Endocrinology and metabolism after premature pubarche in girls

• Published in: Acta Paediatrica Vol. 88; no. s433; pp. 73 - 77
• Main Authors: Lbáñez, L, Potau, N, Zegher, F De
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-1999
• Subjects: Birth Weight; Child; Female; Functional ovarian hyperandrogenism; Humans; hyperinsulinism; Insulin Resistance - physiology; Insulin-Like Growth Factor I - physiology; low birth weight; Ovary - physiopathology; Polycystic Ovary Syndrome - physiopathology; premature pubarche; Puberty, Precocious - metabolism; Puberty, Precocious - physiopathology
• ISSN: 0803-5253; 0803-5326; 1651-2227
• DOI: 10.1111/j.1651-2227.1999.tb14407.x

The prevalence of functional ovarian hyperandrogenism, hyperinsulinism and dyslipidaemia is increased in adolescent girls with a history of premature pubarche, defined as the appearance of pubic hair before the age of 8 years. The ovarian hyperandrogenism is characterized by clinical signs of androgen excess and an exaggerated ovarian 17‐hydroxyprogesterone response to gonadotrophin‐releasing hormone aganist stimulation. The hyperinsulinism and dyslipidaemia are detectable before and during pubertal development, and they are commonly accompanied by low serum levels of insulin‐like growth factor binding protein‐1 (IGEBP‐1) and sex hormone binding globulin, and by an increased prevalence of anovulation from late adolescence onwards. In girls, premature pubarche, hyperinsulinism, low serum levels of IGFBP‐1 dyslipidaemia, anovulation and hyperandrogenism (or various combinations of these conditions) have been related to reduced fetal growth, indicating that these constellations or sequences may have a prenatal origin. These findings suggest that premature pubarche in girls should no longer be regarded as meaely a normal variant of development, but rather as a childhood marker pointing to an increased risk of a polyendocrine‐metabolic disorder of prenatal origin.