Premature Adrenarche in Girls Characterized By Enhanced 17,20-Lyase and 17β-Hydroxysteroid Dehydrogenase Activities

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CONTEXT: Girls with premature adrenarche (PA) may have a higher risk of developing polycystic ovary syndrome (PCOS) and metabolic syndrome. The biological purpose of adrenarche is unknown and the role of novel biosynthetic pathways remains unclear.

OBJECTIVE: To compare the urinary steroid metabolome and enzyme activities of girls with PA to age-matched control girls and to published steroid values of girls with normal adrenarche and of women with PCOS and their newborn daughters.

DESIGN: Prospective observational study from 2009 to 2014.

SETTING: Academic pediatric endocrinology referral center.

PARTICIPANTS: Twenty-three girls with PA and 22 healthy, age-matched girls.

MAIN OUTCOME MEASURES: Steroid metabolites in 24-hour urine samples, including 4 progesterones, 5 corticosterones, aldosterone, 13 androgens, 2 estrogens, 14 glucocorticoids, and enzyme activities represented by metabolite ratios.

RESULTS: Girls with PA had a higher body mass index (mean standard deviation scores 0.9 vs -0.3, P = 0.013). Androgen excretion was higher in PA girls than in control girls (median 3257 nmol/24 hours vs 1627 nmol/24 hours, P < 0.001), in particular metabolites from alternate androgen pathways. The amount of progesterone, corticosterone, aldosterone, estrogen, and cortisol metabolites were similar between groups. Activities of 17β-hydroxysteroid-dehydrogenase and of 17,20-lyase were higher in girls with PA. Activities of 3β-hydroxysteroid-dehydrogenase, 21-hydroxylase, and 5α-reductase activity were not different between groups, in contrast to published results on girls with normal adrenarche or PCOS females.

CONCLUSIONS: Metabolites and enzymes involved in alternate androgen pathways appear to be markers of PA. Prospective studies should assess whether steroid production in PA also differs from adrenarche at normal timing and persists into adulthood.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:105

Enthalten in:

The Journal of clinical endocrinology and metabolism - 105(2020), 12 vom: 01. Dez.

Sprache:

Englisch

Beteiligte Personen:

Janner, Marco [VerfasserIn]
Sommer, Grit [VerfasserIn]
Groessl, Michael [VerfasserIn]
Flück, Christa E [VerfasserIn]

Links:

Volltext

Themen:

17,20-lyase
17βHSD
17-Hydroxysteroid Dehydrogenases
3 (or 17)-beta-hydroxysteroid dehydrogenase
Androgens
Corticosterone
EC 1.1.-
EC 1.1.1.51
EC 1.14.14.19
Estrogens
Hydrocortisone
Journal Article
Observational Study
Premature adrenarche
Research Support, Non-U.S. Gov't
Steroid 17-alpha-Hydroxylase
Urinary steroid metabolome
W980KJ009P
WI4X0X7BPJ

Anmerkungen:

Date Completed 01.03.2021

Date Revised 01.03.2021

published: Print

Citation Status MEDLINE

doi:

10.1210/clinem/dgaa598

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM314383379