الفهرس 
ObesityOnly 14 pages are availabe for public view
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Abstract
Obesity is one of the most public health problem of the 21st century, is a major risk factor for several chronic diseases, such as, DM-II, dyslipidemia, hypertension, coronary heart diseases, many psychosocial and social problems….etc.
Reviewing the literature, few studies addressed the assessment of gonadotropins and androgens among pubertal overweight and obese girls. In addition, they revealed the definite interacting mechanisms between obesity, hyperinsulinieamia, hyperandrogenaemia, and gonadotropins. Therefore, current study represents one of the important studies comparing both androgen and gonadotropin levels among obese, overweight and normal weight pubertal girls.
Current study was a cross sectional case-control one, included 80 pubertal girls (16 overweight, 24 obese and 40 normal/control), their age ranged between 12 up to 18 years with a mean of 15.73 +1.62. They were classified according to their pubertal development using Tanner staging to: early pubertal stage (Tanner 2 & 3), late pubertal (Tanner 4 & 5).
1. Comparing the 3 groups under study revealed
a) Insignificant age differences.
b) The obese girls had the highest significant values than the other 2 groups; followed by the overweight girls then control; in systolic BP, all anthropometric measurements (except Ht), androgens (total and free testosterone), FBG, insulin, insulin resistance and lipid profile (triglycerides, total cholesterol, LDL).
c) They also had the least significant values than the other 2 groups in gonadotropins (FSH and LH), estradiol and HDL.2. Hypogonadotropism (FSH and LH) and hyperandrogenaemia (total and free testosterone) were significantly the most prominent among obese girls; where 58.3% had lower FSH, 95.8% had lower LH, 91.7% had elevated total testosterone and 75% had elevated free testosterone.
3. In overweight girls, 25% had lower FSH and LH, 68.8% had elevated total testosterone and 62.5% had elevated free testosterone.
4. Nobody of the obese girls showed elevated gonadotropin level or lower androgen levels. Whereas, among overweight girls, no one had lower androgen levels, while 25% of had elevated LH and 6.2% had elevated FSH levels. This indicates that the disturbance in the gonadotropin levels, among the overweight girls, occurs before hypogonadotropism among the obese girls, although both overweight and obese girls had hyperandrogenaemia, i.e changes in androgen levels occur earlier than change in gonadotropins among overweight and obese girls.
5. Due to hyperandrogenaemia among both overweight and obese girls, the percent of hirsutism in obese group (20.8%) is the greatest followed by overweight (12.5%) then control girls (2.5%).
6. Frequency distribution of the sample according to puberty (Tanner stage) revealed that; in spite of insignificant difference in age between the 3 groups; 20.8% of the obese girls started puberty stage 2 versus 2.5% of the control ones, while 50% of the control girls complete the puberty stage 5 versus 16.7% of the obese ones. Moreover, 50% of the obese group started the early pubertal stages (stage 2&3) earlier than the other groups (15% of control group & 25% of overweight group), and 50% the obese group reached the late pubertal stages (stage 4&5) in comparison to 85% of control group. This confirmed that obese girls started puberty early, but they were delayed to complete puberty (Tanner stage 5).
7. Correlation between gonadotropins (FSH and LH), androgens (total testosterone and free testosterone), all the studied variables for the total sample, every group under study and the girls with (early and late puberty) revealed that gonadotropins and androgens had opposing correlations.
a) FSH had significant positive correlation with LH, and total testosterone had significant positive correlation with free testosterone,
b) FSH and LH had significant negative correlations with total and free testosterone.
c) Gonadotropins had significant negative correlations, and androgens had significant positive correlations with the anthropometric obesity markers (BMI, Waist C, and W/H ratio except for free testosterone which has insignificant correlation with W/H ratio in obese girls), insulin, insulin resistance and lipid profile (triglycerides, total cholesterol and LDL).
d) Gonadotropins had significant positive correlations, and androgens had significant negative correlations with HDL and estradiol (except free testosterone which was insignificant with estradiol in obese girls).
e) LH had significant negative correlations, and total testosterone had significant positive correlations with blood pressure (systolic and diastolic) , while free testosterone had significant positive correlations only with diastolic blood pressure among total sample and girls with late puberty.f) Body weight and FBG had significant negative correlations with gonadotropins, and significant positive correlation with androgens among total sample (except free testosterone which has insignificant correlation with FBG) and girls with late puberty.
g) LH had significant negative correlations, and total testosterone had significant positive correlations with body weight among girls with early puberty. So, overweight and obesity had no effect on the correlations between gonadotropins and androgens in one side and the other variables on the other side. The pubertal status had effect on the correlations between sex hormones with blood pressure, body weight and FBG.
8. Correlations between the obesity markers and all the studied variables for total sample, the 3 groups under study and the girls with early and late puberty revealed that
a) All the obesity markers (BMI, WC and WHR) had significant positive correlations with each other, androgens (total and free testosterone), insulin, insulin resistance, lipid profile (triglycerides, total cholesterol, LDL) in all study groups and FBG (among total sample and girls with late puberty only).
b) BMI, WC and WHR had significant positive correlation with blood pressure (systolic and diastolic) and body weight among total sample and girls with early and late puberty.
c) BMI, WC and WHR had also significant negative correlations with gonadotropins (FSH and LH), estradiol and HDL in all study groups
There were constant relations between sex hormones and the obesity markers, insulin, insulin resistance and lipid profile and estradiol within the different groups (total, control, overweight, obese, early and late pubertal).