Author:

Keywords:

Biological Markers, Birth Weight, Blood Glucose, Child, Cross-Sectional Studies, Female, Fibrinogen, Humans, Longitudinal Studies, Plasminogen Activator Inhibitor 1, Polycystic Ovary Syndrome, Puberty, Precocious, Risk Factors, Testosterone, Tissue Plasminogen Activator, Science & Technology, Life Sciences & Biomedicine, Pediatrics, IMPAIRED GLUCOSE-TOLERANCE, INDEPENDENT RISK FACTOR, INSULIN-RESISTANCE, PREMATURE PUBARCHE, CARDIOVASCULAR RISK, FACTOR-VII, MYOCARDIAL-INFARCTION, BINDING PROTEIN-1, DIABETIC-PATIENTS, PLASMA-LEVELS, Biomarkers, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services, 3213 Paediatrics

Abstract:

In both obese and nonobese women, polycystic ovary syndrome (PCOS) is essentially a disorder of hyperinsulinemic insulin resistance, and it may be heralded by precocious pubarche (PP; appearance of pubic hair in girls aged < /8 y). The risk of progression from PP to PCOS is related to low birth weight, but there are no early biochemical markers of this risk. As increased plasminogen activator-inhibitor type 1 (PAI-1) activity (act) is an early marker of cardiovascular risk in PCOS, we have sought abnormalities in young girls with PP. In 33 young PP girls (age range 6-11 y), PAI-1-act was increased (mean + SEM: 15.6 +/- 1.5 IU/mL) compared with age-, sex-, and pubertal stage-matched controls (n = 13, 10.7 +/- 1.9, p < / 0.05). PAI-1-act levels were inversely related to birth weight SD score (r = -0.33, p < / 0.05), and PAI-1-act levels were therefore higher in PP girls with low birth weights (n = 14, 19.5 +/- 2.5 IU/mL) than normal birth weights (n = 19, 12.8 +/- 1.5, p < / 0.01). During longitudinal observation in 10 PP girls (mean time interval 2.7 y), PAI-1-act levels in early puberty were positively related to postmenarcheal insulin levels (mean serum insulin SDS postoral glucose, r = 0.65, p < / 0.05), and showed a similar relationship to postmenarcheal testosterone levels (r = 0.61, p = 0.06). Together with low birth weight, increased plasma PAI-1-act levels in early pubertal PP girls may indicate those girls with greater risk of developing hyperinsulinemic-hyperandrogenism features of PCOS.