Adrenal Androgens, Estrone, and Insulin-Like Growth Factor 1 Are Associated with Thelarche without Gonadotropin Activation in Girls
Authors' conclusion
Thelarche with low LH is associated with elevated DHEAS, testosterone, estrone, and IGF-1 concentrations, which is partly explained by BF%, suggesting that aromatization of adrenal androgens to estrogens in adipose tissue is one hormonal mechanism of thelarche in girls without gonadotropin activation.
Study context
- Population
- Population-based sample of girls aged 9–11; hormones and clinical signs of androgen action assessed at ages 7–9 and 9–11 years
- Participants
- 175 participants
- Exposure
- Low luteinizing hormone (LH) with thelarche vs low LH without thelarche vs higher LH with thelarche
- Low LH without thelarchen = 114reference
- Low LH and thelarchen = 32
- Higher LH and thelarchen = 29
- Outcome
- DHEAS
- Follow-up
- 7-9 years
Methodological detailspopulation-based
- Population-based
Main finding
As reported in the abstract
P = 0.03
Observational data: associations, not effects.
Further findings
| Outcome | Low LH without thelarche | Low LH and thelarche | P value |
|---|---|---|---|
| DHEAS · 9-11 yearsLow LH and thelarche vs Low LH without thelarche | 0.72 µmol/L | 0.97 µmol/L | P = 0.03 |
| Testosterone · 7-9 yearsLow LH and thelarche vs Low LH without thelarche | 0.14 nmol/L | 0.18 nmol/L | P = 0.02 |
| Testosterone · 9-11 yearsLow LH and thelarche vs Low LH without thelarche | 0.22 nmol/L | 0.27 nmol/L | P = 0.02 |
| Estrone · 7-9 yearsLow LH and thelarche vs Low LH without thelarche | 11.5 pmol/L | 14.5 pmol/L | P = 0.02 |
| Estrone · 9-11 yearsLow LH and thelarche vs Low LH without thelarche | 18.2 pmol/L | 24.3 pmol/L | P = 0.002 |
| IGF-1 · 7-9 yearsLow LH and thelarche vs Low LH without thelarche | 23.6 nmol/L | 28.6 nmol/L | P = 0.001 |
| IGF-1 · 9-11 yearsLow LH and thelarche vs Low LH without thelarche | 31.1 nmol/L | 35.9 nmol/L | P = 0.006 |
Clinical signs of androgen action and comparisons with higher LH and thelarche
- Low LH and thelarche had more clinical signs of androgen action at both ages than low LH without thelarche
- No statistically significant differences in hormonal concentrations at 7-9 years between low LH and thelarche and higher LH and thelarche
- At 7-9 years, low LH and thelarche had more signs of androgen action than higher LH and thelarche
- At 9-11 years, higher LH and thelarche had higher hormonal concentrations except dehydroepiandrosterone sulfate (DHEAS) than low LH and thelarche
Original publication
Adrenal Androgens, Estrone, and Insulin-Like Growth Factor 1 Are Associated with Thelarche without Gonadotropin Activation in Girls. Horm Res Paediatr. Published 1 September 2026. doi:10.
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