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We have determined the relationship between body mass index (BMI) and serum adrenal androgen levels when age is controlled for in children, aged 7-12 years, living in Lima (150 m above sea level) and in Cusco (3400 m above sea level). The purpose of the study was to determine whether the relationship of serum adrenal androgen levels with both BMI and age differs between low and high altitude. The ratio weight/height2 is not an adequate marker of BMI because it correlates with height in children from Lima and Cusco. The ratio weight/height2,3 correlates with body weight but not with height and was used in the present study as the BMI. From age 7 to 12 years, the BMI increased significantly with age only in boys from sea level and in girls from high altitude. The study demonstrates that serum adrenal androgen levels are not related to BMI in either sea-level or high-altitude children when the effect of age is removed statistically. These data suggest that BMI in children is not related to serum levels of adrenal androgens and that delayed age of adrenarche observed in children at high altitude may be due to factors other than nutritional status.