ADROGEN METABOLISM, GROWTH FACTORS, INSULIN SENSITIVITY

Columbia University Health Sciences, New York NY

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Abstract

Insulin resistance, or altered insulin sensitivity is a risk factor for the development of a common type of diabetes and cardiovascular disease. Insulin resistance is found in girls with obesity and young women with polcystic ovarian syndrome (PCOS). Girls with premature adrenarche are at risk for development of PCOS. In these conditions there may be an elevation of certain growth factors which can stimulate 5-alpha-reductase activity which is associated with increased androgen levels. We propose to determine in girls with premature adrenarche, female adolescents and young adults with PCOS, and in age and ethnic matched controls, markers for insulin resistance. We will measure fasting blood levels of insulin, sugar and a marker for diabetes (HbA1C) as well as levels of blood lipid androgens, and growth factors. We will measure levels of urinary hormones and break-down products of these hormones to evaluate 5 alpha reductase activity. We will assess body composition. We will also determine ovarian size and morphology by pelvic sonography. We will correlate the growth factor levels with insulin sensitivity and the urinary hormones. We will establish a risk factor formula for developing of PCOS and insulin resistance. We will correlate this algorithm with measures of body composition. We will compare the analysis in obese to non-obese participants.