and to identify possible risk factors for future morbidity in Scottish children with clinical features of EA. Design Three-year prospective study. Measurements Auxology, blood pressure (BP), biochemical analysis of blood and urine, pelvic ultrasound in girls. Results Fifty-two patients were recruited of whom one girl had nonclassical congenital adrenal hyperplasia (17-OHP 17 nmol/l) and one had insufficient blood for analysis. The final cohort comprised 42 girls of mean (SD) age 7 center dot 7 (0 center dot 99) and eight boys of 8 center dot 8 (0 center dot 67) years. Mean (SD) birth weight was 3 center dot 27 (0 center dot 49) and 3 center dot 10 (0 center dot 76) kg in girls and boys respectively. Height/weight SDS were 1 center dot 13/1 center dot 69 in girls and 1 center dot 69/1 center dot 88 in boys. Mean systolic/diastolic BP was 107 center dot 8/60 center dot 4 (50th-75th centile) in girls and 115 center dot 5/63 center dot 9 (75th-91st centile) in boys. Uterine and ovarian development was prepubertal. Median serum dehydroepiandrosterone sulphate (DHEAS) was 2 center dot 1 and 4 center dot 1 mu mol/l, androstenedione 3 center dot 1 and 3 center dot 8 nmol/l in girls and boys respectively, with DHEAS within the reference range/undetectable in 18/2 and androstenedione in 12/6 patients. Fasting insulin was 9 center dot 0 and 15 center dot 0 mU/l in girls and boys respectively, with concomitant low normal SHBG. Anti-Mullerian hormone (AMH) was 15 center dot 7 pmol/l in 27 girls, compared with 5 center dot 0 pmol/l in normal girls aged 5-8 years. Conclusions Our Scottish EA cohort showed female predominance, no evidence of reduced foetal growth, a tendency to overweight with commensurate mild hyperinsulinaemia and modest elevation of serum androgens in some patients. We have found raised AMH levels in the girls, indicating advanced ovarian follicular development.

KW - POLYCYSTIC-OVARY-SYNDROME

KW - PREMATURE ADRENARCHE

KW - PRECOCIOUS PUBARCHE

KW - NORMAL GIRLS

KW - HYPERANDROGENISM

KW - HORMONE

KW - SERUM

KW - HYPERINSULINEMIA

KW - MENARCHE

KW - GROWTH

U2 - 10.1111/j.1365-2265.2009.03739.x

DO - 10.1111/j.1365-2265.2009.03739.x

M3 - Article

C2 - 19863577

SN - 0300-0664

VL - 72

SP - 496

EP - 501

JO - Clinical Endocrinology

JF - Clinical Endocrinology

IS - 4

ER -

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

Abstract

Keywords

Access to Document

Fingerprint

Cite this