Cardiometabolic risk profile among young adult females with a history of premature adrenarche

Context: Premature adrenarche (PA) is associated with childhood overweight and hyperinsulinemia; the long-term cardiometabolic outcome is unknown. Objective: To study cardiometabolic profile in adult women with previous PA. Design and participants: Thirty women with PA and 41 control subjects were followed from prepuberty to young adulthood. Main outcome measures: Prevalence of the metabolic syndrome (MetS) and clinical and biochemical cardiovascular risk factors. Results: There were no differences in the prevalence of MetS or in any parameters indicating dyslipidemia, hypertension, hepatosteatosis, atherosclerosis, or low-grade inflammation between the study groups. However, prevalence of insulin resistance (IR; P = 0.014) and acanthosis nigricans (P = 0.010) was higher in the PA group. Neither fasting glucose nor insulin concentrations differed between the study groups, but HbA1c [adjusted for body mass index (BMI) P = 0.011] and Homeostatic Model Assessment of Insulin Resistance (P = 0.044; BMI-adjusted P = nonsignificant) were higher in the PA group. Although BMI and fat percentage were comparable between the study groups, the PA group had higher central fat mass than the control group. In the whole study population, MetS and IR were associated with greater adult fat mass, but no prepubertal factors predicting later IR were found. Conclusion: PA does not seem to be associated with MetS, dyslipidemia, hypertension, atherosclerosis, or low-grade inflammation in young adult women. However, some women with PA may be at an increased risk of unfavorable glucose metabolism, which is associated with increased central adiposity at adult age rather than determined by prepubertal factors. Copyright (C) 2019 Endocrine SocietyPeer reviewe

Tracking of Serum DHEAS Concentrations from Age 1 to 6 Years : A Prospective Cohort Study

Context: Adrenarche is a gradual process, but its programming is unknown. Objective: The objective of this article is to examine the trajectory of dehydroepiandrosterone sulfate (DHEAS) from age 1 to 6 years and the associations of early growth with DHEAS concentration by age 6 years. Design and participants: Longitudinal data from a population sample of 78 children (43 girls) with serum samples for DHEAS and insulin-like growth factor 1 (IGF-1) measurements available at ages 1 and 6 years. Main outcome measure: Serum DHEAS concentration at age 6 years. Results: DHEAS concentration at age 1 year correlated with DHEAS concentration at age 6 years (r = 0.594, P <.001). DHEAS levels at age 6 years increased with tertiles of DHEAS at age 1 year (medians (mu g/dL); 4.2, 14.4, 22.6; P <.001) and with those of greater increase in length by age 1 year (6.0, 11.7, 16.4; P = .047), and decreased with Wailes of birth length (17.7, 13.3, 7.1; P = .042). In a regression model including birth size, biochemical covariates at age 1 year, and growth measures by age 6 years, higher DHEAS concentration at age 1 year was an independent determinant of falling into the highest DHEAS tertile at age 6 years. Conclusions: Higher serum DHEAS concentrations already at age 1 year are associated with those at age 6 years. Also, shorter birth length and rapid catch-up growth in length by age 1 year are associated with higher DHEAS concentrations at age 6 years. These results corroborate the early origin of adrenarche and strongly suggest that part of adrenarchal programming already takes place by the end of infancy. (C) Endocrine Society 2020.Peer reviewe

Ennenaikainen adrenarke : yleinen, moni-ilmeinen ja hyväennusteinen kehitysvariantti

Vertaisarvioitu. English summaryPeer reviewe

Trajectories of Growth and Serum DHEAS and IGF-1 Concentrations in Girls With a History of Premature Adrenarche: Attenuation of the Phenotype by Adulthood

Background: It has been speculated that premature adrenarche (PA) could lead to unfavorable outcome, including shorter adult stature, but longitudinal follow-up data are insufficient.Methods: This prospective case-control study included 30 PA and 42 control females who were born mostly full-term and appropriate for gestational age. They were examined first at the median age of 7.6 years and now at 18.1 years. Main outcome measures were height, body mass index (BMI), age at menarche, and serum dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor 1 (IGF-1) concentrations.Results: The PA and control females had comparable mean (standard deviation) adult height [167.2 (6.8) vs. 164.5 (5.1) cm, P = 0.059] and median (25th–75th percentiles) BMI [22.8 (21.1–28.9) vs. 21.6 (19.8–24.3) kg/m2, P = 0.068, respectively]. Adult heights were comparable with the mid-parental heights in both study groups. The PA females were taller than the controls until the age of 12 years and they lacked a distinct pubertal growth spurt. Serum DHEAS and IGF-1 concentrations did not differ between the PA and control groups at the age of 18 years. Median (range) age at menarche was significantly lower in the PA than control females [11.5 (9.5–15.0) vs. 13.0 (10.0–15.0), P = 0.001].Conclusions: Although PA girls have advanced growth and earlier pubertal development together with a tendency to be more overweight, their height, BMI, and serum DHEAS and IGF-1 concentrations are comparable to those of their peers at the age of 18 years. Our findings indicate a benign outcome of PA in appropriate for gestational age -born females concerning adult height and adrenal androgen secretion

Effects of 2-year physical activity and dietary intervention on adrenarchal and pubertal development: the PANIC study.

