Division of Pediatric Endocrinology, Diabetes and Metabolism, Columbia University Irving Medical Center, New York, New York, USA.
Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Horm Res Paediatr. 2020;93(7-8):460-469. doi: 10.1159/000513236. Epub 2021 Feb 2.
Recent studies have shown 11-oxygenated androgens (11oAs) are the dominant androgens in premature adrenarche (PA). Our objective was to compare 11oAs and conventional androgens in a well-defined cohort of children with PA or premature pubarche (PP) and correlate these androgens with metabolic markers.
A prospective cross-sectional study was conducted at a university hospital. Fasting early morning serum steroids (including 11oAs) and metabolic biomarkers were compared and their correlations determined in children ages 3-8 years (F) or 3-9 years (M) with PA or PP (5 M and 15 F) and healthy controls (3 M and 8 F).
There were no differences between PA, PP, and controls or between PA and PP subgroups for sex, BMI z-score, or criteria for childhood metabolic syndrome. Dehydroepiandrosterone sulfate (DHEAS) was elevated only in the PA subgroup, as defined. 11oAs were elevated versus controls in PA and PP although no differences in 11oAs were noted between PA and PP. Within the case cohort, there was high correlation of T and A4 with 11-ketotestosterone and 11β-hydroxyandrostenedione. While lipids did not differ, median insulin and HOMA-IR were higher but not statistically different in PA and PP.
PA and PP differ only by DHEAS and not by 11oAs or insulin sensitivity, consistent with 11oAs - rather than DHEAS - mediating the phenotypic changes of pubarche. Case correlations suggest association of 11oAs with T and A4. These data are the first to report the early morning steroid profiles including 11oAs in a well-defined group of PA, PP, and healthy children.
最近的研究表明，11-氧代雄激素（11oAs）是性早熟（PA）的主要雄激素。我们的目的是在明确的 PA 或性早熟（PP）患儿队列中比较 11oAs 和常规雄激素，并将这些雄激素与代谢标志物相关联。
在一所大学医院进行了一项前瞻性横断面研究。比较了年龄在 3-8 岁（F）或 3-9 岁（M）的 PA 或 PP（5 名 M 和 15 名 F）和健康对照组（3 名 M 和 8 名 F）的空腹清晨血清类固醇（包括 11oAs）和代谢生物标志物，并确定了它们之间的相关性。
PA、PP 和对照组之间，或 PA 和 PP 亚组之间，在性别、BMI z 评分或儿童代谢综合征标准方面无差异。正如所定义的那样，只有在 PA 亚组中，脱氢表雄酮硫酸盐（DHEAS）升高。PA 和 PP 中的 11oAs 均高于对照组，尽管在 PA 和 PP 之间未观察到 11oAs 差异。在病例队列中，T 和 A4 与 11-酮睾酮和 11β-羟基雄烯二酮高度相关。尽管脂质没有差异，但 PA 和 PP 中的胰岛素和 HOMA-IR 中位数较高，但无统计学差异。
PA 和 PP 仅在 DHEAS 上存在差异，而在 11oAs 或胰岛素敏感性上不存在差异，这与 11oAs 而不是 DHEAS 介导性早熟的表型变化一致。病例相关性表明 11oAs 与 T 和 A4 相关。这些数据是首次在明确的 PA、PP 和健康儿童队列中报告包括 11oAs 在内的清晨类固醇谱。
