Dihydrotestosterone treatment in adolescents with delayed puberty: does it explain insulin resistance of puberty?

  title={Dihydrotestosterone treatment in adolescents with delayed puberty: does it explain insulin resistance of puberty?},
  author={Rola Saad and Bruce S. Keenan and Kapriel Danadian and Vered Lewy and Silva A. Arslanian},
  journal={The Journal of clinical endocrinology and metabolism},
  volume={86 10},
Puberty is characterized by temporary insulin resistance, which subsides with the completion of pubertal development. This insulin resistance is manifested by lower rates of insulin-stimulated glucose metabolism and compensatory hyperinsulinemia in pubertal compared with prepubertal children. Whether or not pubertal insulin resistance is the result of sex steroids or GH or a combination of both has been investigated in our laboratory. Previously, we demonstrated that T treatment in adolescents… 

Figures and Tables from this paper

Longitudinal Study of Physiologic Insulin Resistance and Metabolic Changes of Puberty

A longitudinal study in normal children during the prepubertal and pubertal periods demonstrated that during puberty insulin sensitivity decreased by ∼50%, the decrease in insulin sensitivity was compensated by a doubling in insulin secretion, and the decrease was independent of changes in percentage of body fat.

Growth hormone treatment in adolescent males with idiopathic short stature: changes in body composition, protein, fat, and glucose metabolism.

Four months of GH supplementation in adolescent males with non-GH-deficient idiopathic short stature with ISS is associated with significant body composition changes and hepatic insulin resistance, suggesting that pubertal insulin resistance may be mediated by GH.

Androgen Therapy in Adolescents: A Review

Endocrinologists and physicians should be acquainted with the indications, the forms, optimal timing, monitoring, dose titration and possible side-effects of T therapy to accomplish the best pharmacological outcome.

Sex-related differences between adiponectin and insulin resistance in schoolchildren.

There is a transient drop in the level of adiponectin during male puberty, correlated with the increase in testosterone level in boys, which was inversely correlated with obesity and insulin resistance in boys and girls during the pubertal period.

Novel treatment of short stature with aromatase inhibitors

  • L. DunkelS. Wickman
  • Medicine, Biology
    The Journal of Steroid Biochemistry and Molecular Biology
  • 2003

Longitudinal Analysis of the Pubertal Growth, Body Composition, and Endocrine Development in Young People with and without Diabetes

Differences in these parameters between T1D and control children are only partially explained by endocrine relationships; other factors, relating to T2D including glycaemic control and insulin dose, are important.

An approach to constitutional delay of growth and puberty

In the pre-pubertal male, testosterone (T) replacement therapy can be used to induce pubertal development, accelerate growth and relieve the psychosocial complaints of the adolescents but some issues in the management are still unresolved.

Do reproductive hormones modify insulin sensitivity and metabolism in older men? A randomized, placebo-controlled clinical trial of recombinant human chorionic gonadotropin.

It is concluded that three-Months of treatment with r-hCG demonstrates expected hormonal effects, improved lipids and did not worsen vascular endothelial function and argues against an important role for androgens in the hormonal control of insulin sensitivity in older men.

Management of delayed puberty in boys: tips and tricks

A range of options now exists for the management of DP, and the treating physician should be aware of new advances in the diagnosis and therapy.

Clamp Techniques in Paediatrics: What Have We Learned?

  • S. Arslanian
  • Medicine, Biology
    Hormone Research in Paediatrics
  • 2005
Paediatric experience with the clamp technique, the hyperinsulinaemic-euglycaemic clamp in assessing in vivo insulin sensitivity, and the hyperglycaemic clamped in assessing insulin secretion are delineated.



Testosterone treatment in adolescents with delayed puberty: changes in body composition, protein, fat, and glucose metabolism.

After 4 months of low-dose testosterone treatment in adolescents with delayed puberty, height, weight, and fat free mass (FFM) increased and fat mass, percent body fat, plasma cholesterol, high- and low-density lipoproteins, and leptin levels decreased significantly and insulin sensitivity in glucose metabolism does not change, whereas insulin clearance increases.

Insulin resistance of puberty: a defect restricted to peripheral glucose metabolism.

The data suggest that insulin resistance during puberty is restricted to peripheral glucose metabolism, and selective insulin resistance leading to compensatory hyperinsulinemia may serve to amplify insulin's effect on amino acid metabolism, thereby facilitating protein anabolism during this period of rapid growth.

Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes.

The results of euglycemic insulin-clamp studies in adults and prepubertal and pubertal children with and without insulin-dependent diabetes suggest that insulin resistance occurs during puberty in both normal children and children with diabetes.

Insulin resistance during puberty: results from clamp studies in 357 children.

Significant differences in insulin resistance are present between boys and girls, and while insulin resistance is related to BMI and anthropometric measures of fatness, these factors do not completely explain the insulin resistance that occurs during the Tanner stages of puberty.

Effects of maturational stage on insulin sensitivity during puberty.

It is concluded that the pubertal change in ISI is not necessarily associated with increased GH secretion, but is associated with increase GH peripheral effect, as indicated by the relationship between ISI and IGF-I.

The effects of testosterone and dihydrotestosterone on hypothalamic regulation of growth hormone secretion.

T treatment, via an estrogen-dependent mechanism, caused increased GH pulse amplitude, thereby increasing the mean serum GH concentration and indicates that T exerted its effect on GH via increased GHRH pulse amplitude.

Puberty decreases insulin sensitivity.

Correlations Between Fatty Acid and Glucose Metabolism: Potential Explanation of Insulin Resistance of Puberty

Insulin action in suppressing lipid oxidation and stimulating glucose Rd is decreased during puberty, and data suggest that increased lipid oxidation during puberty may contribute to pubertal insulin resistance at high physiological levels of insulin-like growth factor I.

Induction of insulin resistance by androgens and estrogens.

It is concluded that sex hormone administration, i.e. testosterone treatment in females and ethinyl estradiol treatment in males, can induce insulin resistance in healthy subjects.