{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:50:08Z","timestamp":1785847808199,"version":"3.56.0"},"reference-count":23,"publisher":"Walter de Gruyter GmbH","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2025-0232_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate cardiometabolic risk factors in girls with premature adrenarche (PA), with a specific focus on outcomes based on adrenal androgen levels (typical vs. exaggerated adrenarche).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0232_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty-four girls with PA were followed from diagnosis to mid-puberty. Clinical, biochemical, and hormonal parameters were assessed at both time points. Participants were stratified based on dehydroepiandrosterone sulfate (DHEAS) levels: typical PA (40\u2013130\u202f\u03bcg\/dL) and exaggerated adrenarche (&gt;130\u202f\u03bcg\/dL). Age- and sex-matched controls (n=58) were included for pubertal comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0232_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, 25\u202f% of PA girls were overweight\/obese, and 22\u202f% had elevated HOMA-IR. Exaggerated adrenarche was present in 19\u202f% of subjects. By puberty, overweight\/obesity prevalence rose to 33.3\u202f%, with significant increases in fasting insulin, HOMA-IR, and declines in insulin sensitivity indices (QUICKI, FGIR). Comparisons with controls revealed significantly higher BMI, waist circumference, and insulin resistance among PA girls. However, there were no significant metabolic differences between exaggerated and typical PA groups, except for a higher waist circumference in the exaggerated\u00a0group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2025-0232_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated mid-childhood DHEAS does not independently predict worsened metabolic outcomes by puberty. Baseline adiposity, not androgen level, is the principal determinant of insulin resistance and cardiometabolic risk in PA. Lifestyle interventions targeting weight management are crucial in mitigating future\u00a0risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2025-0232","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T15:29:27Z","timestamp":1758209367000},"page":"1179-1186","source":"Crossref","is-referenced-by-count":1,"title":["Cardiometabolic outcomes in girls with premature adrenarche: a longitudinal analysis of typical vs. exaggerated presentations"],"prefix":"10.1515","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0614-4083","authenticated-orcid":false,"given":"G\u00fclcan","family":"Seymen","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Division of Pediatric Endocrinology , Faculty of Medicine , Kocaeli University , Umuttepe , \u0130zmit , Kocaeli , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"\u0130mal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine , Kocaeli University, Umuttepe , \u0130zmit , Kocaeli , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015e\u00fckr\u00fc","family":"Hatun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Division of Pediatric Endocrinology , Faculty of Medicine , Kocaeli University , Umuttepe , \u0130zmit , Kocaeli , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2025103018011138606_j_jpem-2025-0232_ref_001","doi-asserted-by":"crossref","unstructured":"Voutilainen, R, J\u00e4\u00e4skel\u00e4inen, J. Premature adrenarche: etiology, clinical findings, and consequences. J\u00a0Steroid Biochem Mol Biol 2015;145:226\u201336. https:\/\/doi.org\/10.1016\/j.jsbmb.2014.06.004. PMID: 24923732.","DOI":"10.1016\/j.jsbmb.2014.06.004"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_002","doi-asserted-by":"crossref","unstructured":"Rosenfield, RL, Lipton, RB, Drum, ML. Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index. Pediatr 2009;123:84. https:\/\/doi.org\/10.1542\/peds.2008-0146.","DOI":"10.1542\/peds.2008-0146"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_003","doi-asserted-by":"crossref","unstructured":"G\u00fcven, A, Cinaz, P, Bideci, A. Is premature adrenarche a risk factor for atherogenesis? Pediatr Int 2005;47:20\u20135. https:\/\/doi.org\/10.1111\/j.1442-200X.2004.02006.x. PMID: 15693861.","DOI":"10.1111\/j.1442-200x.2004.02006.x"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_004","doi-asserted-by":"crossref","unstructured":"Ib\u00e1\u00f1ez, L, Potau, N, Chac\u00f3n, P, Pascual, C, Carrascosa, A. Hyperinsulinaemia, dyslipemia and cardiovascular risk in girls with a history of premature pubarche. Diabetologia 1998;41:1057\u201363. https:\/\/doi.org\/10.1007\/s001250051030.","DOI":"10.1007\/s001250051030"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_005","doi-asserted-by":"crossref","unstructured":"Vuguin, P, Linder, B, Rosenfeld, RG, Saenger, P, DiMartino-Nardi, J. The roles of insulin sensitivity, insulin-like growth factor I, and IGF-binding proteins-1 and -3 in the hyperandrogenism of African\u2013American and Caribbean Hispanic girls with premature adrenarche. J\u00a0Clin Endocrinol Metab 1999;84:2037\u201342. https:\/\/doi.org\/10.1210\/jcem.84.6.5722.","DOI":"10.1210\/jc.84.6.2037"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_006","doi-asserted-by":"crossref","unstructured":"Denburg, MR, Silfen, ME, Manibo, AM, Chin, D, Levine, LS, Ferin, M, et al.. Insulin sensitivity and the insulin-like growth factor system in prepubertal boys with premature adrenarche. J\u00a0Clin Endocrinol Metab 2002;87:5604\u20139. https:\/\/doi.org\/10.1210\/jc.2002-020896.","DOI":"10.1210\/jc.2002-020896"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_007","doi-asserted-by":"crossref","unstructured":"Mathew, RP, Byrne, DW, Linton, MF, Vaughan, DE, Fazio, S, Russell, WE. Evidence of metabolic syndrome in lean children with premature pubarche at diagnosis. Metabol 2008;57:733\u201340. https:\/\/doi.org\/10.1016\/j.metabol.2008.01.010.","DOI":"10.1016\/j.metabol.2008.01.010"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_008","doi-asserted-by":"crossref","unstructured":"de Ferran, K, Paiva, IA, Garcia, LS, Gama, MP, Guimar\u00e3es, MM. Isolated premature pubarche: report of anthropometric and metabolic profile of a Brazilian cohort of girls. Horm Res Paediatr 2011;75:367\u201373. https:\/\/doi.org\/10.1159\/000324107.","DOI":"10.1159\/000324107"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_009","doi-asserted-by":"crossref","unstructured":"Kaya, G, Yava\u015f Abal\u0131, Z, Ba\u015f, F, Poyrazo\u011flu, S, Darendeliler, F. Body mass index at the presentation of premature adrenarche is associated with components of metabolic syndrome at puberty. Eur J Pediatr 2018;177:1593\u2013601. https:\/\/doi.org\/10.1007\/s00431-018-3211-1.","DOI":"10.1007\/s00431-018-3211-1"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_010","doi-asserted-by":"crossref","unstructured":"Ib\u00e1\u00f1ez, L, DiMartino-Nardi, J, Potau, N, Saenger, P. Premature adrenarche\u00a0\u2013\u00a0normal variant or forerunner of adult disease? Endocr Rev 2000;21:671\u201396. https:\/\/doi.org\/10.1210\/edrv.21.6.0416.","DOI":"10.1210\/edrv.21.6.0416"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_011","doi-asserted-by":"crossref","unstructured":"Cook, S, Weitzman, M, Auinger, P, Nguyen, M, Dietz, WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey, 1988\u20131994. Arch Pediatr Adolesc Med 2003;157:821\u20137. https:\/\/doi.org\/10.1001\/archpedi.157.8.821. PMID: 12912790.","DOI":"10.1001\/archpedi.157.8.821"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_012","doi-asserted-by":"crossref","unstructured":"Bundak, R, Furman, A, G\u00fcn\u00f6z, H, Darendeliler, F, Ba\u015f, F, Neyzi, O. Body mass index references for Turkish children. Acta Paediatr 2006;95:194\u20138. https:\/\/doi.org\/10.1080\/08035250500334738. PMID: 16449026.","DOI":"10.1080\/08035250500334738"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_013","doi-asserted-by":"crossref","unstructured":"Neyzi, O, Furman, A, Bundak, R, G\u00fcn\u00f6z, H, Darendeliler, F, Ba\u015f, F. Growth references for Turkish children aged 6 to 18\u00a0years. Acta Paediatr 2006;95:1635\u201341. https:\/\/doi.org\/10.1080\/08035250600652013. PMID: 17129974.","DOI":"10.1080\/08035250600652013"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_014","doi-asserted-by":"crossref","unstructured":"Hatipo\u011flu, N, Ozturk, A, Mazicio\u011flu, MM, Kurtoglu, S, Seyhan, S, Lokoglu, F. