The Adrenal Contribution to Androgen Production in Girls During Puberty
The Adrenal Contribution to Androgen Production in Girls During Puberty
In girls with elevated androgens the precise source of androgen excess throughout puberty and
 early adolescence has not been carefully examined. The investigators propose to examine
 whether the adrenal gland produces the majority of androgens during puberty by studying the
 differences in androgen responses to adrenocorticotropin hormone (ACTH) administration in
 normal weight (NW) and obese (OB) girls ages 7-18. The investigators' analyses will compare
 steroid changes before and 60 min after ACTH administration in NW and OB girls.
Subjects will have blood drawn at 1900 hr for baseline hormone measurements. At 2200 hr each
 subject will take a single oral dose of dexamethasone at 2200 hr. At 0700 hr the following
 day, subjects will have a blood sample drawn for hormone measurements. After this blood
 sample, 0.25 mg adrenocorticotropin hormone (ACTH) will be administered as an iv bolus. At 30
 and 60 minutes after Cosyntropin, blood samples will be obtained for repeat hormone
 measurements.
Inclusion Criteria:

 -  Normal CBC (Hemoglobin must be at least 11mg/dl)

 -  Normal renal and liver function tests (AST& ALT 10-45 IU/L; Albumin 3.3-5 g/dL; Alk
 phos 30-130 IU/L;

 -  direct bili <0.2 mg/dL;

 -  total bili <1.2 mg/dL; total protein 6.0-8.0 g/dL) Normal vital signs including normal
 blood pressure (pulse 60-100/min, respirations 12-20/min, BP 80/60-130/80)

 Exclusion Criteria:

 -  Pregnancy

 -  On oral contraceptives

 -  On insulin lowering drugs

 -  On anti-androgens (i.e., spironolactone, flutamide, finasteride, etc)

 -  On medications that will influence androgen metabolism or clearance

 -  On medications that will inhibit the cytochrome P450 enzyme system (cimetidine,
 ketoconazole, etc)

 -  Subjects with morning cortisol<5 ug/dL will be excluded and asked to see their primary
 care physician.

 -  Subjects with 17-OHP>250 ng/dL) will be excluded and asked to see their primary care
 physician.

 -  Subject with a history of Cushing syndrome or adrenal insufficiency will be excluded