{
    "abstract": "We report that intractable early childhood obesity may be associated with severe insulin resistance syndromes (pseudo-Cushing's syndrome and pseudo-acromegaly) and precede polycystic ovary syndrome (PCOS).\nPatient 1 had prepubertal obesity followed by early puberty and was diagnosed with pseudo-Cushing's syndrome and insulin resistance at 10.3 years. Oligomenorrhea, androgen excess, and type 2 diabetes mellitus (DM2) emerged at 13.5 years. Patient 2 developed intractable prepubertal obesity followed by atypical true sexual precocity and pseudo-Cushing's syndrome in early childhood. By 11.3 years, oligomenorrhea, androgen excess, and DM2 had appeared. Patient 3 had prepubertal overgrowth in weight and height and was diagnosed with pseudo-acromegaly, menstrual irregularity, androgen excess, and impaired glucose tolerance at 14.3 years of age. Patient 4 had prepubertal overgrowth that evolved into pseudo-acromegaly, insulin resistance, secondary amenorrhea, and androgen excess at 15.6 years.\nIntractable prepubertal obesity was recognized to culminate in early childhood pseudo-Cushing's syndrome or pseudo-acromegaly, which are manifestations of insulin-resistant hyperinsulinism, and to herald adolescent PCOS.",
    "authors": [
        {
            "affiliation": "University of Chicago, Pritzker School of Medicine, Department of Pediatrics, Section of Pediatric Endocrinology, 5841 S. Maryland Avenue, IL 60637, USA. ebaumann@peds.bsd.uchicago.edu",
            "firstname": "Elizabeth E",
            "initials": "EE",
            "lastname": "Littlejohn"
        },
        {
            "affiliation": null,
            "firstname": "Roy E",
            "initials": "RE",
            "lastname": "Weiss"
        },
        {
            "affiliation": null,
            "firstname": "Dianne",
            "initials": "D",
            "lastname": "Deplewski"
        },
        {
            "affiliation": null,
            "firstname": "Deborah V",
            "initials": "DV",
            "lastname": "Edidin"
        },
        {
            "affiliation": null,
            "firstname": "Robert",
            "initials": "R",
            "lastname": "Rosenfield"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1515/jpem.2007.20.1.41",
    "journal": "Journal of pediatric endocrinology & metabolism : JPEM",
    "keywords": [],
    "methods": null,
    "publication_date": "2007-02-24",
    "pubmed_id": "17315528",
    "results": null,
    "title": "Intractable early childhood obesity as the initial sign of insulin resistant hyperinsulinism and precursor of polycystic ovary syndrome.",
    "xml": "<Element 'PubmedArticle' at 0x788504e3eca0>"
}