Adrenal function during childhood and puberty in daughters of women with polycystic ovary syndrome.
BACKGROUND
In some patients, PCOS may develop as a consequence of an exaggerated adrenarche during pubertal development.


OBJECTIVE
The aim of the study was to assess adrenal function during childhood and pubertal development in daughters of women with PCOS (PCOSd).


METHODS
We included 98 PCOSd [64 during childhood (ages 4-8 yr) and 34 during the peripubertal period (ages 9-13 yr)] and 51 daughters of control women (Cd) [30 during childhood and 21 during the peripubertal period]. In both groups, an acute ACTH-(1-24) stimulation test (0.25 mg) and an oral glucose tolerance test were performed. Bone age and serum concentrations of cortisol, androstenedione, 17-hydroxyprogesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), glucose, and insulin were determined.


RESULTS
PCOSd and Cd were similar in age and body mass index. During the peripubertal period, basal and poststimulated DHEAS concentrations were higher in PCOSd compared to Cd. Among PCOSd, 12.5% of girls in childhood and 32.4% in peripuberty presented biochemical evidence of exaggerated adrenarche. Stimulated insulin was higher in PCOSd compared to Cd during childhood (P = 0.03) and peripuberty (P = 0.03). An advancement of 8 months between bone and chronological age was observed in peripubertal PCOSd compared to Cd.


CONCLUSIONS
In PCOSd, basal and stimulated DHEAS concentrations were higher during the onset of puberty. Around 30% of the PCOSd demonstrated an exacerbated adrenarche, which may reflect increased P450c17 activity. In addition, a modest advance in bone age was observed, probably secondary to the hyperinsulinemia and/or adrenal hyperandrogenism.
Maliqueo
Manuel
M
Laboratory of Endocrinology, Department of Medicine, West Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago, Chile.
Sir-Petermann
Teresa
T
Pérez
Virginia
V
Echiburú
Bárbara
B
de Guevara
Amanda Ladrón
AL
Gálvez
Carla
C
Crisosto
Nicolás
N
Azziz
Ricardo
R
D000293:Adolescent; D000302:Adrenal Cortex / Q000502:physiology*; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000235:genetics / Q000503:physiopathology*; D011627:Puberty / Q000502:physiology*; D013254:Steroid 17-alpha-Hydroxylase / Q000378:metabolism
D007328:Insulin; D019314:Dehydroepiandrosterone Sulfate; C501892:CYP17A1 protein, human; D013254:Steroid 17-alpha-Hydroxylase