Hyperandrogenemia in obese peripubertal girls: correlates and potential etiological determinants.
Hyperandrogenemia in obese peripubertal girls: correlates and potential etiological determinants.
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DOI：
10.1038/oby.2010.58
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发表时间：
2010-11
期刊：
影响因子：
--
通讯作者：
McCartney CR
中科院分区：
文献类型：
--
作者：
Knudsen KL;Blank SK;Burt Solorzano C;Patrie JT;Chang RJ;Caprio S;Marshall JC;McCartney CR
青春期女孩的肥胖与高雄激素血症（HA）有关，高雄激素血症可能是多囊卵巢综合征的先兆。然而，并非所有肥胖女孩都表现出HA，而且肥胖女孩HA的决定因素仍不清楚。我们假设胰岛素和黄体生成素 (LH) 是肥胖女孩游离 T 浓度的独立预测因子。为了进一步评估这一点，我们从青春期不同阶段的 92 名肥胖（年龄体重指数百分位数 [BMI%] ≥ 95）女孩采集了早晨空腹血样。然后使用游离 T（因变量）、LH、胰岛素、青春期组（青春期早期、中期或晚期）、BMI z 分数和年龄构建多变量回归模型。每个青春期组中肥胖女孩的游离 T 浓度差异很大。回归模型大约解释了肥胖女孩游离 T 变异性的一半（调整后的 R2 = 0.53，P < 0.001）。研究发现 LH 具有最大的独立预测游离 T 的能力，其次是胰岛素，然后是年龄和 BMI z 分数。青春期组并不是游离 T 的独立预测因子。我们得出的结论是，即使在调整了潜在的混杂因素（年龄、青春期组、肥胖）后，早晨 LH 和空腹胰岛素也是肥胖女孩中游离 T 的显着预测因子。我们认为LH分泌异常和高胰岛素血症可以促进一些青春期肥胖女孩的HA。
Obesity in peripubertal girls is associated with hyperandrogenemia (HA), which can represent a forerunner of polycystic ovary syndrome. However, not all obese girls demonstrate HA, and determinants of HA in obese girls remain unclear. We hypothesized that insulin and luteinizing hormone (LH) are independent predictors of free T concentration in obese girls. To assess this further, fasting morning blood samples were collected from 92 obese (body mass index-for-age percentile [BMI%] ≥ 95) girls in various stages of puberty. A multivariate regression model was then constructed using free T (dependent variable), LH, insulin, pubertal group (early, mid-, or late puberty), BMI z-score, and age. Free T concentrations were highly variable among obese girls in each pubertal group. The regression model accounted for roughly half of the variability of free T in obese girls (adjusted R2 = 0.53, P < 0.001). LH was found to have the greatest independent ability to predict free T, followed by insulin, then age and BMI z-score. Pubertal group was not an independent predictor of free T. We conclude that morning LH and fasting insulin are significant predictors of free T in obese girls, even after adjusting for potential confounders (age, pubertal group, adiposity). We suggest that abnormal LH secretion and hyperinsulinemia can promote HA in some peripubertal girls with obesity.
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