WOMENS-HEALTH Messages for March, 2001: Re: #2 - my 11 yr old was just diagnosed with polycystic ovary syndrom

Re: #2 - my 11 yr old was just diagnosed with polycystic ovary syndrom

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Fri, 9 Mar 2001 10:56:56 -0600 (CST)

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Pre- and postpuberal findings in premature adrenarche. J Pediatr Endocrinol Metab 2000;13 Suppl 5:1265-9 Di Martino-Nardi J Division of Pediatric Endocrinology, Montefiore Medical Center, Bronx, NY 10467, USA.

The complications of hyperinsulinism and insulin resistance are becoming more common in pediatrics (including type 2 diabetes mellitus, dyslipidemia and polycystic ovary syndrome) because of the increased occurrence of obesity in children. We report the occurrence of insulin resistance and marked hyperandrogenism in prepubertal minority group girls (African-American and Caribbean Hispanic) with premature adrenarche.

The molecular basis of premature adrenarche: an hypothesis. Acta Paediatr Suppl 1999 Dec;88(433):60-6 (ISSN: 0803-5326) Miller WL Department of Pediatrics, University of California - San Francisco, 94143-0978, USA.

Exaggerated premature adrenarche appears to be an early sign of polycystic ovary syndrome (PCOS). Mechanistic considerations of PCOS suggest a key role for serine phosphorylation of P450c17 in both adrenarche and some forms of heritable PCOS.

The roles of insulin sensitivity, insulin-like growth factor I (IGF-I), and IGF-binding protein-1 and -3 in the hyperandrogenism of African-American and Caribbean Hispanic girls with premature adrenarche. J Clin Endocrinol Metab 1999 Jun;84(6):2037-42 (ISSN: 0021-972X) Vuguin P; Linder B; Rosenfeld RG; Saenger P; Di Martino-Nardi J Department of Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.

These findings support the hypothesis that insulin and IGFs may have a role in the hyperandrogenism of premature adrenarche just as they do in PCOS. Hence, in certain girls with premature adrenarche, hyperandrogenism may be the first presentation of PCOS and/or insulin resistance.

Evidence for a genetic basis for hyperandrogenemia in polycystic ovary syndrome. Proc Natl Acad Sci U S A 1998 Dec 8;95(25):14956-60 (ISSN: 0027-8424) Legro RS; Driscoll D; Strauss JF 3rd; Fox J; Dunaif A Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.

We conclude that there is familial aggregation of hyperandrogenemia (with or without oligomenorrhea) in PCOS kindreds. In affected sisters, only one-half have oligomenorrhea and hyperandrogenemia characteristic of PCOS, whereas the remaining one-half have hyperandrogenemia per se. This familial aggregation of hyperandrogenemia in PCOS kindreds suggests that it is a genetic trait. We propose that hyperandrogenemia be used to assign affected status in linkage studies designed to identify PCOS genes.

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

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Next message: Harvey S. Marchbein, M.D.: "Re: #3 - my 11 yr old was just diagnosed with polycystic ovary syndrom"
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