Evidence for functional ovarian hyperandrogenism in early pubertal, but not late pubertal, girls with excess weight

Context Sources of androgen overproduction in peripubertal girls with overweight/obesity (excess weight [EW]) remain unclear. Objective To assess 17-hydroxyprogesterone (17-OHP) responses to recombinant human chorionic gonadotropin (r-hCG) in peripubertal girls with and without EW. We hypothesized that 17-OHP responses are exaggerated in late pubertal girls with EW compared to those without, but similar in early pubertal girls with and without EW. Design Cross-sectional. Setting Academic clinical research unit. Participants Forty-five girls ages 7-18 years: 6 early pubertal (Tanner 1-3) with EW and 8 without; 20 late pubertal (Tanner 4-5) with EW and 11 without. Interventions Research volunteers took oral dexamethasone (1 mg) at 2200 h on study days 1 and 2. On study day 2, volunteers had blood withdrawal at 0800 h and r-hCG administration (25 mcg intravenously) at 0900 h, with repeat blood withdrawal at 0900 h on study day 3. Main Outcome Measure 17-OHP increment with r-hCG. Results 17-OHP responsiveness was 2.31-fold (95% CI, 1.13-4.73) greater in early pubertal girls with EW compared to those without (Bonferroni-corrected P = 0.023), while responses were similar between late pubertal girls with and without EW. 17-OHP responsiveness in late pubertal girls with EW were 59% (95% CI, 9-81%) lower than early pubertal girls with EW (Bonferroni-corrected P = 0.027), while responses were similar between late and early pubertal girls without EW. Conclusions Ovarian responsiveness to r-hCG stimulation during early puberty may be exaggerated in the setting of EW, but excess-weight status per se may not promote long-term ovarian hyperresponsiveness to r-hCG.