Endometrial thickness associated with insulin levels for girls with premature adrenarche
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In girls with premature adrenarche, early uterine and breast gland tissue changes were detectable with imaging, and endometrial thickness was positively associated with insulin levels, according to study findings.
“Premature adrenarche has been considered as an extreme of normal variation with no need for special follow-up or treatment,” Banu K. Aydin, MD, from the department of Women’s and Children’s Health at Uppsala University, Uppsala, Sweden, and the department of pediatrics in the pediatric endocrinology unit at Istanbul University, Istanbul, Turkey, and colleagues wrote. “However, especially after the late 1990s, connections between premature adrenarche and metabolic syndrome features, including central obesity, high blood pressure, decreased serum cholesterol, elevated serum triglycerides and impaired fasting glucose levels, were widely reported. ... We aimed to evaluate early pubertal changes and potential metabolic disturbances in girls with premature adrenarche.”
Study results were published in Clinical Endocrinology.
The study included 48 girls (mean age, 7.6 years) with premature pubarche due to premature adrenarche and 49 girls without palpable breast tissue matched for age, weight, BMI, birth weight and gestational age. Researchers collected blood samples, performed breast and pelvic ultrasounds and assessed bone age for all girls. Early pubertal pelvic and breast ultrasound changes and their associations with obesity and metabolic syndrome features were analyzed.
Girls with premature adrenarche were more likely to be taller (P = .049) with higher bone age (P = .005). Researchers observed a greater proportion of girls with premature adrenarche with breast gland tissue on ultrasound compared with girls without (30% vs. 5%; P = .006). Girls with premature adrenarche also had greater uterine volume (P = .03) and endometrial thickness (P = .04).
Researchers observed a positive association between endometrial thickness and serum insulin levels in the entire study group as well as after adjusting for other age, premature adrenarche, BMI, ovarian volume and sex hormone levels (P = .05).
There was no difference in fasting blood glucose or levels of insulin, HDL cholesterol, LDL cholesteroltriglycerides between girls with and without premature adrenarche. In addition, there were no differences in luteinizing hormone, follicle-stimulating hormone or estradiol levels.
“We could not find any significant association between metabolic parameters and ovarian volumes in this study, but we found a positive association between insulin levels and endometrial thickness,” the researchers wrote. “Future studies, with a larger cohort and a longitudinal design, would be helpful to further investigate and understand these associations.”
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