Intractable early childhood obesity as the initial sign of insulin resistant hyperinsulinism and precursor of polycystic ovary syndrome

Elizabeth E. Littlejohn, Roy E. Weiss, Dianne Deplewski, Deborah V. Edidin, Robert Rosenfield

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Objective: We report that intractable early childhood obesity may be associated with severe insulin resistance syndromes (pseudo-Cushing's syndrome and pseudo-acromegaly) and precede polycystic ovary syndrome (PCOS). Study design/Results: Patient 1 had prepubertal obesity followed by early puberty and was diagnosed with pseudo-Cushing's syndrome and insulin resistance at 10.3 years. Oligomenorrhea, androgen excess, and type 2 diabetes mellitus (DM2) emerged at 13.5 years. Patient 2 developed intractable prepubertal obesity followed by atypical true sexual precocity and pseudo-Cushing's syndrome in early childhood. By 11.3 years, oligomenorrhea, androgen excess, and DM2 had appeared. Patient 3 had prepubertal overgrowth in weight and height and was diagnosed with pseudo-acromegaly, menstrual irregularity, androgen excess, and impaired glucose tolerance at 14.3 years of age. Patient 4 had prepubertal overgrowth that evolved into pseudo-acromegaly, insulin resistance, secondary amenorrhea, and androgen excess at 15.6 years. Conclusions: Intractable prepubertal obesity was recognized to culminate in early childhood pseudo-Cushing's syndrome or pseudo-acromegaly, which are manifestations of insulin-resistant hyperinsulinism, and to herald adolescent PCOS.

Original languageEnglish (US)
Pages (from-to)41-51
Number of pages11
JournalJournal of Pediatric Endocrinology and Metabolism
Volume20
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

Keywords

  • Insulin resistance
  • Obesity
  • Polycystic ovary syndrome
  • Precocious puberty
  • Pseudo-Cushing's syndrome
  • Pseudo-acromegaly

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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