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SINDROME PLURIMETABOLICA: UMA CONSEQUENCIA ENDOCRINO-METABOLICA EM MENINAS COM PUBARCA PRECOCE

(especial para SIIC © Derechos reservados)
Nosso objetivo foi descrever os fatores relacionados à síndrome plurimetabólica (SPM) na pubarca precoce (PP).
rosime9.jpg Autor:
De jesus teixeira, rosimere
Columnista Experto de SIIC

Institución:
Hospital Universitario Pedro Ernesto UERJ RJ, Brasil

Artículos publicados por De jesus teixeira, rosimere
Coautores
Valéria Cataldo Gomes da Silva*  Denise Ginzbarg**  Josele Rodrigues de Freitas*** 
Professora Assistente de Radiologia da UERJ*
Mestre em Endocrinologia pela UERJ**
Mestre em Endocrinologia pela UERJ / Professora Assistente de Ginecologia da UERJ***
Recepción del artículo
2 de Junio, 2004 		Aprobación
12 de Octubre, 2004
Primera edición
24 de Enero, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

SINDROME PLURIMETABOLICA: UMA CONSEQUENCIA ENDOCRINO-METABOLICA EM MENINAS COM PUBARCA PRECOCE

Resumen
Nosso objetivo foi descrever os fatores relacionados à síndrome plurimetabólica (SPM) na pubarca precoce (PP). Selecionamos 45 meninas com 7.2 ± 1.4 ano de idade. Avaliamos os parâmetros clínicos (história familiar de SPM, IMC, pressão arterial sistólica e diastólica [PAS e PAD] e acantose), hormonais (SHBG, IGFBP-1, SDHEA, testosterona e androstenediona), metabólicos (glicose [G], insulina [I] e perfil lipídico) e a presença de ovários microcísticos. Consideramos como resistência à I (RI) a taxa de jejum da G/I < 7. Analisamos os dados após divisão em 2 grupos: RI (n = 16, 36%) e ñRI (n = 29, 64%). Observamos história familiar de SPM em 47%, excesso de peso em 60%, acantose em 36%, pressão arterial anormal em 16%, perfil lipídico alterado em 77% e ovários microcísticos em 55% dos casos. Os níveis de I e de triglicerídeo (TG) foram maiores, enquanto a G/I e os níveis de IGFBP-1 e HDL foram menores no grupo RI do que ñRI. A I mostrou correlação positiva com triglicerídeo (TG), G, PAS e PAD, mas negativa com SHBG. O IMC mostrou correlação negativa com SHBG e positiva com PAS e PAD. Na análise multivariada, o TG (r2 = 0.52) mostrou ser dependente da I e a SHBG (r2 = 0.42) do IMC. Não houve diferença entre os grupos em relação ao IMC e androgênios. Na PP, a hiperinsulinemia parece ocorrer de forma independente da obesidade e do hiperandrogenismo. O grupo RI apresentou hipertrigliceridemia e HDL baixo, alterações típicas da SPM. Como obesidade, dislipidemia e acantose estão associados à RI e são comuns na PP, então a PP pode ser considerada uma população de risco para o desenvolvimento da SPM na vida adulta.

Palabras clave
Hiperinsulinemia, hiperandrogenismo, obesidade, pubarca precoce e síndrome plurimetabólica


Artículo completo
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PLURIMETABOLIC SYNDROME: AN ENDOCRINE AND METABOLIC CONSEQUENCE OF PREMATURE PUBARCHE

Abstract
The aim of this study was to describe the factors associated with the plurimetabolic syndrome (PMS) in premature pubarche (PP). We selected 45 girls of 7.2 ± 1.4 years of age. The clinical parameters (familiar history of PMS, BMI, systolic and diastolic blood pressures [SBP and DBP] and acanthosis), hormonal (SHBG, IGFBP-1, SDHEA, testosterone and androstenedione), metabolic (glucose [G], insulin [I] and lipid profile) and the presence of microcysctic ovaries were evaluated. The fasting G to I rate < 7 was considered as insulin resistance (IR). The data were analysed after the division into two groups: IR (n = 16, 36%) and n-IR (n = 29, 64%). We observed a familiar history of PMS in 47%, the overweight in 60%, acanthosis in 36%, abnormal blood pressure in 16%, changed lipid profile in 77% and microcysctic ovaries in 55% of the cases. Serum levels of I and triglyceride (TG) were higher, while the G/I and serum levels of IGFBP-1 and HDL were lower in IR group than nIR. The insulin disclosed a positive correlation with TG, G, SBP and DBP, but correlated negatively with SHBG. BMI was negatively correlated with SHBG and positively with SBP and DBP. In the multivariated regression analysis, TG (r2 = 0.52) showed to be dependent of the I and SHBG (r2 = 0.42) of the BMI. There were not differences in the BMI and androgens between the groups. In the PP, the hyperinsulinemia appears to exist independently of the obesity and hyperandrogenism. The IR group showed hipertriglyceridemia and low HDL levels - typical changes of the PMS. Since obesity, dyslipidemia and acanthosis are associated with IR and are usual in the PP, than PP could be considered as population at risk for the development of PMS in adult life.

Key words
Hyperinsulinemia, hiperandrogenism, obesity, premature pubarche and plurimetabolic syndrom

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Endocrinología y Metabolismo, Pediatría
Relacionadas: Medicina Interna, Obstetricia y Ginecología



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