CONTEXT Childhood overweight has been linked to earlier development of adrenarche and puberty, but it remains unknown if lifestyle interventions influence sexual maturation in general populations. OBJECTIVE To investigate if a 2-year lifestyle intervention influences circulating androgen concentrations and sexual maturation in a general population of children. DESIGN AND PARTICIPANTS A 2-year intervention study in which 421 prepubertal and mostly normal-weight 6-9-year-old children were allocated either to a lifestyle intervention group (119 girls, 132 boys) or a control group (84 girls, 86 boys). INTERVENTION A 2-year physical activity and dietary intervention. MAIN OUTCOME MEASURES Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and testosterone concentrations, and clinical adrenarchal and pubertal signs. RESULTS The intervention and control groups had no differences in body size and composition, clinical signs of androgen action, and serum androgens at baseline. The intervention attenuated the increase of dehydroepiandrosterone (p = 0.032), dehydroepiandrosterone sulfate (p = 0.001), androstenedione (p = 0.003), and testosterone (p = 0.007) and delayed pubarche (p = 0.038) in boys but it only attenuated the increase of dehydroepiandrosterone (p = 0.013) and dehydroepiandrosterone sulfate (p = 0.003) in girls. These effects of lifestyle intervention on androgens and the development of pubarche were independent of changes in body size and composition but the effects of intervention on androgens were partly explained by changes in fasting serum insulin. CONCLUSIONS A combined physical activity and dietary intervention attenuates the increase of serum androgen concentrations and sexual maturation in a general population of prepubertal and mostly normal-weight children, independently of changes in body size and composition

ABS-optimoitu 3D-tulostin : Käytettävien materiaalien testaus

Tämän opinnäytetyö on osa tuotekehitysprojektia, jossa olemassa olevasta 3D-tulostimesta optimoitiin ABS-muovia paremmin työstävä laite. ABS on yksi yleisimpiä 3D-tulostukseen käytetyistä filamenteista, mutta se on tulostettavuudeltaan hankala, koska se on herkkä lämpötilojen vaihteluille. Uuden laitteen tuli siis olla umpinainen, jotta lämpötila pysyisi vakiona. Osa tulostetuista komponenteista ei kuitenkaan kestänyt niin korkeita lämpötiloja filamentinvalmistajan tuotetiedoista huolimatta. Opinnäytetyössä selvitetään, mitä muovissa tapahtuu korkeiden lämpötilojen vaikutuksen alaisena ja miksi tulostetut osat reagoivat lämpöön. Työssä myös perehdyttiin muovin kemiallisiin ja fyysisiin ominaisuuksiin sekä teoriaan. Tätä tietoa pyrittiin soveltamaan 3D-tulostusfilamentteihinkin, joiden valikoima on laaja ja jatkuvasti kasvava. Lisäksi suoritettiin koe, jossa tulostettuja koekappaleita lämpökuormitettiin ja näin yritettiin löytää kestävä materiaali käytettäväksi tuotekehitysprojektissa. Kokeeseen valituista filamenteista löytyi kaksi projektiin soveltuvaa materiaalia, mutta kriittisimmät osat tullaan valmistamaan varmuuden vuoksi alumiinista. Muovit lämpölaajenevat enemmän kuin metallit, ja pelkästään jo tämä aiheuttaa ongelmia 3D-tulostimen kaltaisessa hienomekaanisessa laitteessa. Muoveja on monen erilaisia ja pienetkin seikat vaikuttavat niiden toimintaan lämmölle altistettuina ja kävi myös ilmi, että valmistajan arvioihin on suhtauduttava varauksella. Tästä syystä on hyvä että tämä opinnäytetyö teorioineen ja ohjeineen, yhdessä testipenkin kanssa, jäävät yritykselle ja he voivat näillä jatkossakin testata eri filamentteja ja todentaa niiden lämmönkestävyyttä.The thesis was part of their product development project in which they optimized one of their existing models to perform better with ABS-plastic. ABS is one of the most commonly used 3D-printing filament but it is not very user-friendly because it is sensitive to temperature fluctuations and it warps easily. Hence the new printer must have closed structure to keep the temperature constant. Some printed parts did not withstand such high temperatures even though filament manufacturer had stated so in their product details. The purpose of this thesis was to find out what happens in plastics at higher temperatures and why they react to heat in the way they do. Chemical and structural properties were studied along with the theory of thermoplastics. This information was applied to 3D-printing filaments which have wide range of selection that is constantly growing. An experiment was also conducted in which printed test pieces were exposed to thermal loads. This was done to determine which material to use in development project. Two of the selected materials passed the test but the company chose aluminum for the most critical parts just in case. Plastics do exhibit lots of thermal expansion which alone causes problems in as precise devices as 3D-printer. Plastics have wide variety of small factors that influence their thermal behavior making them a bit hard to predict. The literature from the field even pointed out that one should treat with caution what manufacturer has stated for their products. The results of this thesis and test bench it created are good tools for the company to use in the future to test variety of different filaments to determine their heat resistance

