title: A cross-sectional study of dehydroepiandrosterone sulfate in prepubertal children with myelomeningocele.
abstract: OBJECTIVE
  To assess biochemical characteristics of adrenarche in patients with myelomeningocele (MMC), we examined serum levels of dehydroepiandrosterone sulfate (DHEAS) in prepubertal MMC patients.
  
  
  METHODS
  The study included a total of 54 prepubertal patients with MMC and shunted hydrocephalus: 13 patients (2 m, 11 f; aged 4.6-10.1 years, mean 8.1 +/- 0.4) with isolated pubarche (Tanner stage PH 2-4, B1 or testes volume < or =3 ml) and 41 prepubertal MMC patients without pubarche (17 m, 24 f; aged 2.0-11.9 years; mean 6.8 +/- 2.5). DHEAS levels were measured directly by chemiluminescence immunoassay (Nichols, USA). Auxological data (supine length, body mass index (BMI), arm span) and bone age (BA) were recorded.
  
  
  RESULTS
  (mean +/- SD): Basal DHEAS levels correlated with chronological age (CA) (r = 0.32, p < 0.05), BA (r = 0.65, p < 0.01; n = 23), BMI (r = 0.54, p < 0.01) and pubic hair stage (PH1 vs. PH2-4, r = 0.49, p < 0.01). 10/11 patients aged 2-4 years had DHEAS levels in the normal range, whereas 18/40 (45.0%) of the 5- to 9-year-old patients showed elevated levels (>+2 SDS). Ten patients with isolated pubarche (10/13; 2 m, 8 f; CA 8.3 +/- 1.5 years) and 9 patients without pubarche (9/41; 6 m, 3 f; CA 6.9 +/- 2.1 years) had elevated DHEAS levels (+6.34 and +4.05 SDS, respectively). The values correlated with BA/CA ratio (p < 0.05, n = 23). There was a trend to higher BMI SDS levels in patients with elevated DHEAS levels.
  
  
  CONCLUSIONS
  Our data show an early and increased activation of adrenal androgen secretion in MMC patients.
authors.affiliation: Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany. regina.trollmann@kinder.imed.uni-erlangen.de
authors.forename: R
authors.initials: R
authors.lastname: Trollmann
authors.forename: B
authors.initials: B
authors.lastname: Langhans
authors.forename: E
authors.initials: E
authors.lastname: Strehl
authors.forename: D
authors.initials: D
authors.lastname: Wenzel
authors.forename: H G
authors.initials: HG
authors.lastname: Dörr
mesh_terms: D000375:Aging / Q000097:blood / Q000502:physiology; D001139:Arnold-Chiari Malformation / Q000150:complications; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D005835:Genitalia; D006197:Hair / Q000254:growth & development; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D008297:Male; D008591:Meningomyelocele / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D011627:Puberty / Q000097:blood*
chemical_list: D019314:Dehydroepiandrosterone Sulfate