Lipoprotein(a) levels in girls with premature adrenarche

Abstract

Elevated lipoprotein(a) (Lp(a)) level is a risk factor for cardiovascular disease (CVD). Women with polycystic ovary syndrome (PCOS) have higher Lp(a) and risk for CVD than controls. The girls with premature adrenarche (PA) were shown to share similar hormonal/metabolic properties with PCOS. We compared Lp(a) levels in PA, with healthy and PCOS girls. In total, 25 PA, 20 controls and 10 girls with PCOS were evaluated. Lp(a), lipid profiles and insulin, glucose, free testosterone, dehydroepiandrosterone sulfate (DHEAS) and androstenedione levels were measured. A family history about CVD was obtained. The mean age of girls with PA, at time of the study, was 10.04 +/- 1.53, control 9.83 +/- 1.58 and PCOS was 16.58 +/- 1.46 years. The median (range) of Lp(a) levels were 22.5 (3.50-99.90), 9.6 (3.33-32.40) and 21.2 (5.89-85.65) mg/dL in PA, control and PCOS groups, respectively (P > 0.05). The median Lp(a)'s were 14.5 (3.50-87.00) and 24.30 (6.20-99.90) mg/dL, in prepubertal (Tanner 1) and pubertal PA girls (Tanner 2-5), respectively (P > 0.05). The median Lp(a) of prepubertal peers was 8.7 (3.33-21.17), while that of pubertal ones was 15.4 (4.72-32.40) mg/dL (P > 0.05). There was no difference between Lp(a) levels of pre-pubertal PA girls and their peers; however, significant difference was found in Lp(a) levels in pubertal stages of PA and healthy peers (P < 0.05). The positive family history of CVD was 60% in PA; 55% and 80% in the control and PCOS groups, respectively, with no statistical difference. Lp(a) level was correlated with DHEAS (r = 0.386, P = 0.008) and free testosterone (r = 0.337, P = 0.022) levels positively. There was no significant correlation between Lp(a) and body mass index, fasting insulin and fasting glucose/insulin ratio. Lipoprotein(a) levels in pubertal girls with PA differ significantly from healthy peers. However, to clarify whether the girls with PA have an additional risk for CVD with respect to Lp(a), further follow-up studies with larger number of patients are necessary.