title: Sex hormone-binding globulin, oligomenorrhea, polycystic ovary syndrome, and childhood insulin at age 14 years predict metabolic syndrome and class III obesity at age 24 years.
abstract: OBJECTIVE
  We hypothesized that oligomenorrhea (menstrual cyclicity ≥42 days), hyperandrogenism, low levels of sex hormone-binding globulin (SHBG), childhood insulin, and metabolic syndrome (MetS) at age 14 years would predict MetS and class III obesity (body mass index ≥40 kg/m(2)) at age 24 years.
  
  
  METHODS
  In this prospective study of schoolgirls, at age 14 years, the girls were categorized as regularly cycling (n = 375), oligomenorrheic (n = 18), or oligomenorrhea plus biochemical hyperandrogenism (polycystic ovary syndrome [PCOS]; n = 12), together designated PCOS.
  
  
  RESULTS
  Significant explanatory variables for MetS at age 24 years included childhood insulin, MetS, and PCOS category (all positive) and SHBG (negative) at age 14 years. Using categorical data, top decile of childhood insulin, MetS at age 14, bottom decile of SHBG, and PCOS category were significant positive predictors for MetS at age 24. SHBG (negative), black race (positive), and oligomenorrhea (positive) were significant explanatory variables for class III obesity at age 24. Using categorical data, black race, MetS at age 14, bottom decile of SHBG, PCOS category, and top decile of childhood insulin were positive explanatory variables for class III obesity at age 24 years.
  
  
  CONCLUSIONS
  Oligomenorrhea, PCOS (a subcohort of oligomenorrhea), hyperandrogenism, low SHBG, MetS, and childhood insulin at age 14 years may represent a critical, reversible pathway for the development of MetS and class III obesity in young adulthood.
authors.affiliation: Cholesterol Center, Jewish Hospital of Cincinnati, Cincinnati, OH 45229, USA. cjglueck@health-partners.org
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Glueck
authors.forename: John A
authors.initials: JA
authors.lastname: Morrison
authors.forename: Stephen
authors.initials: S
authors.lastname: Daniels
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Davis
authors.initials: D
authors.lastname: Stroop
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D009839:Oligomenorrhea / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011446:Prospective Studies; D012372:ROC Curve; D011863:Radioimmunoassay; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007328:Insulin; D012738:Sex Hormone-Binding Globulin