Interpretation of androgen and anti-Mullerian hormone profiles in a Hispanic cohort of 5- to 8-year-old girls with premature adrenarche

다국어 초록 (Multilingual Abstract)

Purpose: Premature adrenarche (PA) often leads to polycystic ovary syndrome (PCOS). Higher anti-mullerian hormone (AMH) levels are reported in PCOS. We studied the androgen profile and AMH profiles in Hispanic girls with PA (aged 5–8 years) and age and body mass index (BMI) matched controls. Methods: Retrospective review of electronic medical records of girls who met the inclusion criteria for premature adrenarche were done. Results: PA girls (n=76) were matched to control girls (n=12) for age (mean±standard deviation) (6.7±1 years vs. 6.2±1.3 years) and BMI (20±10 kg/m2 vs. 17.8±2.7 kg/ m2). Dehydroepiandrostenedione sulfate (63.3±51.3 µg/dL vs. 29.8±17.3 µg/dL, P<0.001) and testosterone levels (11.4±4.8 ng/dL vs. 8.2±2.9 ng/dL, P=0.001) were significantly higher in the PA group than controls. AMH values (<14 years: reference range, 0.49–3.15 ng/mL) were 3.2±2.2 ng/mL vs. 4.6± 3.2 ng/mL respectively in the PA and control groups and were not different (P=0.4). AMH did not show a correlation with bone age (P=0.1), and testosterone (P=0.9) in the PA group. 17-hydroxyprogesterone levels (17-OHP ng/dL) were 39.5±30.5 ng/dL vs. 36.8±19.8 ng/dL in PA versus control girls. The concentration of 17-OHP was not statistically different between the control and PA groups. Conclusion: Higher AMH was not observed in PA girls and no correlation with BA and androgen levels was observed.

참고문헌 (Reference)

1 Ibáñez L, "Usefulness of an ACTH test in the diagnosis of nonclassical 21-hydroxylase deficiency among children presenting with premature pubarche" 44 : 51-56, 1995

2 Hokken-Koèlega AC, "Timing of puberty and fetal growth" 16 : 65-71, 2002

3 Rosenfield RL, "Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index" 123 : 84-88, 2009

4 Qi X, "The role of anti-Müllerian hormone in the pathogenesis and pathophysiological characteristics of polycystic ovary syndrome" 199 : 82-87, 2016

5 Bayley N, "Tables for predicting adult height from skeletal age: revised for use with the Greulich-Pyle hand standards" 40 : 423-441, 1952

6 Utriainen P, "Serum antimüllerian hormone concentrations in prepubertal girls with and without premature adrenarche: The influence of body mass index" 74 : 207-211, 2010

7 Liimatta J, "Serum androgen bioactivity is low in children with premature adrenarche" 75 : 645-650, 2014

8 Montalto J, "Serum 5-androstene-3 beta,17 beta-diol sulphate, sex hormone binding globulin and free androgen index in girls with premature adrenarche" 33 : 1149-1154, 1989

9 Zhang LH, "Serine phosphorylation of human P450c17 increases 17,20-lyase activity: implications for adrenarche and the polycystic ovary syndrome" 92 : 10619-10623, 1995

10 Ankarberg-Lindgren C, "Sensitive RIA measures testosterone concentrations in prepubertal and pubertal children comparable to tandem mass spectrometry" 75 : 341-344, 2015

11 Collins WP, "Radioimmunoassay of plasma testosterone" 3 : 333-348, 1972

12 Sopher AB, "Prepubertal girls with premature adrenarche have greater bone mineral content and density than controls" 86 : 5269-5272, 2001

13 Voutilainen R, "Premature adrenarche:etiology, clinical findings, and consequences" 145 : 226-236, 2015

14 Kousta E., "Premature adrenarche leads to polycystic ovary syndrome? Long-term consequences" 1092 : 148-157, 2006

15 Leung AK, "Premature adrenarche" 22 : 230-233, 2008

16 Ibañez L, "Postpubertal outcome in girls diagnosed of premature pubarche during childhood: increased frequency of functional ovarian hyperandrogenism" 76 : 1599-1603, 1993

17 Ibáñez L, "Polycystic ovaries after precocious pubarche: relation to prenatal growth" 22 : 395-400, 2007

18 Uçar A, "Pelvic ultrasound findings in prepubertal girls with precocious adrenarche born appropriate for gestational age" 80 : 699-705, 2014

19 Vaiarelli A, "Limited ability of circulating anti-Müllerian hormone to predict dominant follicular recruitment in PCOS women treated with clomiphene citrate: a comparison of two different assays" 32 : 227-230, 2016

20 Hagen CP, "Individual serum levels of anti-Müllerian hormone in healthy girls persist through childhood and adolescence: a longitudinal cohort study" 27 : 861-866, 2012

21 DeSalvo DJ, "In children with premature adrenarche, bone age advancement by 2 or more years is common and generally benign" 26 : 215-221, 2013

22 Ibáñez L, "Hyperinsulinemia and decreased insulin-like growth factor-binding protein-1 are common features in prepubertal and pubertal girls with a history of premature pubarche" 82 : 2283-2288, 1997

23 Ibáñez L, "Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche" 41 : 1057-1063, 1998

24 Banerjee S, "Hormonal findings in African-American and Caribbean Hispanic girls with premature adrenarche: implications for polycystic ovarian syndrome" 102 : E36-, 1998

25 Paterson WF, "Exaggerated adrenarche in a cohort of Scottish children: clinical features and biochemistry" 72 : 496-501, 2010

26 Ibáñez L, "Exaggerated adrenarche and hyperinsulinism in adolescent girls born small for gestational age" 84 : 4739-4741, 1999

27 Wu T, "Ethnic differences in the presence of secondary sex characteristics and menarche among US girls: the Third National Health and Nutrition Examination Survey, 1988-1994" 110 : 752-757, 2002

28 Pigny P, "Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome:relationship to the ovarian follicle excess and to the follicular arrest" 88 : 5957-5962, 2003

29 Silfen ME, "Elevated free IGF-I levels in prepubertal Hispanic girls with premature adrenarche: relationship with hyperandrogenism and insulin sensitivity" 87 : 398-403, 2002

30 Gavela-Pérez T, "Earlier menarcheal age in Spanish girls is related with an increase in body mass index between pre-pubertal school age and adolescence" 10 : 410-415, 2015

31 Dorn LD, "Differences in endocrine parameters and psychopathology in girls with premature adrenarche versus on-time adrenarche" 21 : 439-448, 2008

32 Kumar A, "Development of a second generation anti-Müllerian hormone (AMH) ELISA" 362 : 51-59, 2010

33 Diaz A, "Characteristics of children with premature pubarche in the new york metropolitan area" 70 : 150-154, 2008

34 Sopher AB, "Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors" 19 : 1259-1264, 2011

35 Crisosto N, "Anti-Müllerian hormone levels in peripubertal daughters of women with polycystic ovary syndrome" 92 : 2739-2743, 2007

36 Bhide P, "Anti-Müllerian hormone and polycystic ovary syndrome" 37 : 38-45, 2016

37 Łebkowska A, "Anti-Müllerian hormone and polycystic ovary syndrome" 68 : 74-78, 2017

38 Wallace AM, "A multicentre evaluation of the new Beckman Coulter anti-Mullerian hormone immunoassay (AMH Gen II)" 48 (48): 370-373, 2011

39 Kuczmarski RJ, "2000 CDC Growth Charts for the United States: methods and development" 11 : 1-190, 2002