Plasma androgens and LH in scoliotic patients with premature pubarche

Children with postpoliomyelitic scoliosis present often a premature development of pubic hair without other signs of secondary sex characteristics (premature pubarche). Plasma androgens and LH levels were determined in 12 such children (8 girls and 4 boys) and their values were compared with those of 9 nonscoliotic children (7 girls and 2 boys) with premature pubarche. Scoliosis in itself did not appear to influence the results and no significant difference was found between boys and girls. The plasma concentrations of the following androgens were elevated (greater than mean + 2 SD of normal prepubertal children): testosterone (8 out of 21 cases), androstenedione (7 out of 19 cases), dehydroepiandrosterone (16 out of 20 cases), its sulfate (17 out of 19 cases) and androsterone sulfate (17 out of 18 cases). All the patients had normal levels of plasma LH for their age. Dexamethasone suppression in 5 scoliotic patients resulted in a decreased level of plasma androgens, suggesting that these androgens are of adrenal origin. In 8 patients, the percentage binding of testosterone in plasma diluted 1:5 was slightly but significantly lower than that of normal prepubertal children. Therefore, some patients with premature pubarche may have levels of unbound testosterone which are slightly higher than those of normal prepubertal children. Based on the previous observation of aggravation of scoliosis and greater growth of the vertebral column in scoliotic children with premature pubarche (7), it is speculated that adrenal androgens may have a role in growth spurt of the upper segment of the body of these patients as well as of normal children during physiological puberty.