Adrenarche in Prader Willi syndrome appears not related
to insulin sensitivity and serum adiponectin
Nancy Unanue 1*, Germán Iñiguez 1, Fanny Cortés
2, Alejandra Avila 1 and Verónica Mericq 1.
1 Institute of Maternal and Child Research,
University of Chile, Santiago, Chile, and
2 Institute of Nutrition and Food Technology, University of Chile,
Santiago, Chile.
P.O. Box:226-3 Santiago, Chile
Introduction
Prader Willi Syndrome (PWS) is a genetic disorder
characterized by short stature, obesity, mental retardation and hypogonadism.
Obesity has been linked to insulin resistance and the latter is reported to be
associated with premature adrenarche.
Methods
To assess whether prepubertal patients with confirmed PWS
(Fish/Karyotype/Methylation) develop premature adrenarche and its relationship
with markers of insulin sensitivity we studied 14 PWS (8 F/6 M) and 10 paired
obese matched controls (OC) (5 F/5 M) mean ages 7.1+0.5 and 8.3+0.4
years respectively. We performed a complete physical exam (acne, axillary and
pubic hair) and withdraw fasting blood samples to determine DHEAS, 17
hydroxyprogesterone (17OHP), androstenedione (A), SHBG, testosterone (T),
T4, TSH, glucose, insulin, leptin, IGFBP1, lipid profile, adiponectin .
Thereafter an oral glucose tolerance test was performed with blood samples
insulin and glucose at 120 minutes. Statistical analysis was performed using non
paired T test (parametric) or Mann Whitney (non parametric).
Results: PWS patients were shorter than
OC. Axilary hair was present in 1/14 PWS and no OC and pubic hair in 5/14 PWS
and 1/10 OC. Eight out of 14 PWS and 2/10 OC patients were small for gestational
age. No differences in T4, TSH, BMI, lipid profile, A, T, leptin, HOMA, SHBG,
IGFBP1 and free androgen index were observed between PWS patients and OC.
|
|
PWS
n=14 |
OC
n=10 |
Non
paired t test/Mann Whitney |
|
Height (SDS) |
-1.27+
0.35 |
0.62+0.52 |
<0.01 |
|
BMI (SDS) |
2.9+0.4 |
3.2+0.2 |
ns |
|
Fasting glucose (mg/dl) |
67.9+1.2 |
74.4+1.8 |
<0.01 |
|
Fasting insulin (mU/l) |
8.7+1.6 |
11.6+1.3 |
ns |
|
17 OH prog (ng/ml) |
1.62+0.2 |
0.87+0.16 |
<0.03 |
|
DHEAS (ng/ml) |
627.4+106.4 |
246.7+63.2 |
<0.002 |
|
Adiponectin (ug/ml) |
13.9+1.0 |
13.6+0.9 |
ns |
Discussion:
Significantly lower blood glucose and higher 17 OH prog and DHEAS levels were
found in PWS patients. Serum Adiponectin levels were similar in PWS and OC
therefore it is unlikely that differences in insulin sensitivity and adiponectin
are related to the development of premature adrenarche in these patients.
July 2003
|
