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

Author information

Affiliations

  • 1. University of Chicago, Pritzker School of Medicine, Department of Pediatrics, Section of Pediatric Endocrinology, 5841 S. Maryland Avenue, IL 60637, USA.
      Authors
    • Littlejohn EE 1
    (1 author)

Journal of Pediatric Endocrinology & Metabolism : JPEM, 01 Jan 2007, 20(1):41-51
https://doi.org/10.1515/jpem.2007.20.1.41 PMID: 17315528 

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.

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Read article at publisher's site: https://doi.org/10.1515/jpem.2007.20.1.41

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