Sex Hormone-Binding Globulin, Oligomenorrhea, Polycystic Ovary Syndrome, and Childhood Insulin at Age 14 Years Predict Metabolic Syndrome and Class III Obesity at Age 24 Years

• Published in: The Journal of pediatrics Vol. 159; no. 2; pp. 308 - 313.e2
• Main Authors: Glueck, Charles J., MD, Morrison, John A., PhD, Daniels, Stephen, MD, PhD, Wang, Ping, PhD, Stroop, Davis, MSc
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.08.2011; Mosby, Inc; Elsevier
• Subjects: Adolescent; adulthood; animal ovaries; Biological and medical sciences; Biomarkers - blood; Body Mass Index; Child; childhood; Disease Progression; Female; Female genital diseases; Follow-Up Studies; General aspects; girls; Gynecology. Andrology. Obstetrics; Humans; Hyperaldosteronism - blood; Hyperaldosteronism - complications; Hyperaldosteronism - epidemiology; hyperandrogenism; Incidence; insulin; Insulin - blood; Insulin Resistance; Medical sciences; Metabolic diseases; metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Miscellaneous; Non tumoral diseases; obesity; Obesity, Morbid - blood; Obesity, Morbid - epidemiology; Obesity, Morbid - etiology; Oligomenorrhea - blood; Oligomenorrhea - complications; Oligomenorrhea - epidemiology; Other metabolic disorders; Pediatrics; periodicity; polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - epidemiology; Prospective Studies; Radioimmunoassay; ROC Curve; Sex Hormone-Binding Globulin - metabolism; Time Factors; United States - epidemiology; Young Adult; NGHS; Polycystic ovary syndrome; Sex hormone-binding globulin; Metabolic syndrome; E2; Estradiol; AUC; Body mass index; HDL; Area under the receiver operating characteristic curve; PCOS; DHEAS; Dehydroepiandrosterone sulfate; MetS; High-density lipoprotein; National Growth and Health Study; SHBG; BMI; Endocrinopathy; Human; Obesity; Pediatrics; Pancreatic hormone; Menstruation disorders; Nutrition disorder; Prediction; Sex hormone binding protein; Metabolic diseases; Cardiovascular disease; Female sterility; Oligomenorrhea; Polycystic ovary; Insulin; Female genital diseases; Ovarian diseases; Cyst; Benign neoplasm; Predictive factor; Child; Age; Nutritional status
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2011.01.018

Objective We hypothesized that oligomenorrhea (menstrual cyclicity ≥42 days), hyperandrogenism, low levels of sex hormone-binding globulin (SHBG), childhood insulin, and metabolic syndrome (MetS) at age 14 years would predict MetS and class III obesity (body mass index ≥40 kg/m2 ) at age 24 years. Study design In this prospective study of schoolgirls, at age 14 years, the girls were categorized as regularly cycling (n = 375), oligomenorrheic (n = 18), or oligomenorrhea plus biochemical hyperandrogenism (polycystic ovary syndrome [PCOS]; n = 12), together designated PCOS. Results Significant explanatory variables for MetS at age 24 years included childhood insulin, MetS, and PCOS category (all positive) and SHBG (negative) at age 14 years. Using categorical data, top decile of childhood insulin, MetS at age 14, bottom decile of SHBG, and PCOS category were significant positive predictors for MetS at age 24. SHBG (negative), black race (positive), and oligomenorrhea (positive) were significant explanatory variables for class III obesity at age 24. Using categorical data, black race, MetS at age 14, bottom decile of SHBG, PCOS category, and top decile of childhood insulin were positive explanatory variables for class III obesity at age 24 years. Conclusions Oligomenorrhea, PCOS (a subcohort of oligomenorrhea), hyperandrogenism, low SHBG, MetS, and childhood insulin at age 14 years may represent a critical, reversible pathway for the development of MetS and class III obesity in young adulthood.