Testosterone and Obesity and Early Puberty


J Clin Endocrinol Metab. 2006 Feb 21; [Epub ahead of print]


The association of obesity and hyperandrogenemia during the pubertal
transition in girls: obesity as a potential factor in the genesis of
postpubertal hyperandrogenism *

McCartney CR, Prendergast KA, Chhabra S, Eagleson CA, Yoo R, Chang RJ,
Foster CM, Marshall JC.

The Center for Research in Reproduction; Division of Endocrinology,
Department of Internal Medicine; University of Virginia Health System,
Charlottesville, Virginia 22908. Division of Reproductive Endocrinology and
Infertility, Department of Reproductive Medicine, University of California,
San Diego, California 92103. Division of Endocrinology, Department of
Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
48109.

Context: Adolescent hyperandrogenemia is considered a forerunner of adult
PCOS, but its etiology remains uncertain. Objective: To explore the
hypothesis that peripubertal obesity is associated with hyperandrogenemia.
Design: Cross-sectional analysis. Setting: General Clinical Research
Centers. Subjects: 41 obese (BMI-for-age >/= 95%) and 35 normal weight
(BMI-for-age < 95%) peripubertal girls. Intervention: Pooled blood samples
(circa 0500-0700 h; n = 64) while fasting or single morning (fasting)
samples (n = 12). Main outcome measures: Adiposity and androgen
concentrations. Results: BMI correlated with total testosterone (T) (rs =
0.59), SHBG (rs = -0.69), and free T (rs = 0.69); free T was 3 times as
great in obese girls compared with normal weight girls (P < 0.0001 for
all). BMI correlated with insulin (rs = 0.52); both insulin and LH
correlated with free T (rs = 0.45 and 0.44, respectively; P < 0.001 for
all). When analyzing early pubertal girls (pubertal stages 1-3; n = 36)
alone, BMI correlated with total T (rs = 0.65), SHBG (rs = -0.74), and free
T (rs = 0.75); free T was 5 times as great in obese early pubertal girls (P
< 0.001 for all). BMI correlated with insulin (rs = 0.65), and insulin with
free T (rs = 0.63, P < 0.01 for both). BMI correlated with free T while
simultaneously adjusting for age, pubertal stage, insulin, LH, and DHEAS.
Conclusion: Peripubertal obesity is associated with marked
hyperandrogenemia, which is especially pronounced in early puberty.

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