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Early Menarche and Subclinical Ovarian Hyperandrogenism in Girls with Reduced Adult Height after Low Birth Weight

In girls born small for gestational age (SGA), early onset of puberty tends to be followed by a swift progression to early menarche and to growth arrest below target height. We have now examined whether, conversely, girls born SGA with reduced final height experienced an early menarche, and also whether these girls present a subclinical variant of ovarian hyperandrogenism. The latter question was prompted by the emerging evidence that adolescent girls born SGA tend to present hyperinsulinism and adrenal hyperandrogenism. Pelvic ultrasound examination and assessment of ovarian function were performed in the follicular phase of the menstrual cycle (range: day 5 ± 3; duration of cycles 21-35 d) in 14 short, non-obese adolescents born SGA. Blood samples for measurement of serum gonadotropins were obtained before and 3 and 24 h after challenge with the GnRH-agonist leuprolide acetate (Procrin®, Abbott, Spain; 500 μg s.c.), while serum androstenedione, 17-hydroxyprogesterone (17-OHP) and estradiol were measured at 0 and 24 h. Serum glucose, insulin, lipid profile, dehydroepiandrosterone-sulfate (DHEAS), total testosterone and sex hormone-binding globulin (SHBG) were determined from baseline samples. Peak 17-OHP responses above 160 ng/dl (4.8 nmol/1) were considered elevated.