Context: Premature pubarche (PP), the main clinical manifestation of premature adrenarche (PA), has been associated with insulin resistance and dyslipidemia in selected populations.

Objectives: Our aim was to determine the prevalence of childhood metabolic syndrome (cMBS) and to study its components in prepubertal Northern European girls with PA.

Design and Patients: We conducted a cross-sectional study on 63 prepubertal girls with PA (32 with PP = PP-PA, 31 without PP = nonPP-PA) and 80 healthy age-matched control girls. A standard 2-h oral glucose tolerance test (OGTT) with insulin sampling was performed. Plasma lipids and serum SHBG were analysed, and blood pressure (BP) and weight-for-height were recorded. cMBS was defined by modified criteria of the U.S. National Cholesterol Education Project Adult Treatment Panel III (ATPIII) and the World Health Organization (WHO).

Setting: University Hospital.

Results: The mean weight-for-height (p=0.002) and the prevalence of cMBS by the modified ATPIII (24 vs. 10%) and WHO definitions (16 vs. 5%)(p<0.05 for both) were higher in the PA than control girls. The weight-for-height adjusted serum insulin concentrations during the OGTT were elevated in the whole PA group, while the fasting insulin concentrations were increased and SHBG decreased only in the PP-PA subgroup. The weight-for-height adjusted BP, lipid or glucose levels did not differ between the study groups.

Conclusions: Prepubertal Northern European PA girls have increased prevalence of cMBS mainly due to their overweight and hyperinsulinism. Among the PA children, the nonPP-PA girls have milder metabolic changes than the PP-PA girls.