medwireNews: Levels of dehydroepiandrosterone sulfate (DHEAS) at the age of 7 years may determine how soon healthy girls progress to thelarche, pubarche and menarche, say researchers.

Verónica Mericq (University of Chile, Santiago) and colleagues found that high levels predicted an earlier onset of these pubertal stages, even after accounting for BMI.

The team studied 504 girls, 27% of whom were classified as having a high DHEAS level at the age of approximately 7 years, defined as higher than 42.1 µg/dL (which was the 75th percentile for the study population).

Girls with high DHEAS levels at age 7 reached Tanner breast stage 2 significantly earlier than those with lower levels, at the ages of 8.6 versus 9.3 years, on average. This was also true for pubarche (9.3 vs 9.7 years), Tanner breast stage 4 (10.7 vs 11.1 years) and menarche (11.6 vs 12.1 years).

These girls did not progress through puberty any faster, however, with the average time from Tanner breast stage 2 to menarche being 2.9 years, compared with 2.8 years in those with lower DHEAS levels.

Girls with high prepubertal DHEAS had a significantly higher BMI standard deviation score (SDS) than those with lower DHEAS levels, at an average of 1.2 versus 0.7, and significantly more were obese (<2.0 SDS), at 20% versus 12%.

However, the differences in pubertal timing between the girls with high and lower DHEAS levels persisted after accounting for BMI SDS at age 7 years, as well as exact age at the time of prepubertal DHEAS measurement, birthweight and mother’s age at menarche.

Mericq and colleagues also found some hormonal differences between girls with high and lower prepubertal DHEAS levels, they report in Hormone Research in Paediatrics.

Specifically, girls with high DHEAS levels at age 7 had significantly higher average levels of androstenedione (0.28 vs 0.23 ng/mL) and testosterone (0.07 vs 0.06 ng/mL) than those with lower levels at the time of attaining Tanner breast stage 2, and this persisted at Tanner breast stage 4. They also had a higher free androgen index at 1 year after menarche, and significantly lower levels of anti-müllerian hormone at Tanner stage 2 and of sex hormone-binding globulin at 1 year after menarche. These differences were independent of factors including age and BMI SDS.

However, having high DHEAS at age 7 had no effect on later ovarian morphology, with the two groups having similar ovarian volume 1 year after menarche and similar rates of polycystic ovarian morphology (PCOM).

The researchers note that the apparent lack of effect of high DHEAS on ovarian morphology was in spite of differences in androstenedione levels and free androgen index between the two groups, which they say “could be attributed to the fact that PCOM is an inconsistent finding in healthy girls, especially during early puberty.”

They conclude that their study cohort offers “a unique opportunity to prospectively address the inter­relationships between childhood DHEAS levels, early growth, and adiposity as determinants of ovarian function.”

By Eleanor McDermid

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Horm Res Paediatr 2020; doi:10.1159/000506632

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