Prediction models for insulin resistance in girls with premature adrenarche. The premature adrenarche insulin resistance score: PAIR score.
OBJECTIVE
The purpose of this study was to develop an accurate regression model to predict insulin resistance in girls with premature adrenarche.


METHODS
The insulin sensitivity index was calculated from the frequently sampled intravenous glucose tolerance test with tolbutamide. Thirty-five prepubertal girls (23 Caribbean-Hispanic and 12 African-American; mean age 6.8 years) were studied. The insulin sensitivity index was compared to birth weight, body mass index (BMI), the presence of acanthosis nigricans (AN), insulin-like growth factor 1, insulin-like growth factor binding protein 1, sex hormone binding globulin, lipid profile, and adrenocorticotropic hormone stimulated androgens.


RESULTS
The best prediction models included birth weight, BMI, and AN (model 1: R(2) = 0.78) and BMI, AN, and serum 17-OH pregnenolone (model 2: R(2) = 0.76). When viewed as screening tests, a cutoff value <5.5 (premature adrenarche insulin resistance score) in both equations showed a sensitivity of 100% and a specificity of 85%.


CONCLUSIONS
Born small for gestational age, premature adrenarche, obesity, AN, and higher serum 17-OH pregnenolone levels may confer negative, but independent, health risks.
Division of Pediatric Endocrinology, Children's Hospital at Montefiore Medical Center, Bronx, NY 10467, USA. vuguin@aecom.yu.edu
Patricia
P
Vuguin
Gabriela
G
Grinstein
Katherine
K
Freeman
Paul
P
Saenger
Joan
J
DiMartino Nardi
D000052:Acanthosis Nigricans / Q000175:diagnosis / Q000503:physiopathology; D050499:Adrenarche / Q000097:blood / Q000208:ethnology / Q000502:physiology*; D001741:Black or African American; D001724:Birth Weight / Q000502:physiology; D015992:Body Mass Index; D017691:Caribbean Region; D002648:Child; D002675:Child, Preschool; D005260:Female; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology / Q000502:physiology*; D016014:Linear Models; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011280:Pregnanolone / Q000031:analogs & derivatives / Q000097:blood; D011629:Puberty, Precocious / Q000150:complications*; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors
C013051:17-hydroxypregnanolone; D011280:Pregnanolone