Insulin Resistance, Obesity, Hypofibrinolysis, Hyperandrogenism, and Coronary Heart Disease Risk Factors in 25 Pre-Perimenarchal Girls Age <14 Years, 13 with Precocious Puberty, 23 with a First-degree Relative with Polycystic Ovary Syndrome

摘要: Background: Pre-peri-menarchal diagnosis of polycystic ovary syndrome (PCOS) is important, because intervention with metformin-diet may prevent progression to full blown PCOS. Hypothesis: In 25 girls age ≤14 years probable familial PCOS, 10 pre-, 15 post-menarchal, 13 precocious puberty, 23 a first-degree relative we hypothesized that reversible coronary heart disease (CHD) risk factors, insulin resistance, clinical and biochemical hyperandrogenism, hypofibrinolysis were already established. Methods: Fasting measures: insulin, glucose, total, LDL- (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), systolic diastolic blood pressure (SBP, DBP), plasminogen activator inhibitor activity (PAI-Fx), total (T) free testosterone (FT), androstenedione, DHEAS. Results: Clinical and/or hyperandrogenism was present in all girls, elevations T or FT, androstenedione seven ten pre-menarchal post-menarche. PAI-Fx high 28% the vs 6.5% age-gender-race matched controls (p = 0.013). Categorized by race-age-specific distributions 870 schoolgirls, PCOS more likely have top decile body mass index (BMI), HOMA-insulin resistance (HOMA-IR), SBP, DBP, TG, bottom HDL-C. By analysis variance, adjusting for race, BMI, had higher FT waist circumference than controls, but did not differ HDL-C, TG >0.05). Conclusions: acquisition centripetal obesity amplifies CHD factors hyperandrogenemic puberty. When schoolgirls become as obese they acquire same only lower less obesity.