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Hormone profiles, ovarian maturity differ among SGA girls with precocious adrenarche
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Prepubescent girls with precocious adrenarche who were small for gestational age exhibited significant disparities in hormone levels, insulin sensitivity and ovarian maturity, according to recent findings published in The Journal of Clinical Endocrinology & Metabolism.
These differences may help identify risk factors associated with the subsequent development of polycystic ovary syndrome.
In a prospective study, researchers evaluated 87 prepubescent girls with precocious adrenarche seen at an outpatient clinic. Of these, 56 girls were average size for gestational age (AGA) and 31 were small for gestational age (SGA).
The investigators conducted thorough medical examinations and gathered medical histories on each patient, including family history of type 2 diabetes and PCOS. Blood tests were also administered to measure various hormonal parameters.
A pediatric endocrinologist measured the children’s weight, height, BMI and waist circumference. The researchers calculated catch-up growth in weight and height, and also evaluated possible associations between catch-up growth and clinical findings in girls who were SGA at birth and later demonstrated precocious adrenarche.
The ages, Tanner stages of pubertal development, ovarian volumes and uterine volumes were similar for AGA and SGA girls. The investigators found that SGA girls had lower BMI than their AGA counterparts, and also higher blood concentrations of serum follicle-stimulating hormone and bone age-adjusted postcorticotropin cortisol. The SGA participants also had increased BMI-adjusted mean serum insulin, decreased insulin sensitivity and lower insulin-like growth factor-binding protein-1. Multicystic ovaries were more prevalent among SGA girls (OR=9.69; 95% CI, 3.34-28.15). SGA girls who did not achieve catch-up growth also had a higher prevalence of multicystic ovaries than girls with catch-up growth (OR=8.4; 95% CI, 1.4-19.3). There was an association between SGA status at birth and excessive 17-OH progesterone (P=.015) and multicystic ovaries.
According to the researchers, the main objective of this study was to evaluate PCOS symptoms in SGA girls with precocious adrenarche; they added that further study is needed to investigate this potential correlation.
“SGA girls with precocious adrenarche display exaggerated adrenarcheal hormone profiles and mature ovarian morphology, findings which are even more pronounced in SGA girls without catch-up growth,” the researchers wrote. “Continued follow-up of our cohort will determine if these findings in SGA girls with precocious adrenarche are associated with a predilection to a specific PCOS phenotype with greater adherence to the morphological criteria of PCOS.”
Disclosure: The researchers report no relevant financial disclosures.
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