Abstract
We report a case of non-insulin-dependent diabetes mellitus (NIDDM) and growth hormone (GH) deficiency in a 15-year-old female with a history of a idiopathic precocious puberty. Her precocious pubery began at the age of 7, at which time her GH secretion was normal.She was treated with an antiandrogen (cyproteroneacetate), and her weight began to increase gradually.
On reaching 15, she was admitted to hospital for a thorough medical checkup, at which time her height was 141cm (-3SD), her body weight was 54kg (+0.33SD), and she was 56% overweight for a girl of her age. GH deficiency was also noted, as were luteinizing hormone (LH) and follicle-stimulating hormone (FSH) hypersecretion. Sixty minutes after oral administration of glucose (75g), her plasma glucose and immunoreactive insulin (IRI) levels were 449mg/dl and 32.9μU/ml, respectively. Her serum IRI was low but her urinary C-peptide content was normal. Her glucose metabolic clearance rate was 3.3ml/kg/min, which was significantly lower than for normal subjects (7-9ml/kg/mm).
We thus concluded that her idiopathic precocious puberty had been complicated by GH deficinecy and NIDDM. The pathogenesis of her NIDDM is not clear, but we surmise that her obesity might not have been the only factor since LH hypersecretion can also cause insulin resistance, leading to diabetes mellitus.
