Leuprolide acetate-stimulated androgen response during female puberty
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Hernández Cárdenas, María Isabel
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Leuprolide acetate-stimulated androgen response during female puberty
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Abstract
BackgroundA physiological increase in androgen levels occurs during adolescence. Measuring
androgen concentrations is the best method to distinguish normal evolution processes from
hyperandrogenic disorders.
HypothesisThe increase in circulating androgens during puberty is inversely associated with
insulin sensitivity in normal weight girls.
ObjectiveTo assess circulating levels of ovarian androgens and anti-Mullerian hormone (AMH)
at baseline and after GnRH analogue (GnRH-a) stimulation in normal pubertal girls across
different Tanner stages. We also studied the association between this response and insulin
sensitivity.
DesignProspective study of healthy girls (6-12years) from the local community (n=63).
MethodsTanner I (n=23) subjects were assessed cross-sectionally, and Tanner II girls (n=40)
were evaluated every 6months until they reached Tanner V. Early morning
dehydroepiandrosterone sulphate (DHEA-S), AMH, sex hormone-binding globulin (SHBG),
androstenedione, glucose and insulin levels were measured. A GnRH-a test (500g/m(2); sc)
and oral glucose intolerance test (OGTT) were performed. Differences throughout puberty were
evaluated.
ResultsBasal and/or stimulated Testosterone DHEA-S and 17-hydroxyprogesterone (17OHP)
were inversely associated with insulin sensitivity (WIBSI) from the beginning of puberty,
whereas androstenedione was directly associated with gonadotrophins. AMH was inversely
associated with basal and stimulated gonadotrophins and directly with insulin area under the
curve (AUC) only in the early stages of puberty. 17OHP and testosterone responsiveness
increased significantly during puberty in all subjects, whereas testosterone levels changed less
consistently. This pattern of ovarian-steroidogenic response was most evident during mid- and late puberty. Moreover, during late puberty only, basal 17OHP, testosterone and DHEA-S were
positively associated with gonadotrophins.
ConclusionIn normal nonobese girls born appropriate for gestational age, androgen synthesis
was associated with insulin sensitivity in early puberty and with LH only in late puberty.
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Patrocinador
Chilean grants: FONDECYT 1030610
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Clinical Endocrinology Volumen: 83 Número: 2 Aug 2015
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