title: Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls.
abstract: BACKGROUND
  Peripubertal obesity is associated with abnormal sex steroid concentrations, but the timing of onset and degree of these abnormalities remain unclear.
  
  
  OBJECTIVE
  The objective of the study was to assess the degree of hyperandrogenemia across puberty in obese girls and assess overnight sex steroid changes in Tanner stage 1-3 girls.
  
  
  METHODS
  This was a cross-sectional analysis.
  
  
  METHODS
  The study was conducted at general clinical research centers.
  
  
  METHODS
  Thirty normal-weight (body mass index for age < 85%) and 74 obese (body mass index for age >or= 95%) peripubertal girls.
  
  
  METHODS
  Blood samples (circa 0500-0700 h) were taken while fasting. Samples from the preceding evening (circa 2300 h) were obtained in 23 Tanner 1-3 girls.
  
  
  METHODS
  Hormone concentrations stratified by Tanner stage were measured.
  
  
  RESULTS
  Compared with normal-weight girls, mean free testosterone (T) was elevated 2- to 9-fold across puberty in obese girls, whereas fasting insulin was 3-fold elevated in obese Tanner 1-3 girls (P < 0.05). Mean LH was lower in obese Tanner 1 and 2 girls (P < 0.05) but not in more mature girls. In a subgroup of normal-weight Tanner 1-3 girls (n = 17), mean progesterone (P) and T increased overnight 2.3- and 2.4-fold, respectively (P <or= 0.001). In obese Tanner 1-3 girls (n = 6), evening P and T were elevated, and both tended to increase overnight [mean 1.4- and 1.6-fold, respectively (P = 0.06)].
  
  
  CONCLUSIONS
  Peripubertal obesity is associated with hyperandrogenemia and hyperinsulinemia throughout puberty, being especially marked shortly before and during early puberty. P and T concentrations in normal-weight Tanner 1-3 girls increase overnight, with similar but less evident changes in obese girls.
authors.affiliation: Center for Research in Reproduction, Box 800391, University of Virginia Health System, Charlottesville, Virginia 22908, USA. cm2hq@virginia.edu
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McCartney
authors.forename: Susan K
authors.initials: SK
authors.lastname: Blank
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Prendergast
authors.forename: Sandhya
authors.initials: S
authors.lastname: Chhabra
authors.forename: Christine A
authors.initials: CA
authors.lastname: Eagleson
authors.forename: Kristin D
authors.initials: KD
authors.lastname: Helm
authors.forename: Richard
authors.initials: R
authors.lastname: Yoo
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Chang
authors.forename: Carol M
authors.initials: CM
authors.lastname: Foster
authors.forename: Sonia
authors.initials: S
authors.lastname: Caprio
authors.forename: John C
authors.initials: JC
authors.lastname: Marshall
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002648:Child; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D017588:Hyperandrogenism / Q000378:metabolism* / Q000503:physiopathology; D006946:Hyperinsulinism / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology; D011374:Progesterone / Q000097:blood; D011627:Puberty / Q000097:blood*; D013739:Testosterone / Q000097:blood*
chemical_list: D007328:Insulin; D013739:Testosterone; D011374:Progesterone; D006854:Hydrocortisone