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Adrenarche (“awakening of the adrenal glands”) is the developmental period, usually occurring between ages 5 and 8, when adrenal androgens begin to rise. Adrenarche can be thought of as the first component of puberty. The androgens involved include dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS) and androstenedione. These adrenal androgens are relatively weak compared to androgens like testosterone, but they still play important roles in the body. Following adrenarche, gonadarche occurs in which breasts, genitals, pubic hair and reproductive competence develop. During gonadarche, the adrenal androgens continue to rise, but the mechanism for these two processes is thought to be independent.
Premature adrenarche (PA) occurs when adrenarche begins early, usually at or before the age of 8 years in girls. When PA is considered benign and thus has no known cause, it is more frequent in girls. During PA, the concentrations of adrenal androgens are higher than in the child’s same-aged peers. This contributes to the early appearance of pubic hair, body odor, auxiliary hair and often increased height. Some girls with PA may go on to develop disorders like polycystic ovary syndrome (PCOS) and / or metabolic syndrome. Our research suggests that girls with PA may also be more likely to develop mood and behavior problems.
Our lab recently completed an NIH-funded study on PA in girls. We enrolled 40 girls with PA along with 36 on-time adrenarche girls matched by age, race, socioeconomic status and BMI. Participants and their parents completed a number of questionnaires and interviews. The participants also had blood drawn for hormone analysis, a physical exam and neuropsychological testing. The study was cross-sectional and enrollment is complete.
Dorn LD, Rose SR, Rotenstein D, Susman EJ, Huang B, Loucks TL, Berga SL. Differences in endocrine parameters and psychopathology in girls with premature adrenarche versus on-time adrenarche. Journal of Pediatric Endocrinology and Metabolism. 21(5), 439-448. 2008.
Dorn LD. Psychological abnormalities associated with premature adrenarche and precocious puberty. In O. Pescovitz, and E. Walvoord (Eds.), When puberty is precocious: scientific and clinical aspects. Totowa, NJ. The Humana Press. 2008.
Dorn LD, Rotenstein D. Early puberty in girls: the case of premature adrenarche. Women’s Health Issues. 14(6), 177-183. 2004.
Cizza G, Dorn LD, Lotsikas A, Sereika S, Rotenstein D, Chrousos GP. Circulating plasma leptin and IGF-1 levels in girls with premature adrenarche: Potential implications of a preliminary study. Hormone and Metabolic Research. 33(3), 138-143. 2001.
Dorn LD, Hitt SF, Rotenstein D. Biopsychological and cognitive differences in children with premature vs. on-time adrenarche. Archives of Pediatrics and Adolescent Medicine. 153(2), 137-146. 1999.
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