A cross-sectional study of dehydroepiandrosterone sulfate in prepubertal children with myelomeningocele.
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.
Trollmann
R
R
Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany. regina.trollmann@kinder.imed.uni-erlangen.de
Langhans
B
B
Strehl
E
E
Wenzel
D
D
Dörr
H G
HG
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*
D019314:Dehydroepiandrosterone Sulfate