Are Growth Factors and Leptin Involved in the Pathogenesis of Premature Adrenarche in Girls?

Abstract

A transient increase in height and bone age as well as hyperinsulinism is seen in patients with premature adrenarche (PA). In addition, the weights of these patients are more than those of healthy peers. The aim of this study was to evaluate the role of leptin, IGF-I and IGFBPs in hyperandrogenemia and increased body weight observed in girls with PA. In this study, IGF-I, IGFBP-3, IGFBP-1 and leptin levels were investigated in 27 children with PA aged 5.4-8.6 years and 13 healthy children aged 5.7-8.58 years. Twenty patients were lean. The bone ages and BMIs of the children with PA were significantly higher than those of the healthy controls (p < 0.05). IGF-I (p < 0.005), IGFBP-3 (p < 0.05) and leptin (p < 0.0001) levels of lean PA girls were higher than controls. The leptin level of the obese PA girls was higher than that of the lean PA girls (p < 0.05) and controls (p < 0.0001). The IGFBP-1 level of the PA girls with and without obesity was lower than controls (p < 0.05). A negative correlation was observed between IGFBP-1 and leptin levels of the girls with PA (r = -0.64, p < 0.05). Serum leptin levels were influenced by BMI (p = 0.001), basal 17-OHP (p = 0.002) and stimulated 17-OHP (p = 0.019) in patients with PA. In conclusion, we suggest that elevated IGF-I and insulin give rise to increased adrenal androgens and leptin levels. On the other hand, both insulin and leptin cause decreased levels of IGFBP-1 in girls with PA, even if they are lean.

Birth and early life influences on the timing of puberty onset: results from the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) Study

“…Early age at puberty is an established risk factor for many hormone-related cancers, including breast (1, 2) and testicular cancer (30,31), and has also been linked to insulin resistance (4), higher insulin-like growth factor I concentrations, and other hormonal changes associated with cancer risk, obesity (32), and, more recently, mortality (33). If one takes the example of breast cancer, the most common cancer in women, a meta-analysis of 26 epidemiologic studies showed a risk reduction of 9% for every additional year at menarche (34).…”

Evo-Devo of Child Growth III: Premature Juvenility as an Evolutionary Trade-Off

“…This pattern has been recorded in children of recent generations as compared to those of previous generations, owing to the trend of a steeper increase of height as compared to weight in the first years of life. But even lean girls with premature adrenarche have higher levels of IGF-I, IGFBP-3 and leptin [23], mechanisms that may transmit the signal of energy readiness.…”

Juvenility in the context of life history theory

“…It is interesting to note that even lean girls with precocious adrenarche have higher than control levels of IGF-I, IGFBP-3 and leptin,41 as mechanisms that may transmit the signal of energy readiness.…”