Premature adrenarche: novel lessons from early onset androgen excess
Jan Idkowiak,Gareth G. Lavery,Vivek Dhir,Timothy Barrett,Paul M. Stewart,Nils Krone,Wiebke Arlt +6 more
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TLDR
The recent discoveries of two novel monogenic causes of early onset androgen excess, apparent cortisone reductase deficiency and apparent DHEA sulphotransferase deficiency, support the notion that PA may represent a forerunner condition for PCOS.Abstract:
Adrenarche reflects the maturation of the adrenal zona reticularis resulting in increased secretion of the adrenal androgen precursor DHEA and its sulphate ester DHEAS. Premature adrenarche (PA) is defined by increased levels of DHEA and DHEAS before the age of 8 years in girls and 9 years in boys and the concurrent presence of signs of androgen action including adult-type body odour, oily skin and hair and pubic hair growth. PA is distinct from precocious puberty, which manifests with the development of secondary sexual characteristics including testicular growth and breast development. Idiopathic PA (IPA) has long been considered an extreme of normal variation, but emerging evidence links IPA to an increased risk of developing the metabolic syndrome (MS) and thus ultimately cardiovascular morbidity. Areas of controversy include the question whether IPA in girls is associated with a higher rate of progression to the polycystic ovary syndrome (PCOS) and whether low birth weight increases the risk of developing IPA. The recent discoveries of two novel monogenic causes of early onset androgen excess, apparent cortisone reductase deficiency and apparent DHEA sulphotransferase deficiency, support the notion that PA may represent a forerunner condition for PCOS. Future research including carefully designed longitudinal studies is required to address the apparent link between early onset androgen excess and the development of insulin resistance and the MS.read more
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Metabolomic profiles and childhood obesity.
Wei Perng,Matthew W. Gillman,Abby F. Fleisch,Ryan D. Michalek,Steven M. Watkins,Elvira Isganaitis,Mary-Elizabeth Patti,Emily Oken +7 more
TL;DR: To identify metabolite patterns associated with childhood obesity, to examine relations of these patterns with measures of adiposity and cardiometabolic risk, and to evaluate associations with maternal peripartum characteristics.
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Premature Adrenarche - A Common Condition with Variable Presentation
TL;DR: Although this common condition is usually benign, PA children with additional risk factors including obesity should be followed up, with the focus on weight and lifestyle.
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Intracrine androgen biosynthesis, metabolism and action revisited.
TL;DR: An overview of human C19 steroid biosynthesis including the production of 11-oxygenated androgens, their transport in circulation and uptake into peripheral tissues, and the mechanisms of intracrinology are conceptualised and reviewed.
References
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W. A. Marshall,James M. Tanner +1 more
TL;DR: Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development, finding that boys' genitalia begin to develop only about 6 months later than the girls' breasts and Pubic hair appears about 1½ years later in boys than in girls.
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TL;DR: It is proposed that the epidemiological associations between poor fetal and infant growth and the subsequent development of type 2 diabetes and the metabolic syndrome result from the effects of poor nutrition in early life, which produces permanent changes in glucose-insulin metabolism.
Journal ArticleDOI
Variations in pattern of pubertal changes in girls
TL;DR: The extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study is described.