{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:21:45Z","timestamp":1772580105419,"version":"3.50.1"},"reference-count":32,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Res Paediatr"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>&lt;i&gt;Background:&lt;\/i&gt; Insulin resistance (IR), abnormal lipid profile, and other features of the metabolic syndrome have been described in &lt;i&gt;CYP19&lt;\/i&gt; gene knockout mice and in aromatase-deficient adult men but not in prepubertal affected girls. &lt;i&gt;Aims:&lt;\/i&gt; To study insulin sensitivity, as well as the effects of estrogen, metformin and GnRHa treatment on glucose homeostasis, in an aromatase-deficient girl. &lt;i&gt;Methods:&lt;\/i&gt; Clinical, metabolic and hormonal follow-up data, from 8 to 12 years of age, is presented. &lt;i&gt;Results:&lt;\/i&gt; At 9 years of age, IR (HOMA 5.6) and glucose intolerance was detected, along with high serum testosterone (2.28 nmol\/l), androstenedione (4.92 nmol\/l) and FSH (13.4 mIU\/ml) levels. Estrogen replacement was ineffective to suppress gonadotropin and androgen levels, as well as IR. Under metformin therapy, she developed type 2 diabetes and acanthosis nigricans. GnRHa administration for 1 year resulted in marked decreases in gonadotropin and serum androgens, but severe IR persisted. &lt;i&gt;Conclusion:&lt;\/i&gt; Postnatal estrogen replacement and a marked decrease of endogenous androgens failed to improve IR and glucose tolerance. We propose that, in females, the increment of androgens and\/or lack of estrogens during fetal life might alter the mechanism of fetal programming of insulin sensitivity.<\/jats:p>","DOI":"10.1159\/000249165","type":"journal-article","created":{"date-parts":[[2009,10,23]],"date-time":"2009-10-23T14:20:24Z","timestamp":1256307624000},"page":"370-376","source":"Crossref","is-referenced-by-count":13,"title":["Metformin, Estrogen Replacement Therapy and Gonadotropin Inhibition Fail to Improve Insulin Sensitivity in a Girl with Aromatase Deficiency"],"prefix":"10.1159","volume":"72","author":[{"given":"Gabriela","family":"Guercio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Isabel","family":"Di 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