title: Premature pubarche in girls is associated with functional adrenal but not ovarian hyperandrogenism.
abstract: OBJECTIVE
  We hypothesized that there would be evidence of functional ovarian hyperandrogenism in girls with premature pubarche (PP) at diagnosis.
  
  
  METHODS
  White girls <8 years of age and black girls <6 years with PP (n = 15) were studied. Prepubertal girls (n = 13; 5.3-10.9 years) and early pubertal girls (n = 8) served as control subjects. The biochemical marker for functional ovarian hyperandrogenism was the 17-hydroxyprogesterone (17-OHP), androstenedione (AD), and estradiol (E2) response to subcutaneous leuprolide during adrenal suppression with dexamethasone. This was studied in girls with PP and in control subjects.
  
  
  RESULTS
  ACTH stimulated 17-hydroxypregnenolone (17-OH Preg), dehydroepiandrosterone (DHEA), and AD levels, and 17-OH Preg:17-OHP and DHEA:AD ratios were significantly higher in girls with PP than in prepubertal control subjects (n = 18) (P < or =.003). The ovarian response to leuprolide stimulation was comparable in girls with PP and prepubertal control subjects, but the response in prepubertal study subjects was significantly lower than in pubertal control subjects (P =.016 for Delta17-OHP, P =.001 for DeltaAD, and P =.026 for DeltaE2).
  
  
  CONCLUSIONS
  Contrary to the hypothesis, PP in girls was not associated with prepubertal evidence of ovarian hyperandrogenism but was associated with functional adrenal hyperandrogenism.
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, Tennessee 37232, USA.
authors.forename: Revi P
authors.initials: RP
authors.lastname: Mathew
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Najjar
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Lorenz
authors.forename: Darrel E
authors.initials: DE
authors.lastname: Mayes
authors.forename: William E
authors.initials: WE
authors.lastname: Russell
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000302:Adrenal Cortex / Q000378:metabolism*; D000735:Androstenedione / Q000097:blood; D015415:Biomarkers; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D006628:Hirsutism / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology* / Q000378:metabolism; D007124:Immunoenzyme Techniques; D010053:Ovary / Q000378:metabolism*; D018709:Statistics, Nonparametric; D013256:Steroids / Q000097:blood*
chemical_list: D015415:Biomarkers; D013256:Steroids; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D004958:Estradiol; D019326:17-alpha-Hydroxyprogesterone