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Cited by 138Ovarian function and disordersAdrenal Hormones and DisordersPancreatic function and diabetes

Hyperinsulinemia in postpubertal girls with a history of premature pubarche and functional ovarian hyperandrogenism.

Ibanez, L, Potau, N, Zampolli, M, Prat, N, Virdis, R, Vicens-Calvet, E, Carrascosa, A·1996·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.81.3.8772605
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Abstract

Previous studies have documented the association of insulin resistance and hyperandrogenism in adult women with functional ovarian hyperandrogenism (FOH) or polycystic ovary syndrome (a form of FOH). However, the possible impact of adrenal hyperandrogenism development during childhood in premature pubarche (PP) patients on postpubertal insulin secretion patterns remains unclear. The fasting insulin to glucose ratio, C peptide, early insulin response to glucose (IRG), mean blood glucose, mean serum insulin (MSI), glucose uptake rate in peripheral tissues (M), and insulin sensitivity indexes (SI) in response to a standard oral glucose tolerance test were evaluated in 13 PP girls with FOH (group A; age, 17.2 +/- 0.5 yr), 11 eumenorrheic nonhirsute PP girls (group B; age, 16.6 +/- 0.5 yr), and 21 age-matched controls (group C). Body mass indexes (BMI) were similar in the 3 groups (group A, 23.3 +/- 0.8; group B, 22.5 +/- 0.6; group C, 20.6 +/- 0.5 kg/m2). MSI values were significantly higher in FOH patients than in controls (74.7 +/- 17.6 vs. 45.7 +/- 4.1 mU/L; P < 0.01), but were not different from those in group B (63.3 +/- 11.1 mU/L). Thirty-eight percent of FOH patients (group A) and 27% of non-FOH patients (group B), all of whom had normal BMI, showed MSI levels well above the upper normal limit for controls (> 83.3 mU/L). MSI correlated with the degree of ovarian hyperandrogenism [defined by an abnormal 17-hydroxyprogesterone response to challenge with the GnRH analog leuprolide acetate; group A] and with the free androgen index [testosterone (nanomoles per L)/sex hormone-binding globulin (nanomoles per L) x 100; groups A and B)]. Although IRG, glucose uptake rate in peripheral tissues, mean blood glucose, and SI values were not significantly different in the 3 groups, 3 patients in group A and 1 patient in group B showed decreased insulin sensitivity and/or an enhanced early IRG. Among others, significant correlations between MSI and free androgen index values (r = 0.6; P < 0.002; groups A and B) and between BMI and SI (r = -0.53; P < 0.05; groups A and B) were found. Peak 17-hydroxyprogesterone responses to ACTH at PP diagnosis correlated positively with SI in both groups of patients (r = 0.53; P < 0.007). Hyperinsulinemia is a common feature in adolescent PP patients with FOH and appears to be directly related to the degree of androgen excess. Long term follow-up of PP patients into adulthood is warranted to ascertain whether hyperinsulinemia actually precedes FOH development and whether overt insulin resistance ensues.

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  • Premature and exaggerated adrenarche may be associated with insulin resistance, and girls with premature exaggerated adrenarche appear to be at much higher risk of developing the polycystic ovary syndrome as adults, and infants born small for gestational age may be at increased risk.

    “Premature and exaggerated adrenarche may be associated with insulin resistance, and girls with premature exaggerated adrenarche appear to be at much higher risk of developing the polycystic ovary syndrome as adults (characterized by hyperandrogenism, fewer ovulatory cycles, insulin resistance, and hypertriglyceridemia) (729 -731), and infants born small for gestational age may be at increased risk”

    From The Molecular Biology, Biochemistry, and Physiology of Human Steroidogenesis and Its Disorders (2011) · cites this paper as [731]

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Authors
Ibanez, L., Potau, N., Zampolli, M., Prat, N., Virdis, R., Vicens-Calvet, E., & Carrascosa, A.
Affiliations
Vall d'Hebron Hospital Universitari (ES)
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1996-03
Volume
81
Issue
3
Pages
1237-1243
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem.81.3.8772605
OpenAlex
W2075987903
Cited by
138
References
45
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 4 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 4
FWCI
7.82
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 › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
hyperinsulinemia, premature pubarche, insulin resistance, insulin secretion, adrenal hyperandrogenism, polycystic ovary syndrome, insulin sensitivity index, free androgen index, oral glucose tolerance
MeSH terms
Insulin Secretion, Adolescent, Androgens, Blood Glucose, C-Peptide, Female, Hair, Humans, Hyperinsulinism, Insulin, Medical Records, Ovary, Puberty, Sexual Maturation, Hyperandrogenism

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