Evidence for Functional Ovarian Hyperandrogenism in Early Pubertal, but Not Late Pubertal, Girls With Excess Weight

Sources of androgen overproduction in peripubertal girls with overweight/obesity (excess weight [EW]) remain unclear.

To assess 17-hydroxyprogesterone (17-OHP) responses to recombinant human chorionic gonadotropin (r-hCG) in peripubertal girls with and without EW. We hypothesized that 17-OHP responses are exaggerated in late pubertal girls with EW compared to those without EW, but similar in early pubertal girls with and without EW.

This cross-sectional study conducted at an academic clinical research unit included 45 girls ages 7 to 18 years: 6 early pubertal (Tanner 1-3) with EW and 8 without; 20 late pubertal (Tanner 4-5) with EW and 11 without. Research volunteers took oral dexamethasone (1 mg) at 22:00 hours on study days 1 and 2. On study day 2, volunteers had blood withdrawal at 08:00 hours and r-hCG administration (25 mcg intravenously) at 09:00 hours, with repeat blood withdrawal at 09:00 hours on study day 3; the 17-OHP increment was analyzed.

17-OHP responsiveness was 2.31-fold (95% CI, 1.13-4.73) greater in early pubertal girls with EW compared to those without (Bonferroni-corrected P = .023), while responses were similar between late pubertal girls with and without EW. 17-OHP responsiveness in late pubertal girls with EW were 59% (95% CI, 9%-81%) lower than early pubertal girls with EW (Bonferroni-corrected P = .027), while responses were similar between late and early pubertal girls without EW.

Ovarian responsiveness to r-hCG stimulation during early puberty may be exaggerated in the setting of EW, but excess-weight status per se may not promote long-term ovarian hyperresponsiveness to r-hCG.