This paper reports an analysis of the clinical, endocrine and ultrasound data within a population of 556 patients with ultrasound-diagnosed polycystic ovaries. Compared with those not so affected, hirsutism was associated with a higher mean serum testosterone concentration, infertility was associated with higher mean gonadotrophin concentrations, obesity was associated with a higher mean serum testosterone concentration, hyperprolactinaemia was associated with a lower mean serum testosterone concentration and smaller ovaries, alopecia was associated with lower mean serum LH and testosterone concentrations, and acanthosis nigricans was associated with obesity and a raised mean serum testosterone concentration. The heterogeneity illustrates the limitations in the use of specific clinical or endocrine criteria as requirements for the diagnosis of the polycystic ovary syndrome.

Associations between low birth weight and higher adrenal androgen secretion before puberty have yet only been reported in case-control studies in girls. We examined the influence of birth weight and early postnatal weight gain on overnight-fasting adrenal androgen and cortisol levels in 770 children from a large normal United Kingdom birth cohort at age 8 yr. In univariate analyses, adrenal androgen levels were inversely related to birth weight SD score in each sex [dehydroepiandrosterone sulfate in boys: regression coefficient (B) ‫؍‬ ؊2.5 g/dl/SD; 95% confidence interval (CI), ؊4.7 to ؊0.2; in girls: B ‫؍‬ ؊3.8 g/dl/SD; 95% CI, ؊6.2 to ؊1.4; androstenedione in boys: B ‫؍‬ ؊0.15 nmol/liter/SD, 95% CI, ؊0.25 to ؊0.6; in girls: B ‫؍‬ ؊0.13 nmol/liter/SD; 95% CI, ؊0.24 to ؊0.02). In multivariate analyses, both lower birth weight and larger current body weight predicted higher adrenal androgen levels (P < 0.005 for all comparisons). Allowing for current weight, children who showed rapid postnatal weight gain between 0 and 3 yr had higher dehydroepiandrosterone sulfate (P ‫؍‬ 0.002) and androstenedione (P ‫؍‬ 0.004) levels at 8 yr. In contrast, cortisol levels were unrelated to birth weight or current body size. In summary, the relationship between lower birth weight and higher childhood adrenal androgen levels was continuous throughout the range of normal birth weights, and was similar in boys and girls. Adrenal androgen levels were highest in small infants who gained weight rapidly during early childhood. We suggest that higher adrenal androgen secretion could contribute to links between early growth and adult disease risks, possibly by enhancing insulin resistance and central fat deposition. (J Clin Endocrinol

The development of elbow flexor (biceps) and knee extensor (quadriceps) strength has been followed in a mixed longitudinal study of 50 boys and 50 girls from the age of 8 to 17 years. Sex differences in strength emerged at the time of peak height velocity and were especially marked for the biceps. Data for individual children were aligned to the time of peak height velocity and associations between strength, height, weight and circulating testosterone were investigated using multi-level modelling. The results show that, for girls, quadriceps strength is proportional to height and weight while for boys there is an additional factor which can be fully attributed to increasing levels of testosterone. Testosterone is important in explaining differences in biceps strength between the sexes but an additional factor is also required. It is suggested that, in addition to a direct effect on muscle, testosterone could have a second indirect action on biceps strength by promoting growth in length of the humerus as part of the general development of the male upper limb girdle.

These findings suggests that the intra-uterine environment, as measured by fetal size at birth, has long-lasting effects on the function of the hypothalamo-pituitary-adrenal axis.