Sopher A B, Thornton J C, Silfen M E, Manibo A, Oberfield S E, Wang J, Pierson R N, Levine L S, Horlick M
Department of Pediatrics, Columbia University, New York, New York 10032, USA.
J Clin Endocrinol Metab. 2001 Nov;86(11):5269-72. doi: 10.1210/jcem.86.11.8045.
Body composition in premature adrenarche (PA) has not been described. We hypothesized that the increased adrenal androgens in PA would have a trophic effect on lean body components. We studied 14 PA subjects and 16 controls, all prepubertal Hispanic girls. The body composition parameters tested included height, weight, bone mineral density (BMD), bone mineral content (BMC), nonbone fat-free mass, total body potassium, total body water, and extracellular water. Bone age was determined in all PA subjects. Compared with controls, PA subjects had significantly higher BMC (P = 0.02) and BMD (P = 0.03) when adjusted for age, weight, height, and fat mass, but were not different in the following lean body components: fat-free mass, total body potassium, total body water, and extracellular water. There was no difference in BMD or BMC between the PA subjects with and without advanced bone age. These data suggest a specific effect of PA on bone mineral, but not on other lean body components. The absence of a correlation between bone age and bone mineral in this small group leads us to propose there are separate promoters of bone age advancement and bone mineral accrual. Candidate hormones for these processes include adrenal androgens, E, and IGF-I. The findings of this study suggest that hormonal alterations associated with PA affect bone mineral accrual and may elucidate the mechanisms involved in this process.
早熟肾上腺初现(PA)患者的身体组成尚未见报道。我们推测,PA患者体内肾上腺雄激素增加会对瘦身体成分产生营养作用。我们研究了14例PA受试者和16例对照,均为青春期前的西班牙裔女孩。所检测的身体组成参数包括身高、体重、骨矿物质密度(BMD)、骨矿物质含量(BMC)、非骨去脂体重、全身钾、全身水和细胞外液。对所有PA受试者测定了骨龄。与对照组相比,校正年龄、体重、身高和脂肪量后,PA受试者的BMC(P = 0.02)和BMD(P = 0.03)显著更高,但在以下瘦身体成分方面无差异:去脂体重、全身钾、全身水和细胞外液。骨龄提前和未提前的PA受试者之间的BMD或BMC无差异。这些数据表明PA对骨矿物质有特定作用,但对其他瘦身体成分无作用。在这个小样本中骨龄与骨矿物质之间缺乏相关性,这使我们提出骨龄进展和骨矿物质积累有各自独立的促进因素。这些过程的候选激素包括肾上腺雄激素、雌激素和胰岛素样生长因子-I(IGF-I)。本研究结果提示,与PA相关的激素改变影响骨矿物质积累,并可能阐明这一过程的机制。