Cross-sectional phenotyping reveals normal standard cardiometabolic outcomes in children with premature adrenarche, highlighting preserved metabolic health despite early androgen excess.
Objectives Aim: We have launched a detailed phenotyping study in children with premature adrenarche and adolescent with PCOS recruiting from our large, multi-diverse population. Herein, we report standard clinical cardiometabolic risk outcomes from our initial recruits. Methods Single-centre cross-sectional phenotyping study. We report on standard auxology and fasting biochemical parameters, including androgen profile (DHEAS [RIA], androstenedione [A4] and testosterone [T] [LC/MSMS]), fasting glucose, HbA1c and lipids (cholesterol, triglycerides). Results 30 PA children ( were included after excluding other differential diagnoses. (precocious puberty and congenital adrenal hyperplasia). The age range is 5–8 years and 43% are of non-White British background. Median BMI z-score was +1.36 (range -0.05 – 3.65). All girls had elevated DHEAS (median: 3.22 mcmol/L; range 1.3 – 5.6); in four girls, A4 was elevated above one-fold the upper limit of normal; in all, T levels were within the limit of normal. Median HbA1c was 33 mmol/mol (range 27–39), fasting glucose was 5.6 mmol/L (Range 3.5 – 5.6); fasting cholesterol and triglyceride levels were within the normal range. Linear regression analysis showed a weak positive correlation between DHEAS and HbA1c (R² 0.21). No association was found between DHEAS and fasting glucose, DHEAS and lipids, DHEAS and BMI z-score, or BMI z-score with any metabolic parameters. So far, nine PCOS adolescent girls were included, the age range is 14–17 years, almost half of them are of non-White British background. Median BMI z-score was +1.64 (range 1.00–4.65). Conclusion Our pilot cohort of girls with PA is characterised by DHEAS excess. An unfavourable metabolic signature based on standard clinical parameters was not identified. Recruitment of children with PA and the establishment of a matched control cohort is ongoing, which will include in-depth biochemical assessment such as untargeted metabolomics and multi-steroid profiling.
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