The Relationship Between Ovarian Structure and Serum Insulin, Insulin-like Growth Factor I (IGF-I) and its Binding Protein (IGFBP-1 and IGFBP-3) Levels in Premature Pubarche

Teixeira, Rosimere J.; Silva, Valéria Cataldo Gomes da; Gazolla, Helena M.; Cunha, Sônia B. da; Guimarães, Marília M.

doi:10.1515/jpem.2002.15.1.69

Cited by 11 publications

(9 citation statements)

References 8 publications

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“…9,17,18 Some of these changes (eg, hyperinsulinemia, insulin resistance) are evident at approximately the time of puberty. 19,20 Girls who exhibit these features are frequently obese (notably those of black or Caribbean Hispanic origin), 21 and ϳ30% have marked hyperandrogenism; those with the more marked hyperandrogenism tend to exhibit the greatest insulin resistance and hyperinsulinemia, even after correction for BMI. 22,23 Girls who have PA and remain obese are at risk for developing PCOS, 21 particularly when PA itself was preceded by low birth weight.…”

Section: Metabolic Syndrome and Pcosmentioning

confidence: 99%

Public Health Implications of Altered Puberty Timing

et al. 2008

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Changes in puberty timing have implications for the treatment of individual children, for the risk of later adult disease, and for chemical testing and risk assessment for the population. Children with early puberty are at a risk for accelerated skeletal maturation and short adult height, early sexual debut, potential sexual abuse, and psychosocial difficulties. Altered puberty timing is also of concern for the development of reproductive tract cancers later in life. For example, an early age of menarche is a risk factor for breast cancer. A low age at male puberty is associated with an increased risk for testicular cancer according to several, but not all, epidemiologic studies. Girls and, possibly, boys who exhibit premature adrenarche are at a higher risk for developing features of metabolic syndrome, including obesity, type 2 diabetes, and cardiovascular disease later in adulthood. Altered timing of puberty also has implications for behavioral disorders. For example, an early maturation is associated with a greater incidence of conduct and behavior disorders during adolescence. Finally, altered puberty timing is considered an adverse effect in reproductive toxicity risk assessment for chemicals. Recent US legislation has mandated improved chemical testing approaches for protecting children's health and screening for endocrinedisrupting agents, which has led to changes in the US Environmental Protection Agency's risk assessment and toxicity testing guidelines to include puberty-related assessments and to the validation of pubertal male and female rat assays for endocrine screening.

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Section: Metabolic Syndrome and Pcosmentioning

confidence: 99%

Public Health Implications of Altered Puberty Timing

et al. 2008

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“…Adicionalmente, tem sido demonstrado que em mulheres hiperandrogênicas a diminuição dos níveis de insulina através de agentes sensibilizadores da insulina reduz os níveis séricos dos androgênios, aumenta a concentração da SHBG e restaura a ovulação e os ciclos menstruais, provavelmente através da redução da atividade do citocromo P450c17α ovariano (20). segue o mesmo padrão e é fortemente correlacionada com a SHBG (32). Nesta amostra a IGFBP-1 se correlacionou com o índice de RI independentemente dos níveis da insulina e SHBG.…”

Section: Discussionunclassified

Globulina ligadora dos hormônios sexuais e proteína ligadora 1 do IGF-1: marcadores para resistência à insulina na pubarca precoce?

Teixeira

Ginzbarg

Freitas

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOA hiperinsulinemia parece contribuir para o hiperandrogenismo por reduzir os níveis séricos tanto da SHBG quanto da IGFBP-1. Avaliamos os níveis de SHBG e IGFBP-1 e sua correlação com androgênios e insulina em 44 meninas selecionadas com pubarca precoce (PP) e 18 controles (C) pré-puberais (7,3±1,3 x 6,8±1,6 anos). Foram avaliados: o índice de massa corporal (IMC), a idade óssea (IO) e os níveis séricos de SHBG, IGFBP-1, insulina (I), glicose (G), testosterona (T), androstenediona (A), SDHEA e cortisol (F). Calculamos a relação glicose: insulina (G/I) no jejum como índice de resistência à insulina (RI). A IO foi maior na PP, mas o IMC foi semelhante aos C. Os níveis de SDHEA, T e A foram maiores, enquanto a SHBG e a IGFBP-1 foram menores na PP do que nos C. Na regressão simples, a SHBG mostrou correlação com IMC, F, SDHEA, T, I, G/I e IGFBP-1, enquanto a IGFBP-1 se correlacionou com IMC, I e a G/I. No modelo de regressão múltipla, tanto a SHBG quanto a IGFBP-1 correlacionaramse apenas com o IMC e a taxa G/I (r 2 =0,45; p<0,01 e r 2 =0,44; p<0,01, respectivamente). Nossos dados demonstram que o peso corporal e a insulina têm um papel sinérgico na regulação dos níveis da SHBG e da IGFBP-1, sugerindo que ambos podem ser marcadores sutis da RI na PP. ABSTRACT Sex Hormone Binding Globulin and IGF-Binding-Protein 1: Markers of Insulin Resistance in Premature Pubarche?Hyperinsulinemia may contribute to hyperandrogenism because it reduces the levels of SHBG and IGFBP-1. In this study we determined serum levels of SHBG and IGFBP-1 and their association with androgen and insulin in 44 selected girls with premature pubarche (PP) and 18 prepubertal controls (C) (7.3±1.3 x 6.8±1.6years). The body mass index (BMI) and bone age (BA) were determined, as well as the serum levels of SHBG, IGFBP-1, insulin (I), glucose (G), testosterone (T), DHEAS, androstenedione (A), 17-hydroxyprogesterone (17OHP) and cortisol (F). Fasting glucose to insulin ratio (G/I) was calculated as an index of insulin resistance (IR). BA was higher in PP than in C, but BMI was similar in both groups. Serum levels of DHEAS, T and A were higher in PP than in C, whereas SHBG and IGFBP-1 were lower. SHBG was correlated with BMI, SDHEA, T, F, I, G/I and IGFBP-1; and IGFBP-1 was correlated with BMI, I and G/I ratio. In the multiple regression model, SHBG and IGFBP-1 were correlated only with BMI and G/I ratio (r 2 =0.45; p<0.01 and r 2 =0.44; p<0.01, respectively). The present data demonstrate that body weight and insulin have a synergic role in the regulation of serum SHBG and IGFBP-1 levels, suggesting that both could be tenuous markers of IR in PP.

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“…Esta associação entre PP e SOP tem sido descrita mesmo em pacientes não-obesas e parece estar relacionada ao grau de hiperandrogenismo. Em estudos prévios, descrevemos que meninas com PP e ovários microcísticos eram menos obesas do que as com ovários homogêneos, embora com um maior grau de hiperandrogenismo e níveis mais elevados de IGFBP-3, que tem sido considerado como fator preditivo negativo da sensibilidade à insulina durante a puberdade (31,32). Geralmente a evolução para a SOP ocorre durante o desenvolvimento puberal, principalmente naquelas meninas com predisposição genética.…”

Section: Obesidade E Baixo Peso Ao Nascer Na Pubarca Precoceunclassified

Prevalência de obesidade e baixo peso ao nascer na pubarca precoce

Teixeira

Coelho

Perecmanis

et al. 2003

Arq Bras Endocrinol Metab

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Arq Bras Endocrinol Metab vol 47 nº 2 Abril 2003 166 RESUMOA prevalência de obesidade e a presença de baixo peso ao nascer (BPN) foram avaliadas retrospectivamente em 96 crianças com pubarca precoce (PP), das quais foram selecionados 90 casos com adrenarca precoce. Em 46 prontuários havia informações quanto ao peso ao nascer, sendo 5 excluídos por prematuridade. Foram avaliados os está-dios de Tanner, índice de massa corporal (IMC), presença de acanthosis nigricans e idade óssea (IO). Consideramos como obesidade o IMC ≥ percentil 95 e como sobrepeso o IMC ≥ 85 e < percentil 95. O IMC foi reavaliado em 62 casos após follow-up mínimo de seis meses. A IO foi maior do que a cronológica (7,9±1,97 x 7,0±1,7 anos; p<0,001). O está-dio de Tanner II para pêlos pubianos foi notado em 72% e acanthosis nigricans em 31% dos casos. O peso ao nascer foi de 3.168±528g. Em 12% dos casos havia história de BPN, mas sem diferença com a população geral (10%). Não foi encontrada correlação entre o IMC e o PN. Obesidade foi notada em 31% e sobrepeso em 19%. O IMC aumentou após o follow-up (18±3,0 x 19,4±3,5kg/m 2 , p=0,008). A prevalência de obesidade na PP foi maior do que na população brasileira (31% x 15%, p<0,02). O excesso de peso é um achado comum na PP, entretanto o peso ao nascer é normal. É importante ressaltar que essas crianças devem ser estimuladas a perder peso, pois tanto a PP quanto a obesidade estão associados a um maior risco de desenvolver a síndrome dos ovários policísticos e a síndrome plurimetabólica na vida adulta. ABSTRACT Prevalence of Obesity and Low Birth Weight in Premature Pubarche.The prevalence of obesity and presence of low birth weight (LBW) were evaluated retrospectively in 96 children with premature pubarche (PP), from which 90 cases of premature adrenarche were selected. Information on BW was found in 46 charts, and 5 prematures were excluded. Tanner stages, body mass index (BMI), presence of acanthosis nigricans and bone age (BA) were evaluated. Obesity was considered when BMI ≥ the 95 th percentile and overweight when BMI ≥ the 85 and <95 percentiles. After a six-month follow-up, the BMI of 62 patients was reevaluated. The results showed that BA was higher than chronological age (7.9±1.97 x 7.0±1.7 years, p<0.001). 70% of the sample showed pubic hair in Tanner II stage in and 31% had acanthosis nigricans. The BW was 3,168.2±528.2g. In 12% of the cases a history of LBW was present, a result not different from the general population (10%). No correlation was found between BMI and BW. Obesity was observed in 31% and overweight in 19% of the cases. BMI increased after follow-up (18±3.0 x 19.4±3.5kg/m 2 , p=0.008). The prevalence of obesity was higher in children with PP than in the Brazilian population (31% x 15%, p<0.02). In conclusion, although excess weight is a common finding in PP, birth weight is normal. It is remarkable that these children must be stimulated to lose weight, since PP and obesity are associated with a higher risk for policystic ovary and plurimetabolic syndromes in adulthood.

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The Relationship Between Ovarian Structure and Serum Insulin, Insulin-like Growth Factor I (IGF-I) and its Binding Protein (IGFBP-1 and IGFBP-3) Levels in Premature Pubarche

Cited by 11 publications

References 8 publications

Public Health Implications of Altered Puberty Timing

Public Health Implications of Altered Puberty Timing

Globulina ligadora dos hormônios sexuais e proteína ligadora 1 do IGF-1: marcadores para resistência à insulina na pubarca precoce?

Prevalência de obesidade e baixo peso ao nascer na pubarca precoce

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