Context: In some patients PCOS may develop as a consequence of an exaggerated adrenarche during pubertal development.

Objective: To assess adrenal function during childhood, and pubertal development in daughters of women with PCOS (PCOSd).

Design: We included ninety eight PCOSd [64 during childhood (4–8 yr old) and 34 during the peripubertal period (9–13 yr old)] and 51 daughters of control women (Cd) [30 during childhood and 21 during the peripubertal period]. In both groups, an acute ACTH-(1–24) stimulation test (0.25 mg) and an oral glucose tolerance test (OGTT) were performed. Bone age and serum concentrations of cortisol, androstenedione, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA), DHEA-sulfate (DHEAS), glucose, and insulin were determined.

Results: PCOSd and Cd were similar in age and BMI. During the peripubertal period, basal and post-stimulated DHEAS concentrations were higher in PCOSd compared to Cd. Among PCOSd, 12.5% of girls in childhood and 32.4% in peripuberty presented biochemical evidence of exaggerated adrenarche. Stimulated insulin was higher in PCOSd compared to Cd during childhood (p=0.03) and peripuberty (p=0.03). An advancement of eight months between bone and chronological age was observed in peripubertal PCOSd compared to Cd.

Conclusions: In PCOSd, basal and stimulated DHEAS concentrations were higher during the onset of puberty. Around 30% of the PCOSd demonstrated an exacerbated adrenarche which may reflect increased P450c17 activity. In addition, a modest advance in bone age was observed, probably secondary to the hyperinsulinemia and/or adrenal hyperandrogenism.