Early adrenarche in normal prepubertal girls: a prospective longitudinal study.
OBJECTIVE
To study basal and ACTH stimulated levels of dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), and cortisol (F) in healthy girls during prepuberty.


METHODS
Six prepubertal girls, ages 3.7-10.9 years.


METHODS
The six girls underwent a physical examination and an acute ACTH stimulation test on a yearly basis. Serum DHEA, DHEAS, A4, and F at 0 min (Steroid0) and 60 min (Steroid60) after 0.25 mg ACTH1-24 i.v., and the net increment (delta Steroid60-0) were calculated.


RESULTS
DHEAS0, DHEAS60, DHEA0, DHEA60 and A40 were positively correlated to chronological age. DHEAS0 and DHEAS60 levels rose gradually beginning at 6.1-7.0 years of chronological age, and were found to be significantly different at 9.1-10.0 years and 10.1-11.0 years of age, compared to the median values obtained at < or =6.0 years of age. There was a tendency for DHEA0, DHEA60, and A40 to increase beginning at 9.1-10.0 years of age. Net increment values of all hormones did not change throughout the study.


CONCLUSIONS
An increase in the circulating level of DHEAS appears to be the first event observed during adrenarche, prior to clinical evidence of the process.
Azziz
Ricardo
R
Departments of Obstetrics and Gynecology and Medicine, The University ofAlabama at Birmingham, Birmingham, AL, USA. azzizr@cshs.org
Farah
Lisa A
LA
Moran
Carlos
C
Knochenhauer
Eric S
ES
Potter
H Downing
HD
Boots
Larry R
LR
D000305:Adrenal Cortex Hormones / Q000096:biosynthesis*; D000324:Adrenocorticotropic Hormone; D000367:Age Factors; D000704:Analysis of Variance; D000886:Anthropometry; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D003687:Dehydroepiandrosterone / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D010808:Physical Examination; D011336:Probability; D011446:Prospective Studies; D011627:Puberty / Q000502:physiology*; D012016:Reference Values
D000305:Adrenal Cortex Hormones; D003687:Dehydroepiandrosterone; D000324:Adrenocorticotropic Hormone