title: The presentation of adrenarche is sexually dimorphic and modified by body adiposity.
abstract: BACKGROUND
  Adrenarche refers to the onset of increased production of adrenal androgens in childhood leading variably to clinical signs of androgen action. The prevalence and presentation of adrenarche in prepubertal girls and boys is not well known.
  
  
  OBJECTIVE
  Our objective was to examine the prevalence and clinical presentation of adrenarche in a population sample of prepubertal children aged less than 9 years.
  
  
  METHODS
  This cross-sectional study included prepubertal children (209 girls and 228 boys; median age 7.6 [range 6.8-8.9] years) taking part in The Physical Activity and Nutrition in Children (PANIC) Study.
  
  
  METHODS
  The prevalence of adrenarche was assessed.
  
  
  RESULTS
  The prevalence of any clinical sign of androgen action was higher in girls than in boys (26.1% vs 10.0%; P < .001) and biochemical adrenarche without any clinical sign was less common in girls than in boys (8.1% vs 16.7%; P = .007). When premature adrenarche was defined by serum dehydroepiandrosterone sulfate concentration ≥1 μmol/L (≥37 μg/dL) and any clinical sign before the age of 8 years in girls and 9 years in boys, its total prevalence was 8.6% in girls and 1.8% in boys. The risk of having any clinical sign increased with higher body fat percentage in boys and with higher serum dehydroepiandrosterone sulfate concentration in girls.
  
  
  CONCLUSIONS
  Clinical signs of androgen action are more common, but biochemical adrenarche without any clinical sign is less common in prepubertal girls than boys. This sexual dimorphism of adrenarche might be explained by sex-dependent differences in peripheral androgen metabolism or action that are modified by body fat.
authors.affiliation: Department of Pediatrics (A.M., J.J., R.V.), University of Eastern Finland and Kuopio University Hospital; Department of Physiology (V.L., A.V., T.T., T.A.L.), Institute of Biomedicine, and Institute of Dentistry (A.V.), University of Eastern Finland; Department of Clinical Physiology and Nuclear Medicine (T.T., T.A.L.), Kuopio University Hospital; and Kuopio Research Institute of Exercise Medicine (T.A.L.), FI-70029 Kuopio, Finland.
authors.forename: Aino
authors.initials: A
authors.lastname: Mäntyselkä
authors.forename: Jarmo
authors.initials: J
authors.lastname: Jääskeläinen
authors.forename: Virpi
authors.initials: V
authors.lastname: Lindi
authors.forename: Anna
authors.initials: A
authors.lastname: Viitasalo
authors.forename: Tuomo
authors.initials: T
authors.lastname: Tompuri
authors.forename: Raimo
authors.initials: R
authors.lastname: Voutilainen
authors.forename: Timo A
authors.initials: TA
authors.lastname: Lakka
mesh_terms: D000273:Adipose Tissue / Q000502:physiology*; D050154:Adiposity / Q000502:physiology*; D000302:Adrenal Cortex / Q000254:growth & development* / Q000378:metabolism; D050499:Adrenarche / Q000502:physiology*; D000728:Androgens / Q000097:blood; D001823:Body Composition / Q000502:physiology; D002648:Child; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D015995:Prevalence; D011629:Puberty, Precocious / Q000453:epidemiology* / Q000378:metabolism; D012307:Risk Factors; D012727:Sex Characteristics
chemical_list: D000728:Androgens; D019314:Dehydroepiandrosterone Sulfate