Abstract
24h urine collections from a mixed longitudinal sample of 180 boys aged 3 to 16.5 years were analyzed for steroid metabolites by gas-liquid chromatography. As expected DHA excretion rose markedly over the whole age range but especially between ages 7-9; by contrast, although a substantial rise in THDOC and THS excretion was noted. THB and THF excretions did not increase more than could be explained by surface area changes. Enzymic activities at each step in the biosynthetic pathway were determined by ratios of metabolites excreted. A fall in 3β-hydroxysteroid dehydrogenation, especially of non-17 hydroxylated steroids, a marked fall of 21 hydroxylation of 17 hydroxylated steroids and a lack of change of 11β-hydroxylation contrasted with a marked rise in 17.20 lyase activity. Studies in patients with disorders of growth and puberty showed adrenal androgens to be ACTH stimulable and dexamethasone suppressible.
These results are consistent with the hypothesis that a relative decline in the ability to synthesize cortisol leads to a marginal increase in ACTH production which is responsible for the rise of adrenal androgens which constitutes adrenarche. It does not seem necessary to postulate the existence of a separate adrenal androgen stimulating hormone, at least in man.
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Kelnar, C., Wallis, A. & Brook, C. Adrenal steroid excretion in childhood and the mechanism of adrenarche. Pediatr Res 15, 1564 (1981). https://doi.org/10.1203/00006450-198112000-00174
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DOI: https://doi.org/10.1203/00006450-198112000-00174