Kang Min Jae, Yang Seung, Hwang Il Tae
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang-si, Korea.
Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2016 Dec;21(4):219-225. doi: 10.6065/apem.2016.21.4.219. Epub 2016 Dec 31.
As metabolic complication and polycystic ovarian syndrome due to childhood obesity is rising, the role of hyperandrogenemia (HA) and hyperinsulinism is receiving attention. The aims of this study were to investigate the presence of obvious HA according to pubertal status and to find potential etiologic determinants of HA in Korean obese (OB) girls.
We analyzed 91 girls aged 6-17 years (prepuberty, n=54; puberty, n=37). Each girl was classified as being either normal weight (NW) or OB. Anthropometric measurements were obtained and blood test was performed early in the morning after at least 8 hours of fasting to measure glucose, insulin, total testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular-stimulating hormone, estradiol, and progesterone.
The plasma levels of free testosterone (FT) and DHEAS were markedly higher in OB girls compared to NW girls in puberty (FT, =0.009; DHEAS, =0.046) but not in prepuberty (FT, =0.183; DHEAS, =0.052). Hyperinsulinemia and high homeostasis model assessment of insulin resistance (HOMA-IR) values were found regardless of pubertal status in OB girls. The significant related factor to HA in puberty was the body mass index -score (=0.003). But HOMA-IR, LH, and progesterone levels were not relevant to HA in pubertal girls.
OB prepubertal girls did not show HA in the present study but they should be regularly monitored because they already had hyperinsulinemia. OB pubertal girls had significant HA and hyperinsulinemia, and obesity was the most important factor for HA.
由于儿童肥胖导致的代谢并发症和多囊卵巢综合征日益增多，高雄激素血症（HA）和高胰岛素血症的作用受到关注。本研究的目的是根据青春期状态调查明显HA的存在情况，并找出韩国肥胖（OB）女孩中HA的潜在病因决定因素。
我们分析了91名6 - 17岁的女孩（青春期前，n = 54；青春期，n = 37）。每个女孩被分类为正常体重（NW）或肥胖。进行人体测量，并在至少禁食8小时后的清晨进行血液检测，以测量葡萄糖、胰岛素、总睾酮、性激素结合球蛋白、硫酸脱氢表雄酮（DHEAS）、黄体生成素（LH）、卵泡刺激素、雌二醇和孕酮。
与青春期NW女孩相比，OB女孩的血浆游离睾酮（FT）和DHEAS水平显著更高（FT，= 0.009；DHEAS，= 0.046），但青春期前则不然（FT，= 0.183；DHEAS，= 0.052）。无论青春期状态如何，OB女孩均存在高胰岛素血症和高胰岛素抵抗稳态模型评估（HOMA - IR）值。青春期HA的显著相关因素是体重指数评分（= 0.003）。但青春期女孩的HOMA - IR、LH和孕酮水平与HA无关。
在本研究中，青春期前OB女孩未表现出HA，但由于她们已经存在高胰岛素血症，应定期监测。青春期OB女孩存在显著的HA和高胰岛素血症，肥胖是HA最重要的因素。
