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Cited by 123Ovarian function and disordersHypothalamic control of reproductive hormonesSexual Differentiation and Disorders

Early Metformin Therapy (Age 8–12 Years) in Girls with Precocious Pubarche to Reduce Hirsutism, Androgen Excess, and Oligomenorrhea in Adolescence

Ibáñez, Lourdes, López-Bermejo, Abel, Díaz, Marta, Marcos, Maria Victoria, de Zegher, Francis·2011·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2011-0555
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Abstract

CONTEXT: Girls with a combined history of low(-normal) birth weight (LBW) and precocious pubarche (PP) are at high risk to develop polycystic ovary syndrome (PCOS). OBJECTIVE: The objective of the study was to compare the capacity of early vs. late metformin treatment to prevent adolescent PCOS. DESIGN: This was a randomized, open-label study over 7 yr. SETTING: The study was conducted at a university hospital. PATIENTS: Thirty-eight LBW-PP girls were followed up from the mean age 8 until age 15 yr. INTERVENTION: Early metformin (study yr 1-4; age 8-12 yr) vs. late metformin (yr 6; age 13-14 yr). MAIN OUTCOME MEASURES: Measures included height; weight; hirsutism score; menstrual cycle; endocrine-metabolic screening (fasting; follicular phase); C-reactive protein; body composition (absorptiometry); abdominal fat partitioning (magnetic resonance imaging); ovarian morphology (ultrasound); PCOS (National Institutes of Health and Androgen Excess Society definitions) after yr 7 (all girls thus untreated for at least 1 yr). RESULTS: None of the girls dropped out of the study. At age 15 yr, early-metformin girls were taller (4 cm), were in a less proinflammatory state, and had less central fat due to reductions in visceral and hepatic fat. Hirsutism, androgen excess, oligomenorrhea, and PCOS were between 2- and 8-fold more prevalent in late- than early-treated girls. Abdominal adiposity was the first variable to diverge (at age 8-10 yr) between girls without vs. with PCOS at age 15 yr. CONCLUSIONS: In LBW-PP girls, early metformin therapy was found to prevent or delay the development of hirsutism, androgen excess, oligomenorrhea, and PCOS more effectively than late metformin. The time window of late childhood and early puberty may be more critical for the development, and thus for the prevention, of adolescent PCOS than the first years beyond menarche.

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  • A multifollicular pattern, defined by the presence of large follicles distributed throughout the ovary, does not have a relationship with hyperandrogenism, is more common in adolescents, and should not be considered a pathological finding.

    “Further, a multifollicular pattern, which is defined by the presence of large follicles distributed throughout the ovary, does not have a relationship with hyperandrogenism, is more common in adolescents, and should not be considered a pathological finding (Level C).”

    From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [81]

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Authors
Ibáñez, L., López-Bermejo, A., Díaz, M., Marcos, M. V., & de Zegher, F.
Affiliations
Hospital Sant Joan de Déu Barcelona (ES)
Corresponding author
Ibáñez, Lourdes
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2011-08
Volume
96
Issue
8
Pages
E1262-E1267
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2011-0555
OpenAlex
W2091519032
Cited by
123
References
25
Citations by year
2025: 5 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 11 · 2015: 17 · 2014: 13 · 2013: 13 · 2012: 14
FWCI
15.26
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
metformin, precocious pubarche, low birth weight, hirsutism, hyperandrogenism, oligomenorrhea, adolescent girls, early childhood intervention, abdominal fat, visceral fat, liver fat, C-reactive protein
MeSH terms
Adolescent, Child, Female, Follow-Up Studies, Hirsutism, Humans, Hypoglycemic Agents, Menarche, Metformin, Oligomenorrhea, Polycystic Ovary Syndrome, Puberty, Precocious, Risk Factors, Prevalence, Treatment Outcome, Hyperandrogenism

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