Adrenarche and fetal growth.

Dehydroepiandrosterone sulfate (DHEAS) is prenatally secreted by the fetal adrenal, is an indicator of adrenarche from late childhood onward and is a marker of the individual hormonal milieu in the adult. The regulation of DHEAS secretion is still poorly understood. We postulated that serum DHEAS concentrations in children may be related to fetal growth. To test this hypothesis, serum DHEAS was measured at a median age of 8.2 y (range 5.8-16.0 y) in 13 pairs of discordant siblings after twin (n = 8), triplet (n = 4), or quadruplet (n = 1) pregnancy. At birth, one of each pair was small for gestational age (SGA) and the other had an appropriate weight (AGA), weight of the smallest infant was a median 67% (range 33-80%) of that of the largest sibling. In all 10 pairs with similar weight (< or = 1 SD difference) at the time of sampling, serum DHEAS concentration in the SGA child was higher (median 2-fold increase; range 1.1-7; p = 0.002) than in the AGA sibling. Conversely, in the 3 pairs with still discordant weight (> 2 SD difference), serum DHEAS levels in SGA children were lower than in AGA children. In conclusion, the presented findings, which account for both prenatal and postnatal weight gain, unmask a link between adrenarche and fetal growth. This relationship further supports the concept of early endocrine "programming" and extends this principle to adrenarche.