Obesity in puberty linked to hormone disorder

NEW YORK, June 3 (Reuters) Girls who are obese during the early stages of puberty have an increased risk of developing abnormally high levels of androgens, a type of steroid hormone, according to a report in The Journal of Clinical Endocrinology&Metabolism.

This condition, referred to as hyperandrogenemia, is characterised by high levels of androgens, such as testosterone or androsterone, hormones that control the development masculine characteristics. Hyperandrogenemia is also associated with the later development of polycystic ovarian syndrome, a condition that includes infertility, obesity, abnormal menstrual cycles, and excessive hair growth.

''I would be pleased if these findings contribute to an increased awareness that hyperandrogenemia may be more common in obese children and adolescents, and that relative hyperandrogenemia may be present very early on (i.e., even before clinical puberty is evident),'' Dr Christopher R McCartney from the University of Virginia Health System, Charlottesville, told Reuters Health.

McCartney and colleagues evaluated the relationship between weight, hormonal measurements, and pubertal stage in 76 girls aged 7 to 17 years. Forty-one of the girls were classified as obese.

Total testosterone levels were 2.1 times higher, sex-hormone binding globulin 50 per cent lower, and free testosterone 3 times higher in obese girls than in normal-weight girls, the team reports.

The associations were similar, but less marked, when girls with excessive facial hair growth (hirsutism) or irregular menstrual periods were excluded from the analysis.

Obesity was also associated with higher testosterone and lower sex-hormone binding globulin levels when considering only girls earlier in puberty, the results indicate, even when girls with hirsutism were excluded.

Most doctors known that childhood obesity is associated with abnormal glucose metabolism, high blood pressure and cholesterol problems, all conditions the increase the future risk of cardiovascular disease, McCartney said. ''However, it seems less well appreciated that obesity may be associated with cosmetic problems (e g, hirsutism) in the near-term and may have implications for future fertility.'' He said it is important for obese adolescent girls and their parents to be aware of these potential risks, ''and these risks may provide additional incentive for such patients to lose (or maintain) weight.'' Also, McCartney commented, ''Since it takes time to develop physical evidence of hyperandrogenemia (e.g., hirsutism), I think it is prudent for clinicians to consider the possibility of hyperandrogenemia in obese girls with irregular (or delayed) periods whether or not hirsutism is present.'' REUTERS SI RN1034