Endocrine consequences of premature pubarche in post-pubertal Caucasian girls.
BACKGROUND
It has been postulated that intrauterine undernutrition may predispose to serious endocrine consequences, including precocious pubarche (PP), functional ovarian hyperandrogenism and insulin resistance syndrome.


OBJECTIVE
The aim of this study was to determine whether a history of PP was associated with the development of hyperandrogenism and/or metabolic consequences and to evaluate the effect of birth weight on this association.


METHODS
The study population comprised 27 Caucasian girls with a history of PP and 25 healthy girls of similar age (17.4 +/- 1.3 vs. 17.7 +/- 0.9 years).


RESULTS
Gynecological age, irregular menses and oral contraceptive use were similar in the two groups. PP girls showed an increased Ferriman-Gallway Score [median (range) 8 (4-17) vs. 6 (2-10), P = 0.02] and tended to have more previous history of acne. No statistical differences were found between the groups for mean testosterone (1.7 +/- 0.7 vs. 1.4 +/- 0.7 nmol/l, P = 0.49) and dehydroepiandrosterone sulphate concentrations (7.2 +/- 3.7 vs. 5.8 +/- 2.0 micromol/l, P = 0.15), but mean Delta4-androstenedione concentrations (7.3 +/- 2.4 vs. 4.9 +/- 2.1 nmol/l, P = 0.007) and free androgen index (8.5 +/- 9.7 vs. 3.6 +/- 3.9 IU, P = 0.003) were significantly increased in the PP group. All girls showed normal glucose tolerance with an oral glucose tolerance test. Derived insulin resistance parameters were not statistically different between the two groups and fasting lipids were comparable in both groups. There was no significant effect of birth weight on androgen levels in the PP girls. Moreover, none of the PP girls demonstrated the above-described association.


CONCLUSIONS
Precocious pubarche could be the first sign of future functional ovarian hyperandrogenism but a link between this condition and intrauterine undernutrition or insulin resistance could not be demonstrated in this study.
Meas
Taly
T
Inserm Unit 457, Robert Debré Hospital, Paris, France.
Chevenne
Didier
D
Thibaud
Elisabeth
E
Léger
Juliane
J
Cabrol
Sylvie
S
Czernichow
Paul
P
Lévy-Marchal
Claire
C
D000293:Adolescent; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D001724:Birth Weight; D016022:Case-Control Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D011446:Prospective Studies; D011629:Puberty, Precocious / Q000097:blood*; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000097:blood
D000728:Androgens; D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate