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.
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Abbreviations
- PCOS:
-
polycystic ovary syndrome
- PP:
-
precocious pubarche
- PAI-1:
-
plasminogen activator-inhibitor type 1
- PAI-1-act:
-
plasminogen activator-inhibitor type 1 activity
- t-PA:
-
tissue plasminogen activator
- DHEAS:
-
dehydroepiandrosterone-sulfate
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Acknowledgements
The authors thank Dr. Lluis Masana from The University Rovira i Virgili, Reus, Spain, for his methodological advice, Maria Jesús Gras for hormone measurements, and Inge Laleeuwe for editorial assistance.
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Supported by a Visiting Scholarship from the European Society for Paediatric Endocrinology and by the Agència per a la Recerca i la Docència from the Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.
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Ibáñez, L., Aulesa, C., Potau, N. et al. Plasminogen Activator Inhibitor-1 in Girls with Precocious Pubarche: A Premenarcheal Marker for Polycystic Ovary Syndrome?. Pediatr Res 51, 244–248 (2002). https://doi.org/10.1203/00006450-200202000-00019
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DOI: https://doi.org/10.1203/00006450-200202000-00019
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