Metabolic and hormonal assessment of adolescent and young adult women with prior premature adrenarche

Flávia Alves Ribeiro,Elisabete Aparecida Mantovani Rodrigues De Resende,Adriana Paula Da Silva,Janaíne Machado Tomé,Heloísa Marcelina Da Cunha Palhares,Maria De Fátima Borges

doi:10.6061/clinics/2019/e836

Abstract

OBJECTIVE:Follow-up studies of girls with premature adrenarche have reported the development of polycystic ovary syndrome, insulin resistance, and dyslipidemia and a propensity to cardiovascular disease. The aim of this study was to analyze the presence of these conditions in patients previously treated at the Universidade Federal do Triângulo Mineiro.METHODS:A total of 130 medical records reported premature adrenarche. One hundred and twenty-two patients were invited to participate, of whom 54 accepted; 34 patients were selected, as they had reached their final height. Anthropometric, blood glucose, insulin, and lipid and hormonal profile (LH, FSH, estradiol, 17α-OH-progesterone, androstenedione, dehydroepiandrosterone sulfate, testosterone) data were obtained, the HOMA-IR index was calculated, and pelvic ultrasonography was performed. To characterize polycystic ovary syndrome and metabolic syndrome, the Rotterdam and International Diabetes Federation criteria, respectively, were used. Data were analyzed according to measures of dispersion, frequency and correlations of interest.RESULTS:The age of the participants ranged from 15.2 to 28.2 years/months; 23.5% of the patients were overweight, 11.8% were obese, 29.4% had a large waist circumference, and 8.8% were hypertensive. None of the patients had altered glucose levels, and insulin levels and HOMA-IR were elevated in 29.4% and 38.2% of the participants, respectively; 14.7% of the patients exhibited acanthosis nigricans. The lipid profiles of the participants were variable, and one patient (2.9%) had metabolic syndrome. Polycystic ovary syndrome was found in 41.2% of patients.CONCLUSION:The percentage of patients with polycystic ovary syndrome who also had overweight, obesity and insulin resistance corroborates the literature data about the need for follow-up aiming at interventions, especially for conditions associated with cardiometabolic risk.

Highlights

Some children develop isolated and idiopathic premature adrenarche (PA), which is defined as the onset of androgenic signs before 8 years of age in girls and 9 years of age in boys, in the absence of true puberty, steroidogenic enzymatic defects and virilizing tumors
Initial data of patients with premature adrenarche The retrospective analysis of the selected patients’ files showed that at the first consultation, the patients ranged from 10 months to 10 years and seven months of age
blood pressure (BP) shows normal circadian fluctuations; adolescents with polycystic ovary syndrome (PCOS) and abnormal glucose tolerance have an interruption in these fluctuations, and this may be a precursor for the development of arterial hypertension in this population [32]

Summary

Introduction

Some children develop isolated and idiopathic premature adrenarche (PA), which is defined as the onset of androgenic signs before 8 years of age in girls and 9 years of age in boys, in the absence of true puberty, steroidogenic enzymatic defects and virilizing tumors. PA corresponds to the presence of androgen action signs, including adult body odor, oily skin and pubic hair growth. Precocious pubarche (PP) refers to the early appearance of pubic and/or axillary hair in these age groups [1,2]. No potential conflict of interest was reported. Received for publication on June 19, 2018. Accepted for publication on March 27, 2019

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