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 2008;167:383\u20139. https:\/\/doi.org\/10.1007\/s00431-007-0502-3. PMID: 17487506.","DOI":"10.1007\/s00431-007-0502-3"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_015","doi-asserted-by":"crossref","unstructured":"Marshall, WA, Tanner, JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291\u2013303. https:\/\/doi.org\/10.1136\/adc.44.235.291. PMID: 5785179; PMCID: PMC2020314.","DOI":"10.1136\/adc.44.235.291"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_016","doi-asserted-by":"crossref","unstructured":"Kurto\u011flu, S, Hatipo\u011flu, N, Maz\u0131c\u0131o\u011flu, M, Kendirci, M, Keskin, M, Kondolot, M. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J\u00a0Clin Res Pediatr Endocrinol 2010;2:100\u20136. https:\/\/doi.org\/10.4274\/jcrpe.v2i3.100. PMID: 21274322; PMCID: PMC3005684.","DOI":"10.4274\/jcrpe.v2i3.100"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_017","doi-asserted-by":"crossref","unstructured":"Ten, S, Maclaren, N. Insulin resistance syndrome in children. J\u00a0Clin Endocrinol Metab 2004;89:2526\u201339. https:\/\/doi.org\/10.1210\/jc.2004-0276. PMID: 15181020.","DOI":"10.1210\/jc.2004-0276"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_018","doi-asserted-by":"crossref","unstructured":"Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (National Heart, Lung, and Blood Institute). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatr 2011;128:S213\u2013256. https:\/\/doi.org\/10.1542\/peds.2009-2107C. PMID: 22084329; PMCID: PMC4536582.","DOI":"10.1542\/peds.2009-2107C"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_019","doi-asserted-by":"crossref","unstructured":"Zimmet, P, Alberti, KG, Kaufman, F, Tajima, N, Silink, M, Arslanian, S, et al.. IDF Consensus Group. The metabolic syndrome in children and adolescents: an IDF consensus report. Pediatr Diabetes 2007;8:299\u2013306. https:\/\/doi.org\/10.1111\/j.1399-5448.2007.00271.x. PMID: 17850473.","DOI":"10.1111\/j.1399-5448.2007.00271.x"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_020","doi-asserted-by":"crossref","unstructured":"Utriainen, P, J\u00e4\u00e4skel\u00e4inen, J, Romppanen, J, Voutilainen, R. Childhood metabolic syndrome and its components in premature adrenarche. J\u00a0Clin Endocrinol Metab 2007;92:4282\u20135. https:\/\/doi.org\/10.1210\/jc.2006-2412. PMID: 17698912.","DOI":"10.1210\/jc.2006-2412"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_021","doi-asserted-by":"crossref","unstructured":"Corval\u00e1n, C, Uauy, R, Mericq, V. Obesity is positively associated with dehydroepiandrosterone sulfate concentrations at age 7\u00a0years in Chilean children of normal birth weight. Am J Clin Nutr 2013;97:318\u201325. https:\/\/doi.org\/10.3945\/ajcn.112.037325. PMID: 23283497; PMCID: PMC3545681.","DOI":"10.3945\/ajcn.112.037325"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_022","doi-asserted-by":"crossref","unstructured":"Liimatta, J, Utriainen, P, Laitinen, T, Voutilainen, R, J\u00e4\u00e4skel\u00e4inen, J. Cardiometabolic risk profile among young adult females with a history of premature adrenarche. J\u00a0Endocr Soc 2019;3:1771\u201383. https:\/\/doi.org\/10.1210\/js.2019-00205.","DOI":"10.1210\/js.2019-00193"},{"key":"2025103018011138606_j_jpem-2025-0232_ref_023","doi-asserted-by":"crossref","unstructured":"Ribeiro, FA, Resende, EAMR, Silva, APD, Tom\u00e9, JM, Palhares, HMDC, Borges, MF. Metabolic and hormonal assessment of adolescent and young adult women with prior premature adrenarche. Clinics 2019;74:e836. https:\/\/doi.org\/10.6061\/clinics\/2019\/e836. PMID: 31241662; PMCID: PMC6558997.","DOI":"10.6061\/clinics\/2019\/e836"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0232\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0232\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T18:01:54Z","timestamp":1761847314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0232\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":23,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,7,21]]},"published-print":{"date-parts":[[2025,11,25]]}},"alternative-id":["10.1515\/jpem-2025-0232"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2025-0232","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}