From premature adrenarche to adult metabolic risk and hyperandrogenism: a systematic review and meta-analysis.

Background

To assess the relationship between IPA and metabolic syndrome, as well as polycystic ovarian syndrome, in premenarcheal adolescent and adult women.

评估IPA与代谢综合征以及多囊卵巢综合征之间的关系，特别是在青春期前的女性和成年女性中。

Methods

We conducted a systematic reviewand meta-analysisof observational studies reporting outcomes in females with IPA after menarche.

我们对报告了青春期后IPA女性结果的观察性研究进行了系统评价和荟萃分析。

Databases were searched through February 2025.

数据库搜索至2025年2月。

Primary outcomes included body mass index (BMI), insulin resistance markers, and clinical and biochemical markers of hyperandrogenism.

主要结果包括体重指数(BMI)、胰岛素抵抗标志物以及高雄激素血症的临床和生化标志物。

Data were pooled using random-effects models.

使用随机效应模型合并数据。

The GRADE approach was applied to assess the certainty of evidence.

应用GRADE方法评估证据的确定性。

Results

A total of 21 studies comprising 635 females with IPA and 307 age-matched controls were included.

共纳入了21项研究，包括635名IPA女性和307名年龄匹配的对照组。

Compared to controls, IPA individuals showed significantly higher BMI (mean difference: 1.4; CI: 1.0-1.9), fasting insulin, and homeostasis model assessment of insulin resistance, indicating persistent insulin resistance.

与对照组相比，IPA个体显示出显著更高的BMI（平均差异：1.4；CI：1.0-1.9）、空腹胰岛素和胰岛素抵抗的稳态模型评估，表明持续的胰岛素抵抗。

Markers of hyperandrogenism, including Ferriman-Gallwey score, dehydroepiandrosterone sulfate, and Free androgenic index, were also elevated.

包括Ferriman-Gallwey评分、脱氢表雄酮硫酸盐和游离雄激素指数在内的雄激素过多标志物也有所升高。

Secondary analyses revealed higher triglycerides, lower high-density lipoprotein, increased leptin, and greater carotid intima-media thickness, supporting an early pattern of cardiometabolic risk.

次要分析显示甘油三酯更高，高密度脂蛋白更低，瘦素增加，以及颈动脉内膜中层厚度更大，支持早期心血管代谢风险模式。

GRADE assessment rated most outcomes as low certainty.

GRADE评估将大多数结果评为低确定性。

Conclusions

Women with a history of IPA are at increased risk of long-term insulin resistance and hyperandrogenism, with early signs of adverse cardiometabolic profiles.

有IPA病史的女性长期胰岛素抵抗和雄激素过多的风险增加，早期出现不利的心血管代谢剖面。

These findings support the need for long-term monitoring in this population.

这些发现支持了对该人群进行长期监测的需要。