Disease relevance of Adrenarche

• As insulin and insulin-like growth factors (IGFs) have been implicated in the pathogenesis of PCOS, we hypothesize that they may also have a role in the hyperandrogenism of premature adrenarche [1].
• Adrenal androgen hyperresponsiveness to adrenocorticotropin in women with acne and/or hirsutism: adrenal enzyme defects and exaggerated adrenarche [2].
• Responsivity of pituitary gonadotropes to luteinizing hormone-releasing factor in idiopathic precocious puberty, precocious thelarche, precocious adrenarche, and in patients treated with medroxyprogesterone acetate [3].
• We therefore aimed to review the clinical and biochemical aspects of a large number of patients presenting with premature adrenarche without virilization and determine the relation between clinical and biochemical characteristics and the frequency of adrenal steroid disorders [4].
• Premature adrenarche presents with the early development of pubic hair only and must be distinguished from adrenal hyperplasia or an androgen-secreting neoplasm, which may be associated with accelerated growth, advanced bone age, and virilization [5].

High impact information on Adrenarche

• The chief hormonal product of adrenarche is dehydroepiandrosterone (DHEA) and its sulfated product DHEA-S [6].
• In children with the onset of progression of adrenarche during maintenance of a prepubertal gonadal steroid milieu, there was less evidence than in preadrenarchal children of a restraint upon skeletal maturation [7].
• Adrenarche and skeletal maturation during luteinizing hormone releasing hormone analogue suppression of gonadarche [7].
• The subsequent increase in plasma adrenal androgen concentration during adrenarche is coincident with a rise in 17,20-desmolase and 17-hydroxylase activity [8].
• The plasma concentrations of dehydroepiandrosterone, androstenedione, and dehydroepiandrosterone sulfate decrease during the first year of life, remain low during childhood, and then increase during adrenarche [8].

Chemical compound and disease context of Adrenarche

• Serum dehydroepiandrosterone sulphate negatively correlated with birth weight standard deviation scores in the group of girls with premature adrenarche (r=-0.57, p<0.001) [9].
• In order to evaluate whether changes of adrenal steroid serum levels occurring during the prepubertal period influence the degree of osteopenia, dehydroepiandrosterone sulfate (DHEAS) was longitudinally monitored as marker of the onset of adrenarche [10].

Biological context of Adrenarche

• Serine phosphorylation of human P450c17 increases 17,20-lyase activity: implications for adrenarche and the polycystic ovary syndrome [11].
• Fasting glucose insulin ratio: a useful measure of insulin resistance in girls with premature adrenarche [12].
• Adrenal androgen excretion during adrenarche. Relation to race and blood pressure [13].
• Molecular evolution of adrenarche: structural and functional analysis of p450c17 from four primate species [14].
• However, DHEAS levels in young children before adrenarche correlated inversely with weight at birth, indicating a relationship with fetal growth [15].

Anatomical context of Adrenarche

• It is suggested here that the postulated hormone does not exist and that the adrenarche, which parallels the development of the inner zone, the zona reticularis, is best explained by a morphological and functional change in the inner cells that is induced locally by high levels of cortisol [16].
• Females in the thelarche pathway also had greater body fat and BMI 1 year before puberty and throughout puberty compared with those in the adrenarche pathway [17].
• These data imply a significant contribution of ACTH to the regulation of adrenarche in normal children either by having a priming effect on the adrenal gland or by acting in concert with other adrenal androgen stimulating factors [18].
• Recently, GH therapy was found to amplify the adrenarche of short SGA children and to induce a pro-inflammatory shift, as judged by a rise of neutrophil count and circulating interleukin-6 (IL-6), and a fall in adiponectin levels [19].

Associations of Adrenarche with chemical compounds

• Serum dehydroepiandrosterone-sulfate (DHEAS) is a classic marker for adrenarche and, subsequently, for the individual hormonal milieu [20].
• Twenty-two girls with precocious adrenarche (PA) aged 3-8 years had mean concentrations of T, DHT, delta4 and DHEA that were significantly higher (P less than 0.05) than in prepubertal children, but similar to those of girls in stage II and significantly lower (P less than 0.02) than in late pubertal girls (stage IV/V) [21].
• Dehydroepiandrosterone sulfate levels are not suppressible by glucocorticoids before adrenarche [22].
• Comparison of simple measures of insulin sensitivity in young girls with premature adrenarche: the fasting glucose to insulin ratio may be a simple and useful measure [23].
• Altered sensitivity to low dose dexamethasone in a subset of patients with premature adrenarche [24].

Gene context of Adrenarche

• The roles of insulin sensitivity, insulin-like growth factor I (IGF-I), and IGF-binding protein-1 and -3 in the hyperandrogenism of African-American and Caribbean Hispanic girls with premature adrenarche [1].
• The absence/delay of adrenarche in POU1F1-deficient patients and the absence/delay of pubarche in POU1F1-deficient females suggest that a POU1F1-dependent factor contributes to the normal development of adrenarche and female pubarche [25].
• On the other hand, in short children with normal GH secretion, attention should be paid to whether or not the GH therapy in early childhood induces precocious adrenarche [26].
• A child with pituitary gigantism and precocious adrenarche: does GH and/or PRL advance the onset of adrenarche [26]?
• CRH is an adrenal androgen secretagogue in men and has been proposed as a candidate regulator of adrenarche [27].

Analytical, diagnostic and therapeutic context of Adrenarche

• A mixed longitudinal study of adrenal steroid excretion in childhood and the mechanism of adrenarche [28].
• Proceedings: Multiple steroid immunoassay in the study of the role of oestrogens in the human adrenarche [29].
• OBJECTIVE: This retrospective study was performed to characterize the adrenocorticotropin-stimulated androgen response in an African-American and Caribbean Hispanic population of girls with premature adrenarche [30].

References