Obesity and Sex Steroid Changes across Puberty: Evidence for Marked Hyperandrogenemia in Pre- and Early Pubertal Obese Girls

• Published in: The journal of clinical endocrinology and metabolism Vol. 92; no. 2; pp. 430 - 436
• Main Authors: McCartney, Christopher R., Blank, Susan K., Prendergast, Kathleen A., Chhabra, Sandhya, Eagleson, Christine A., Helm, Kristin D., Yoo, Richard, Chang, R. Jeffrey, Foster, Carol M., Caprio, Sonia, Marshall, John C.
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Oxford University Press 01.02.2007; Endocrine Society
• Subjects: Adolescent; Biological and medical sciences; Body mass index; Body Weight; Child; Circadian Rhythm; Cross-Sectional Studies; Endocrinopathies; Fasting; Female; Fundamental and applied biological sciences. Psychology; Humans; Hydrocortisone - blood; Hyperandrogenism - metabolism; Hyperandrogenism - physiopathology; Hyperinsulinemia; Hyperinsulinism - metabolism; Hyperinsulinism - physiopathology; Insulin - blood; Luteinizing hormone; Medical sciences; Obesity; Obesity - metabolism; Obesity - physiopathology; Progesterone; Progesterone - blood; Puberty; Puberty - blood; Steroids; Testosterone; Testosterone - blood; Vertebrates: endocrinology; Weight; Endocrinopathy; Human; Obesity; Puberty; Nutrition disorder; Prepuberty; Female; Hyperandrogenism; Early; Sex steroid hormone; Child; Endocrinology; Nutritional status
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2006-2002

Context: Peripubertal obesity is associated with abnormal sex steroid concentrations, but the timing of onset and degree of these abnormalities remain unclear. Objective: The objective of the study was to assess the degree of hyperandrogenemia across puberty in obese girls and assess overnight sex steroid changes in Tanner stage 1–3 girls. Design: This was a cross-sectional analysis. Setting: The study was conducted at general clinical research centers. Subjects: Thirty normal-weight (body mass index for age < 85%) and 74 obese (body mass index for age ≥ 95%) peripubertal girls. Intervention: Blood samples (circa 0500–0700 h) were taken while fasting. Samples from the preceding evening (circa 2300 h) were obtained in 23 Tanner 1–3 girls. Main Outcome Measures: Hormone concentrations stratified by Tanner stage were measured. Results: Compared with normal-weight girls, mean free testosterone (T) was elevated 2- to 9-fold across puberty in obese girls, whereas fasting insulin was 3-fold elevated in obese Tanner 1–3 girls (P < 0.05). Mean LH was lower in obese Tanner 1 and 2 girls (P < 0.05) but not in more mature girls. In a subgroup of normal-weight Tanner 1–3 girls (n = 17), mean progesterone (P) and T increased overnight 2.3- and 2.4-fold, respectively (P ≤ 0.001). In obese Tanner 1–3 girls (n = 6), evening P and T were elevated, and both tended to increase overnight [mean 1.4- and 1.6-fold, respectively (P = 0.06)]. Conclusions: Peripubertal obesity is associated with hyperandrogenemia and hyperinsulinemia throughout puberty, being especially marked shortly before and during early puberty. P and T concentrations in normal-weight Tanner 1–3 girls increase overnight, with similar but less evident changes in obese girls.