Endocrinology and metabolism after premature pubarche in girls.
The prevalence of functional ovarian hyperandrogenism, hyperinsulinism and dyslipidaemia is increased in adolescent girls with a history of premature pubarche, defined as the appearance of pubic hair before the age of 8 years. The ovarian hyperandrogenism is characterized by clinical signs of androgen excess and an exaggerated ovarian 17-hydroxyprogesterone response to gonadotrophin-releasing hormone agonist stimulation. The hyperinsulinism and dyslipidaemia are detectable before and during pubertal development, and they are commonly accompanied by low serum levels of insulin-like growth factor binding protein-1 (IGFBP-1) and sex hormone binding globulin, and by an increased prevalence of anovulation from late adolescence onwards. In girls, premature pubarche, hyperinsulinism, low serum levels of IGFBP-1, dyslipidaemia, anovulation and hyperandrogenism (or various combinations of these conditions) have been related to reduced fetal growth, indicating that these constellations or sequences may have a prenatal origin. These findings suggest that premature pubarche in girls should no longer be regarded as merely a normal variant of development, but rather as a childhood marker pointing to an increased risk of a polyendocrine-metabolic disorder of prenatal origin.
Ibáñez
L
L
Hospital Sant Joan de Déu, University of Barcelona, Hospital Materno-lnfantil Vall d'Hebron, Spain. lourdes.ibanez@deinfo.es
Potau
N
N
De Zegher
F
F
D001724:Birth Weight; D002648:Child; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007334:Insulin-Like Growth Factor I / Q000502:physiology; D010053:Ovary / Q000503:physiopathology*; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology; D011629:Puberty, Precocious / Q000378:metabolism / Q000503:physiopathology*
D007334:Insulin-Like Growth Factor I