Figure 2.

Changing rapid steroid secretory response to ACTH stimulation across adrenarche in females. Note increased responses of the Δ ⁵-3ß-hydroxysteroids 17-hydroxypregnenolone and DHEA through maturational stages, in parallel with baseline DHEAS. Serum androstenedione and its Δ ⁴-3-ketosteroid precursor 17-hydroxyprogesterone (17OHP) rise to a lesser extent. Cortisol responses remain unchanged. Basal levels were obtained early morning after overnight dexamethasone suppression. Post-ACTH levels obtained 30 min post-ACTH1-24 administered intravenously at 8 am. Prepubertal children were 2 to 12 years old; adrenarchal girls had PreAd; adults were normal volunteers in early follicular phase of menstrual cycle. For conversion factors to nmol/L, see Table 1.

Data are from Rich et al (3). Figure adapted from Rosenfield RL, Cooke DW, Radovick S. Puberty and its disorders in the female. In: Sperling M, Majzoub JA, Menon RK, Stratakis CA, eds. Pediatric Endocrinology. 5th ed. Elsevier; 2021: 528-626. Copyright Elsevier 2021. Abbreviations: 11-deoxycortisol, Cmpd S; androstenedione, adione.