The Relationship between Birth Weight (BW), Body Mass Index (BMI) and Insulin Sensitivity (S_I) in Prepubertal Caribbean Hispanic (CH) and Black African-American (BAA) Girls with Premature Adrenarche (PA)

Abstract 516 Poster Session II, Sunday, 5/2 (poster 212)

We have reported that many BAA and CH girls with PA have an increased BMI and a reduced S_I that correlate with the degree of hyperandrogenism ( JCE&M. 80:614, 1995; Peds. Res., 41:73 1997). In addition, children who were born SGA have been reported to have insulin resistance and PA. It has been hypothesized that the hyperandrogenism and the hyperinsulinism of PA may have common origins in early gestation and are the result of reduced fetal weight. The purpose of this study was to determine the role of BW and BMI on S_I in BAA and CH patients with PA. The BW of 52 (30 CH; 22 BAA) prepubertal fullterm girls with PA were compared to 970 ethnic matched controls (Cazano. C, personal communication). S_I, calculated from the frequently sampled intravenous glucose tolerance test, was available for 25 patients. Patients with reduced S_I had an S_I more than 2 SD below the mean for prepubertal girls ( JCE&M 70:1644, 1990). The mean BW and SD score for the entire group and for the children with S_I data are listed according to ethnic background. (Table)

Table 1 No caption available.

The BW of the entire group was significantly lower than normal. There was a significant correlation between S_I and BW (r=0.51; p<0.01), and BMI (r=-0.56, p<0.01). Of the eight patients with reduced S_I, 7 were obese and 4 had a reduced BW. Using a multiple linear regression model controlled for BMI, BW still had a significant predictive value for S_I (p<0.01).

In CH and BAA patients with PA, both reduced BW and obesity contribute to decreased S_I and hyperandrogenism.