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.
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
Christopher R
CR
McCartney
Kathleen A
KA
Prendergast
Sandhya
S
Chhabra
Christine A
CA
Eagleson
Richard
R
Yoo
R Jeffrey
RJ
Chang
Carol M
CM
Foster
John C
JC
Marshall
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