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Submitted on August 15, 2005
Accepted on February 14, 2006
The Center for Research in Reproduction; Division of Endocrinology, Department of Internal Medicine; University of Virginia Health System, Charlottesville, Virginia 22908. Division of Reproductive Endocrinology and Infertility, Department of Reproductive Medicine, University of California, San Diego, California 92103. Division of Endocrinology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan 48109
* To whom correspondence should be addressed. E-mail: cm2hq{at}virginia.edu.
Context: Adolescent hyperandrogenemia is considered a forerunner of adult PCOS, but its etiology remains uncertain.
Objective: To explore the hypothesis that peripubertal obesity is associated with hyperandrogenemia.
Design: Cross-sectional analysis.
Setting: General Clinical Research Centers.
Subjects: 41 obese (BMI-for-age 
95%) and 35 normal weight (BMI-for-age < 95%) peripubertal girls.
Intervention: Pooled blood samples (circa 0500-0700 h; n = 64) while fasting or single morning (fasting) samples (n = 12).
Main outcome measures: Adiposity and androgen concentrations.
Results: BMI correlated with total testosterone (T) (rs = 0.59), SHBG (rs = -0.69), and free T (rs = 0.69); free T was 3 times as great in obese girls compared with normal weight girls (P < 0.0001 for all). BMI correlated with insulin (rs = 0.52); both insulin and LH correlated with free T (rs = 0.45 and 0.44, respectively; P < 0.001 for all). When analyzing early pubertal girls (pubertal stages 1-3; n = 36) alone, BMI correlated with total T (rs = 0.65), SHBG (rs = -0.74), and free T (rs = 0.75); free T was 5 times as great in obese early pubertal girls (P < 0.001 for all). BMI correlated with insulin (rs = 0.65), and insulin with free T (rs = 0.63, P < 0.01 for both). BMI correlated with free T while simultaneously adjusting for age, pubertal stage, insulin, LH, and DHEAS.
Conclusion: Peripubertal obesity is associated with marked hyperandrogenemia, which is especially pronounced in early puberty.
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