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Endocrine consequences of premature pubarche in post-pubertal Caucasian girls
Taly Meas1, Didier Chevenne, Elisabeth Thibaud
1Inserm Unit 457, Robert Debré Hospital, Paris, France.
Insights
Precocious pubarche (PP) may signal future hyperandrogenism, but this study found no link to intrauterine undernutrition or insulin resistance. Birth weight did not influence androgen levels in girls with PP.
Area of Science:
- Reproductive Endocrinology
- Pediatric Endocrinology
- Metabolic Disorders
Background:
- Intrauterine undernutrition is hypothesized to increase endocrine risks, including precocious pubarche (PP), functional ovarian hyperandrogenism, and insulin resistance.
- Precocious pubarche is a condition characterized by early onset of pubertal development.
Purpose of the Study:
- To investigate the association between a history of precocious pubarche and the development of hyperandrogenism.
- To evaluate potential metabolic consequences in individuals with a history of precocious pubarche.
- To assess the influence of birth weight on the relationship between precocious pubarche and hyperandrogenism.
Main Methods:
- A case-control study comparing 27 Caucasian girls with a history of precocious pubarche to 25 healthy controls.
- Assessment of hyperandrogenism through clinical signs (Ferriman-Gallway Score, acne history) and serum androgen levels (testosterone, dehydroepiandrosterone sulphate, Delta4-androstenedione).
- Evaluation of metabolic consequences using oral glucose tolerance tests and derived insulin resistance parameters, alongside fasting lipid profiles.
Main Results:
- Girls with a history of precocious pubarche exhibited significantly higher Delta4-androstenedione concentrations and free androgen index compared to controls.
- Increased Ferriman-Gallway Score and a tendency for more acne history were observed in the precocious pubarche group.
- No significant differences were found in testosterone, dehydroepiandrosterone sulphate, glucose tolerance, insulin resistance parameters, or fasting lipids between the groups.
Conclusions:
- Precocious pubarche may serve as an early indicator for future functional ovarian hyperandrogenism.
- This study did not establish a link between precocious pubarche, intrauterine undernutrition, and insulin resistance.
- Birth weight did not demonstrate a significant effect on androgen levels in girls with a history of precocious pubarche.
Background:
It has been postulated that intrauterine undernutrition may predispose to serious endocrine consequences, including precocious pubarche (PP), functional ovarian hyperandrogenism and insulin resistance syndrome.
Objective:
The aim of this study was to determine whether a history of PP was associated with the development of hyperandrogenism and/or metabolic consequences and to evaluate the effect of birth weight on this association.
Patients:
The study population comprised 27 Caucasian girls with a history of PP and 25 healthy girls of similar age (17.4 +/- 1.3 vs. 17.7 +/- 0.9 years).
Results:
Gynecological age, irregular menses and oral contraceptive use were similar in the two groups. PP girls showed an increased Ferriman-Gallway Score [median (range) 8 (4-17) vs. 6 (2-10), P = 0.02] and tended to have more previous history of acne. No statistical differences were found between the groups for mean testosterone (1.7 +/- 0.7 vs. 1.4 +/- 0.7 nmol/l, P = 0.49) and dehydroepiandrosterone sulphate concentrations (7.2 +/- 3.7 vs. 5.8 +/- 2.0 micromol/l, P = 0.15), but mean Delta4-androstenedione concentrations (7.3 +/- 2.4 vs. 4.9 +/- 2.1 nmol/l, P = 0.007) and free androgen index (8.5 +/- 9.7 vs. 3.6 +/- 3.9 IU, P = 0.003) were significantly increased in the PP group. All girls showed normal glucose tolerance with an oral glucose tolerance test. Derived insulin resistance parameters were not statistically different between the two groups and fasting lipids were comparable in both groups. There was no significant effect of birth weight on androgen levels in the PP girls. Moreover, none of the PP girls demonstrated the above-described association.
Conclusions:
Precocious pubarche could be the first sign of future functional ovarian hyperandrogenism but a link between this condition and intrauterine undernutrition or insulin resistance could not be demonstrated in this study.