The Clinical Study Of DHEAS And Insulin In Prepubertal Girls Born Small For Gestational Age

Objectives: To investigate whether the association between low birth weight and increased risk of developing premature adrenarche, adrenal hyperandrogenism, hyperinsulinism and insulin resistance is apparent in prepubertal girls born small for gestational age. And analyze what time adrenarche occurs in SGA and normal birth weight girls.Methods: The study was performed in 39 prepubertal SGA girls with a mean age of 7.38±1.68 yr and 42 prepubertal AGA girls with a mean age of 7.44±1.73 yr served as controls. All children were born at term and were prepubertal. All children were performed detailed physical examination after 12 h of overnight fasting. Blood samples were taken for the measurement of glucose, insulin, DHEAS, cortisol and estradiol concentrations. Insulin sensitivity was assessed by Li guangwei index [IAI=loge1/(FPG×FINS)]. Natural log-transformed plasma insulin and DHEAS concentrations were used in the correlations because the data were log-normally distributed.Result: There is no one premature adrenarche in SGA and AGA groups. As expected from the inclusion criteria, birth weight was significantly lower in SGA group(P<0.001) . Gestational age was similar in both groups(P=0.09). At the time of the study, means ages, BMI, fastings glucose, cortisol and estradiol did not significantly differ between the two groups. But body height and weight were significantly lower in the SGA group(P=0.01; P=0.02, respectively). The fasting plasma insulin in the SGA group was significantly higher than that in AGA group (11.97±1.10VS. 11.38±1.37uU/ml, P=0.036). The insulin sensitivity assessed by Li guangwei index were no significant difference in two groups (-4.0165±0.1761VS.-3.9768±0.2314, P=0.386). From about age 6—8 or so the concentration of DHEAS is a gradual rise in AGA children. The time of DHEAS rise tended to be earlier in SGA children compared with AGA children. The serum DHEAS was significantly higher in SGA children than in AGA children (51.62±28.50VS 38.47±22.72ug/dl, P= 0.024). We found no relationship between natural log-transformed plasma insulin and DHEAS concentrations in both groups. Conclusions: Adrenarche commences at approximately 6—8 yr of age in normal girls. The time of adrenarche tended to be earlier in SGA girls compared with AGA girls. There were adrenal hyperandrogenism and hyperinsulinism in prepubertal girls born small for gestational age. But there is no insulin resistance assessed by Li guangwei index. There is no correlation between plasma insulin and DHEAS concentrations in prepuberatl girls.