The impact of obesity on hyperandrogenemia in Korean girls
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: 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. Methods: 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 hormonebinding globulin, dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicularstimulating hormone, estradiol, and progesterone. Results: The plasma levels of free testosterone (FT) and DHEAS were markedly higher in OB girls compared to NW girls in puberty (FT, P=0.009; DHEAS, P=0.046) but not in prepuberty (FT, P=0.183; DHEAS, P=0.052). Hyperinsulinemia and high homeostasis model assessment of insulin resistance (HOMAIR) values were found regardless of pubertal status in OB girls. The significant related factor to HA in puberty was the body mass index Zscore (P=0.003). But HOMAIR, LH, and progesterone levels were not relevant to HA in pubertal girls. Conclusion: 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 per se was the most important factor for HA.
Abstract
Purpose: 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. Methods: 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 hormonebinding globulin, dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicularstimulating hormone, estradiol, and progesterone. Results: The plasma levels of free testosterone (FT) and DHEAS were markedly higher in OB girls compared to NW girls in puberty (FT, P=0.009; DHEAS, P=0.046) but not in prepuberty (FT, P=0.183; DHEAS, P=0.052). Hyperinsulinemia and high homeostasis model assessment of insulin resistance (HOMAIR) values were found regardless of pubertal status in OB girls. The significant related factor to HA in puberty was the body mass index Zscore (P=0.003). But HOMAIR, LH, and progesterone levels were not relevant to HA in pubertal girls. Conclusion: 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 per se was the most important factor for HA.
참고문헌 (35)
- 김기은, "한국 소아 청소년의 비만 및 저체중 유병률 변화: 1998-2008", 대한비만학회지, 21(4), pp.228~235 (2012), 대한비만학회
- Yang S, "Serum lipid concentrations, prevalence of dyslipidemia, and percentage eligible for pharmacological treatment of Korean children and adolescents; data from the Korea National Health and Nutrition Examination Survey IV (2007-2009)", PLoS One, 7, pp.e49253~ (2012)
- Anderson AD, "Childhood obesity and its impact on the development of adolescent PCOS", Semin Reprod Med, 32, pp.202~213 (2014)
- Vilmann LS, "Development of obesity and polycystic ovary syndrome in adolescents", Horm Res Paediatr, 78, pp.269~278 (2012)
- Stanley T, "Polycystic ovary syndrome in obese adolescents", Curr Opin Endocrinol Diabetes Obes, 15, pp.30~36 (2008)
- Burt Solorzano CM, "Hyperandrogenaemia in adolescent girls:origins of abnormal gonadotropin-releasing hormone secretion", BJOG, 117, pp.143~149 (2010)
- Ibáñez L, "Hyperinsulinaemic androgen excess in adolescent girls", Nat Rev Endocrinol, 10, pp.499~508 (2014)
- Azziz R, "Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline", Clin Endocrinol Metab, 91, pp.4237~4245 (2006)
- Pasquali R, "PCOS Forum: research in polycystic ovary syndrome today and tomorrow", Clin Endocrinol (Oxf), 74, pp.424~433 (2011)
- Franks S, "Adult polycystic ovar y syndrome begins in childhood", Best Pract Res Clin Endocrinol Metab, 16, pp.263~272 (2002)
- McCartney CR, "The association of obesity and hyperandrogenemia during the pubertal transition in girls:obesity as a potential factor in the genesis of postpubertal hyperandrogenism", J Clin Endocrinol Metab, 91, pp.1714~1722 (2006)
- McCartney CR, "Ob esity and s ex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls", J Clin Endocrinol Metab, 92, pp.430~436 (2007)
- McCartney CR, "Maturation of luteinizing hormone (gonadotropin-releasing hormone) secretion across puberty: evidence for altered regulation in obese peripubertal girls", J Clin Endocrinol Metab, 94, pp.56~66 (2009)
- Knudsen KL, "Hyperandrogenemia in obese peripubertal girls: correlates and potential etiological determinants", Obesity (Silver Spring), 18, pp.2118~2124 (2010)
- Burt Solorzano CM, "Obesity and the pubertal transition in girls and boys", Reproduction, 140, pp.399~410 (2010)
- Reinehr T, "Androgens before and after weight loss in obese children", J Clin Endocrinol Metab, 90, pp.5588~5595 (2005)
- Cara JF, "Insulin-like growth factor I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian thecal-interstitial cells", Endocrinology, 123, pp.733~739 (1988)
- Moghetti P, "Insulin infusion amplifies 17 alphahydroxycorticosteroid intermediates response to adrenocorticotropin in hyperandrogenic women: apparent relative impairment of 17,20-lyase activity", J Clin Endocrinol Metab, 81, pp.881~886 (1996)
- Nestler JE, "Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system", J Clin Endocrinol Metab, 83, pp.2001~2005 (1998)
- Ng M, "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013", Lancet, 384, pp.766~781 (2014)
- Korea Centers for Disease Control and Prevention, "2007 Korean children and adolescents growth standard (commentary for the development of 2007 growth chart)" (2007), Korea Centers for Disease Control and Prevention, Division of Chronic Disease Surveillance
- Vermeulen A, "A critical evaluation of simple methods for the estimation of free testosterone in serum", J Clin Endocrinol Metab, 84, pp.3666~3672 (1999)
- Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)
- Strauss RS, "Childhood obesity", Pediatr Clin North Am, 49, pp.175~201 (2002)
- Dieudonne MN, "Androgen receptors in human preadipocytes and adipocytes: regional specificities and regulation by sex steroids", Am J Physiol, 274(6 Pt 1), pp.C1645~C1652 (1998)
- Kershaw EE, "Adipose tissue as an endocrine organ", J Clin Endocrinol Metab, 89, pp.2548~2556 (2004)
- Pugeat M, "Pathophysiology of sex hormone binding globulin (SHBG): relation to insulin", J Steroid Biochem Mol Biol, 40, pp.841~849 (1991)
- Soldani R, "Insulin, insulin-like growth factor I (IGF-I) and IGF-II enhance basal and gonadotrophin-releasing hormone-stimulated luteinizing hormone release from rat anterior pituitary cells in vitro", Eur J Endocrinol, 131, pp.641~645 (1994)
- Rosenfield RL, "Evidence that obesity and androgens have independent and opposing effects on gonadotropin production from puberty to maturity", Brain Res, 1364, pp.186~197 (2010)
- Wang Y, "Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls", Pediatrics, 110, pp.903~910 (2002)
- Ahmed ML, "Childhood obesity and the timing of puberty", Trends Endocrinol Metab, 20, pp.237~242 (2009)
- Pastor CL, "Polycystic ovary syndrome: evidence for reduced sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by estradiol and progesterone", J Clin Endocrinol Metab, 83, pp.582~590 (1998)
- Travers SH, "Gender and Tanner stage differences in body composition and insulin sensitivity in early pubertal children", J Clin Endocrinol Metab, 80, pp.172~178 (1995)
- Ibáñez L, "Premature adrenarche--normal variant or forerunner of adult disease?", Endocr Rev, 21, pp.671~696 (2000)
- Wabitsch M, "Body fat distribution and steroid hormone concentrations in obese adolescent girls before and after weight reduction", J Clin Endocrinol Metab, 80, pp.3469~3475 (1995)
