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Prepubertal Girls with Premature Adrenarche Have Greater Bone Mineral Content and Density Than Controls

Department of Pediatrics (A.B.S., M.E.S., A.M., S.E.O., L.S.L., M.H.) and Institute of Human Nutrition (A.B.S.), Columbia University, New York, New York 10032; and Body Composition Unit, St. Luke’s-Roosevelt Hospital Center (A.B.S., J.C.T., J.W., R.N.P., M.H.), New York, New York 10025

Address all correspondence and requests for reprints to: Mary Horlick, M.D., Body Composition Unit, Plant Basement, St. Luke’s-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, New York 10025. E-mail: mnh1{at}columbia.edu

Abstract

Body composition in premature adrenarche (PA) has not been described. We hypothesized that the increased adrenal androgens in PA would have a trophic effect on lean body components. We studied 14 PA subjects and 16 controls, all prepubertal Hispanic girls. The body composition parameters tested included height, weight, bone mineral density (BMD), bone mineral content (BMC), nonbone fat-free mass, total body potassium, total body water, and extracellular water. Bone age was determined in all PA subjects.

Compared with controls, PA subjects had significantly higher BMC (P = 0.02) and BMD (P = 0.03) when adjusted for age, weight, height, and fat mass, but were not different in the following lean body components: fat-free mass, total body potassium, total body water, and extracellular water. There was no difference in BMD or BMC between the PA subjects with and without advanced bone age.

These data suggest a specific effect of PA on bone mineral, but not on other lean body components. The absence of a correlation between bone age and bone mineral in this small group leads us to propose there are separate promoters of bone age advancement and bone mineral accrual. Candidate hormones for these processes include adrenal androgens, E, and IGF-I. The findings of this study suggest that hormonal alterations associated with PA affect bone mineral accrual and may elucidate the mechanisms involved in this process.

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