The association of obesity and hyperandrogenemia during the pubertal transition in girls: obesity as a potential factor in the genesis of postpubertal hyperandrogenism.
BACKGROUND
Adolescent hyperandrogenemia is considered a forerunner of adult polycystic ovary syndrome, but its etiology remains uncertain.


OBJECTIVE
Our objective was to explore the hypothesis that peripubertal obesity is associated with hyperandrogenemia.


METHODS
We performed a cross-sectional analysis of data obtained at General Clinical Research Centers.


METHODS
Subjects were 41 obese [body mass index (BMI) for age, >or=95%] and 35 normal-weight (BMI for age, <95%) peripubertal girls.


METHODS
We used pooled blood samples (approximately 0500-0700 h; n = 64) while fasting or single morning (fasting) samples (n = 12).


METHODS
We assessed adiposity and androgen concentrations.


RESULTS
BMI correlated with total testosterone (T) (r(s) = 0.59), SHBG (r(s) = -0.69), and free T (r(s) = 0.69); free T was three times as great in obese girls compared with normal-weight girls (P < 0.0001 for all). BMI correlated with insulin (r(s) = 0.52); both insulin and LH correlated with free T (r(s) = 0.45 and 0.44, respectively; P < 0.001 for all). When analyzing early pubertal girls (pubertal stages 1-3; n = 36) alone, BMI correlated with total T (r(s) = 0.65), SHBG (r(s) = -0.74), and free T (r(s) = 0.75); free T was five times as great in obese early-pubertal girls (P < 0.001 for all). BMI correlated with insulin (r(s) = 0.65), and insulin correlated with free T (r(s) = 0.63, P < 0.01 for both). BMI correlated with free T while simultaneously adjusting for age, pubertal stage, insulin, LH, and dehydroepiandrosterone sulfate.


CONCLUSIONS
Peripubertal obesity is associated with marked hyperandrogenemia, which is especially pronounced in early puberty.
McCartney
Christopher R
CR
The Center for Research in Reproduction and Division of Endocrinology, Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia 22908, USA. cm2hq@virginia.edu
Prendergast
Kathleen A
KA
Chhabra
Sandhya
S
Eagleson
Christine A
CA
Yoo
Richard
R
Chang
R Jeffrey
RJ
Foster
Carol M
CM
Marshall
John C
JC
D000293:Adolescent; D000728:Androgens / Q000097:blood; D015992:Body Mass Index; D002648:Child; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications* / Q000209:etiology; D007328:Insulin / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D009765:Obesity / Q000150:complications*; D011627:Puberty / Q000502:physiology*; D011629:Puberty, Precocious / Q000150:complications; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
D000728:Androgens; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone