Abstract Context Peripubertal obesity is associated with variable hyperandrogenemia, but precise mechanisms remain unclear. Objective To assess the roles of insulin resistance, hyperinsulinemia, and luteinizing hormone (LH) in peripubertal obesity-associated hyperandrogenemia. Design Cross-sectional analysis. Setting Academic clinical research unit. Participants Eleven obese (body mass index-for-age ≥ 95%) peripubertal girls. Intervention Blood samples were taken during a mixed meal tolerance test (1900-2100 h), overnight (2100-0700 h), while fasting (0700-0900 h), and during an 80 mU/m2/min hyperinsulinemic-euglycemic clamp (0900-1100 h). Main Outcome Measures Dependent variable: morning free testosterone; independent variables: insulin sensitivity index (ISI), estimated 24-hour insulin, and estimated 24-hour LH. Results All subjects demonstrated insulin resistance and hyperinsulinemia. ISI, but not estimated 24-hour insulin, correlated positively with morning free testosterone when correcting for estimated 24-hour LH and Tanner stage (rs = 0.68, p = 0.046). The correlation between estimated 24-hour LH and free testosterone approached significance after adjusting for estimated 24-hour insulin and Tanner stage (rs = 0.63, p = 0.067). Estimated 24-hour insulin did not correlate with free testosterone after adjusting for estimated 24-hour LH and Tanner stage (rs = 0.47, p = 0.20). Conclusions In insulin-resistant obese girls with hyperinsulinemia, free testosterone levels correlate positively with insulin sensitivity and (likely) circulating LH concentrations, but not with circulating insulin levels. We propose that the results are consistent with the notion that, in the setting of relatively uniform hyperinsulinemia, variable steroidogenic cell insulin sensitivity correlates with metabolic insulin sensitivity and can contribute to variable free testosterone concentrations. Copyright © 2018 Endocrine Society
Journal of Clinical Endocrinology and Metabolism – Oxford University Press
Published: Apr 20, 2018
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