title: Hyperandrogenism and hyperinsulinism in children of women with polycystic ovary syndrome: a controlled study.
abstract: OBJECTIVE
  Hyperandrogenia and insulin resistance are heritable family traits, likely to cluster in children of polycystic ovary syndrome (PCOS) mothers.
  
  
  METHODS
  We performed a case control study of PCOS children (n = 32) compared with children from control women (n = 38) for reproductive and metabolic abnormalities, stratifying results by three Tanner stage groupings. The children underwent history and physical examinations, a 3-h timed urine collection, a 2-h oral glucose tolerance test, and abdominal ultrasound examination (females only). Serum was obtained in older children (age > 8 yr) who consented.
  
  
  RESULTS
  Urine LH levels were significantly lower in the Tanner IV-V PCOS girls compared with controls (P = 0.04). Urine testosterone levels were significantly elevated in Tanner II-III PCOS boys compared with controls (P = 0.007). There were no significant differences in dehydroepiandrosterone levels. We validated the correlation between salivary and serum levels of insulin (insulin areas under the curve) in an adult population [n =30, Pearson correlation coefficient (r) = 0.67; P < 0.0001], which also replicated in the children (2-h insulin r = 0.57; P = 0.0004). Mean area under the curve salivary insulin levels were significantly higher in the Tanner IV-V PCOS girls in the later stages of puberty when compared with controls (3625 +/- 1372 vs. 1766 +/- 621 min x muU/ml, 95% confidence interval 475-3242; P < 0.02).
  
  
  CONCLUSIONS
  Hyperinsulinism may be a familial characteristic of PCOS children (or at least girls) but does not appear until the later stages of puberty. Other reproductive abnormalities that characterize PCOS may develop later.
authors.affiliation: Department of Obstetrics and Gynecology, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Kent
authors.forename: Carol L
authors.initials: CL
authors.lastname: Gnatuk
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Demers
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
authors.forename: Richard S
authors.initials: RS
authors.lastname: Legro
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005951:Glucose Tolerance Test; D006062:Gonadotropins / Q000652:urine; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D006946:Hyperinsulinism / Q000209:etiology*; D007328:Insulin / Q000032:analysis; D008055:Lipids / Q000097:blood; D008297:Male; D011085:Polycystic Ovary Syndrome / Q000235:genetics*; D012463:Saliva / Q000737:chemistry; D014463:Ultrasonography
chemical_list: D006062:Gonadotropins; D007328:Insulin; D008055:Lipids