title: Plasminogen activator inhibitor-1 in girls with precocious pubarche: a premenarcheal marker for polycystic ovary syndrome?
abstract: In both obese and nonobese women, polycystic ovary syndrome (PCOS) is essentially a disorder of hyperinsulinemic insulin resistance, and it may be heralded by precocious pubarche (PP; appearance of pubic hair in girls aged <8 y). The risk of progression from PP to PCOS is related to low birth weight, but there are no early biochemical markers of this risk. As increased plasminogen activator-inhibitor type 1 (PAI-1) activity (act) is an early marker of cardiovascular risk in PCOS, we have sought abnormalities in young girls with PP. In 33 young PP girls (age range 6-11 y), PAI-1-act was increased (mean + SEM: 15.6 +/- 1.5 IU/mL) compared with age-, sex-, and pubertal stage-matched controls (n = 13, 10.7 +/- 1.9, p < 0.05). PAI-1-act levels were inversely related to birth weight SD score (r = -0.33, p < 0.05), and PAI-1-act levels were therefore higher in PP girls with low birth weights (n = 14, 19.5 +/- 2.5 IU/mL) than normal birth weights (n = 19, 12.8 +/- 1.5, p < 0.01). During longitudinal observation in 10 PP girls (mean time interval 2.7 y), PAI-1-act levels in early puberty were positively related to postmenarcheal insulin levels (mean serum insulin SDS postoral glucose, r = 0.65, p < 0.05), and showed a similar relationship to postmenarcheal testosterone levels (r = 0.61, p = 0.06). Together with low birth weight, increased plasma PAI-1-act levels in early pubertal PP girls may indicate those girls with greater risk of developing hyperinsulinemic-hyperandrogenism features of PCOS.
authors.affiliation: Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain. libanez@hsjdbcn.org
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ibáñez
authors.forename: Carles
authors.initials: C
authors.lastname: Aulesa
authors.forename: Neus
authors.initials: N
authors.lastname: Potau
authors.forename: Ken
authors.initials: K
authors.lastname: Ong
authors.forename: David B
authors.initials: DB
authors.lastname: Dunger
authors.forename: Francis
authors.initials: F
authors.lastname: de Zegher
mesh_terms: D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008137:Longitudinal Studies; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000209:etiology*; D011629:Puberty, Precocious; D012307:Risk Factors; D013739:Testosterone / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D017395:Plasminogen Activator Inhibitor 1; D013739:Testosterone; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator