Andiran Nesibe, Yordam Nurşen, Kirazli Serafettin
Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2005 Dec;18(12):1373-81. doi: 10.1515/jpem.2005.18.12.1373.
Global fibrinolytic capacity (GFC) is a sensitive method reflecting all of the molecular components involved in the process of fibrinolysis. Recently, a decrease in GFC has been shown in women with polycystic ovary syndrome (PCOS). Girls with premature adrenarche (PA) have been shown to have hyperinsulinemia and dyslipidemia in addition to hyperandrogenemia, similar to women with PCOS. The aim of this study was to evaluate GFC levels in girls with PA.
Twenty-five girls with PA, who had developed pubic/axillary hair at age of 7.09 +/- 0.74 (5.1-7.9) years, were studied at the age of 10.04 +/- 1.53 years and compared with 20 age-matched healthy controls and 10 girls with PCOS (mean age 16.58 +/- 1.46 years).
Median DHEAS and free testosterone levels were significantly higher in girls with PA than in the control group. The median serum sex hormone binding globulin (SHBG) level was higher in controls than in both PA and PCOS groups (49.85, 38.60 and 21.30 nmol/l, respectively). The median fasting glucose:insulin ratio (FGIR) levels were similarly low in PA and PCOS groups, while it was significantly higher in controls. The FGIR levels were less than 7 in 52% of girls with PA and 50% of girls with PCOS; however, in controls, only 5% of girls had FGIR <7. Median GFC in girls with PA (1.67 microg/ml) and PCOS (1.06 microg/ml) were significantly lower than that of the controls (3.48 microg/ml, p <0.001). The GFC level correlated positively with SHBG and FGIR.
A reduction in GFC was demonstrated in girls with PA compared to healthy controls. This important finding, newly added to previous ones, may strengthen the view that PA is not a benign condition, and also points to the presence of potential risk factors for vascular diseases in these girls starting from childhood.
全球纤溶能力（GFC）是一种反映纤溶过程中所有分子成分的敏感方法。最近的研究表明，多囊卵巢综合征（PCOS）女性的GFC有所下降。早熟肾上腺初现（PA）的女孩除了雄激素过多外，还存在高胰岛素血症和血脂异常，这与PCOS女性相似。本研究的目的是评估PA女孩的GFC水平。
对25名PA女孩进行研究，她们在7.09±0.74（5.1 - 7.9）岁时出现阴毛/腋毛，在10.04±1.53岁时接受研究，并与20名年龄匹配的健康对照以及10名PCOS女孩（平均年龄16.58±1.46岁）进行比较。
PA女孩的硫酸脱氢表雄酮（DHEAS）和游离睾酮水平中位数显著高于对照组。对照组血清性激素结合球蛋白（SHBG）水平中位数高于PA组和PCOS组（分别为49.85、38.60和21.30 nmol/l）。PA组和PCOS组的空腹血糖：胰岛素比值（FGIR）水平中位数同样较低，而对照组则显著更高。52%的PA女孩和50%的PCOS女孩的FGIR水平低于7；然而，在对照组中，只有5%的女孩FGIR<7。PA女孩（1.67μg/ml）和PCOS女孩（1.06μg/ml）的GFC中位数显著低于对照组（3.48μg/ml，p<0.001）。GFC水平与SHBG和FGIR呈正相关。
与健康对照相比，PA女孩的GFC降低。这一重要发现是在先前研究基础上新增加的，可能会强化PA并非良性疾病的观点，也表明这些女孩从儿童期起就存在血管疾病的潜在危险因素。