Girls with a History of Premature Adrenarche Have Advanced Growth and Pubertal Development at the Age of 12 Years

BackgroundPremature adrenarche (PA) has been linked to early thelarche and menarche, but longitudinal data on growth and pubertal development after PA are insufficient.MethodsGrowth and pubertal development of mostly full-term and appropriate for gestational age-born 43 PA (36 girls) and 63 control children (52 girls) were analyzed prospectively. Children examined first at the mean age of 7.6 years were reexamined at the mean age of 12.0 years.ResultsThe PA girls but not the boys were taller and had higher body mass index (BMI) than the controls. A higher proportion of the PA than control girls had reached menarche, while the same percentage of the PA and control boys were at Tanner genital stage ≥2. The PA girls with premature pubarche (PP) were taller but not heavier and had more often reached menarche by the age of 12 years than the PA girls without PP. The PA girls with menarche had lower birth length (BL) and higher prepubertal insulin-like growth factor 1 (IGF-1) concentrations compared with non-menarcheal PA girls. In logistic regression analyses for all girls, lower BL standard deviation score, earlier maternal menarche, and higher prepubertal IGF-1 were independently associated with menarche.ConclusionAt 12 years of age, the PA girls had higher BMI, advanced linear growth, and accelerated pubertal development with earlier menarche than the control girls. The PA girls with PP were taller and had earlier menarche than the PA girls without PP. Lower BL and higher prepubertal IGF-1 concentration were predictive factors for menarche by the age of 12 years

PCOS Features and Steroid Profiles Among Young Adult Women with a History of Premature Adrenarche

Context: Premature adrenarche (PA) may increase the risk for polycystic ovary syndrome (PCOS). Objective: To study features of PCOS in young adult women with a history of PA. Methods: Thirty PA and 42 control females were followed from prepuberty to young adulthood (median age 18.1 years).The main outcome measures were ovarian function, the use of contraceptives, and clinical and biochemical indicators of hyperandrogenism. Results: We found no differences in the use of hormonal contraceptives (50 vs 50%, PA vs controls, respectively; P> .999), indication for using contraceptives (P= .193), or in the history of oligo- (17 vs 26%, P= .392) and amenorrhea (0 vs 0%, P> .999). Among women not using hormonal contraceptives, those with a history of PA had a higher prevalence of hirsutism (27 vs 0%, P= .023) but not acne (87 vs 67%, P= .252). Steroid profiles were broadly comparable between the groups, but PA women had lower sex hormone-binding globulin (SHBG) concentrations (30.1 vs 62.4 nmol/L, P< .001) resulting in higher free androgen index (3.94 vs 2.14, P< .001). The difference in SHBG levels persisted through body mass index adjustment. SHBG correlated negatively with the homeostasis model assessment for insulin resistance (r -0.498, P= .003). Anti-Mullerian hormone concentrations were comparable between the groups (39.3 vs 32.1 pmol/L, P= .619). Conclusion: PA was not associated with evident ovarian dysfunction in young adult women. However, women with a history of PA had decreased SHBG levels and thus, increased bioavailability of circulating androgens.Peer reviewe

Cardiorespiratory Fitness in Young Adult Women With a History of Premature Adrenarche

Context: Premature adrenarche (PA) may predispose to some adverse long-term health outcomes. Cardiorespiratory fitness (CRF) is one of the strongest factors known to predict overall health, but no data exist on the CRF of women with a history of PA.Objective: To study if hyperandrogenism in childhood resulting from PA leads to a measurable difference in CRF between young adult PA and control women.Methods: A total of 25 women with PA and 36 age-matched controls were followed from prepubertal age until adulthood. Anthropometric measurements, body composition, biochemical, and lifestyle factors were assessed. The main outcome measure was maximal cycle ergometer test result at the mean age of 18.5 years. We also assessed prepubertal predicting factors for CRF with different linear regression models.Results: Though prepubertal children with PA were taller and heavier than their non-PA peers, there were no significant differences in height, body mass index, body composition, or physical activity in young adulthood. We observed no significant differences in any of the parameters of the maximal cycle ergometer test, including maximal load (P = .194) or peak oxygen consumption (P = .340). Hemodynamic responses of the groups were similar. None of the examined models or prepubertal factors significantly predicted CRF at adult age.Conclusion: This study suggests that hyperandrogenism in childhood/adolescence resulting from PA does not have a significant impact on adulthood CRF.Peer reviewe