University of Oulu

Jussi Tennilä, Jarmo Jääskeläinen, Pauliina Utriainen, Raimo Voutilainen, Merja Häkkinen, Seppo Auriola, Laure Morin-Papunen, Jani Liimatta, PCOS Features and Steroid Profiles Among Young Adult Women with a History of Premature Adrenarche, The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 9, September 2021, Pages e3335–e3345,

PCOS features and steroid profiles among young adult women with a history of premature adrenarche

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Author: Tennilä, Jussi1; Jääskeläinen, Jarmo1; Utriainen, Pauliina2,3;
Organizations: 1Kuopio Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
2Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
3Pediatric Research Center, Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
4School of Pharmacy, University of Eastern Finland, Kuopio, Finland
5Department of Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland
6Medical Research Center and PEDEGO Research Unit, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Endocrine society, 2021
Publish Date: 2021-11-11


Context: Premature adrenarche (PA) may increase the risk for polycystic ovary syndrome (PCOS).

Objective: To study features of PCOS in young adult women with a history of PA.

Methods: Thirty PA and 42 control females were followed from prepuberty to young adulthood (median age 18.1 years). The main outcome measures were ovarian function, the use of contraceptives, and clinical and biochemical indicators of hyperandrogenism.

Results: We found no differences in the use of hormonal contraceptives (50 vs 50%, PA vs controls, respectively; P > .999), indication for using contraceptives (P = .193), or in the history of oligo- (17 vs 26%, P = .392) and amenorrhea (0 vs 0%, P > .999). Among women not using hormonal contraceptives, those with a history of PA had a higher prevalence of hirsutism (27 vs 0%, P = .023) but not acne (87 vs 67%, P = .252). Steroid profiles were broadly comparable between the groups, but PA women had lower sex hormone–binding globulin (SHBG) concentrations (30.1 vs 62.4 nmol/L, P < .001) resulting in higher free androgen index (3.94 vs 2.14, P < .001). The difference in SHBG levels persisted through body mass index adjustment. SHBG correlated negatively with the homeostasis model assessment for insulin resistance (r –0.498, P = .003). Anti-Müllerian hormone concentrations were comparable between the groups (39.3 vs 32.1 pmol/L, P = .619).

Conclusion: PA was not associated with evident ovarian dysfunction in young adult women. However, women with a history of PA had decreased SHBG levels and thus, increased bioavailability of circulating androgens.

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Series: Journal of clinical endocrinology & metabolism
ISSN: 0021-972X
ISSN-E: 1945-7197
ISSN-L: 0021-972X
Volume: 106
Issue: 9
Pages: E3335 - E3345
DOI: 10.1210/clinem/dgab385
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was supported by Kuopio University Hospital (Kuopio, Finland), the Foundation for Pediatric Research (Helsinki, Finland), the Finnish Medical Foundation (Helsinki, Finland), the Päivikki and Sakari Sohlberg Foundation (Helsinki, Finland), the Sigrid Jusélius Foundation (Helsinki, Finland), and the Emil Aaltonen Foundation (Tampere, Finland). The funders had no role in (1) study design; (2) the collection, analysis, and interpretation of data; (3) writing of the report; and (4) the decision to submit the paper for publication.
Copyright information: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (, which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact