J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-98704 | DOI: 10.4274/jcrpe.galenos.2022.2022-1-1

An Evaluation of Glucose Metabolism and Cardiovascular Risk Factors in Prepubertal Girls with Premature Pubarche

Digdem Bezen¹, Filiz Tutunculer Kokenli², Emine Dilek², Didem Ag Seleci³, Hakan Erbas^3
1Department of Pediatrics, Pediatric Endocrinology, University of Health Sciences, Prof. Dr. Cemil Taþçýoðlu City Hospital, Ýstanbul, Turkey
²Department of Pediatrics, Pediatric Endocrinology, Trakya University, Medical Faculty, Edirne, Turkey
³Department of Biochemistry, Trakya University, Medical Faculty, Edirne, Turkey

INTRODUCTION: Objective: Premature pubarche (PP) is a risk factor for metabolic syndrome (MS). We aimed to evaluate if glucose-insulin metabolism, cardiovascular risk factors, cardiovascular risk factors in family (FCVRF) create a risk for insulin resistance and if PP is a risk factor alone for metabolic syndrome (MS) in normal weight prepubertal girls with PP.
METHODS: Methods: Prepubertal, non-obese 35 PP girls with normal birth weight and 35 control girls were evaluated for FCVRF, anthropometric measurements, blood pressure, lipid profile, fasting blood glucose-insulin, hemoglobin A1c (HbA1c), sex hormone binding globulin (SHBG), leptin, adiponectin, tumor necrotizing factor-alpha (TNF-α), androgen levels, bone age. Oral glucose tolerance test was performed in PP participants. homeostasis model of assessment of insulin resistance (HOMA-IR), fasting glucose/insulin ratio, atherogenic index (AI), free androgen index (FAI) were calculated. PP participants were, also, divided into two subgroups by presence of FCVRF.
RESULTS: Results: HbA1c, lipid profile, testosterone, leptin, adiponectin, TNF-α, HOMA-IR, glucose/insulin ratio, AI, fasting glucose-insulin levels were similar. In PP group FAI was significantly higher (p=0.001), whereas SHBG was significantly lower (p=0.010) than the control group. Leptin levels of FCVRF+ and FCVRF- subgroups were 15.2±9.1 and 9.7±7.2 ng/ml, respectively (p=0.016).
DISCUSSION AND CONCLUSION: Conclusion: As PP is not a risk factor alone for impaired glucose metabolism and insulin resistance in prepubertal non-obese girls with normal birth weight, it is unnecessary to examine in detail such cases before puberty. Low SHBG levels in PP group and high leptin levels in FCVRF+ subgroup might suggest that these may be predictive for MS in the future.

Keywords: premature pubarche, prepubertal, leptin, glucose metabolism, adipocytokines, cardiovascular risk

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