OR15-4 Heterogeneity of Clinical Presentation of Adolescent PCOS Is Attributable to Distinct Subtypes (original) (raw)
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BMC Medicine, 2020
Background Polycystic ovary syndrome (PCOS) is challenging to diagnose. While the 2003 Rotterdam criteria are widely used for adults, the 2018 international PCOS guideline recommended updated Rotterdam criteria with both hyperandrogenism and oligo-anovulation for adolescents based on evidence-informed expert consensus. This study compared the prevalence of PCOS using updated and original Rotterdam criteria in community-based adolescents and explored long-term body mass index (BMI) trajectories across different diagnostic phenotypes. Methods Overall, 227 postmenarchal adolescent females from the prospective cohort Raine Study undertook comprehensive PCOS assessment at age 14–16 years. Detailed anthropometric measurements were collected from birth until age 22 years. Cross-sectional and longitudinal BMI were analyzed using t tests and generalized estimating equations. Results PCOS was diagnosed in 66 (29.1%) participants using original criteria versus 37 (16.3%) participants using upd...
The Journal of Clinical Endocrinology and Metabolism, 2003
Approximately half of all women with polycystic ovary syndrome (PCOS) are overweight or obese, and studies have reported endocrine and metabolic differences between lean and obese women with PCOS. PCOS has not been as extensively investigated in the adolescent population. The objectives of our study were to further characterize early endocrine and metabolic alterations in adolescents with PCOS and to determine whether differences between nonobese and obese women with PCOS are present early in its course. We studied an ethnically heterogeneous group of 48 adolescents: 11 nonobese with PCOS [age, 16.1 ؎ 1.9 yr; body mass index (BMI), 22.5 ؎ 1.5 kg/m 2 ], 22 obese with PCOS (age, 15.5 ؎ 1.4 yr; BMI, 35.9 ؎ 6.2 kg/m 2), and 15 obese controls (age, 14.4 ؎ 1.5 yr; BMI, 35.8 ؎ 7.1 kg/m 2). Fasting levels of glucose, insulin, proinsulin, hemoglobin A1c, testosterone, SHBG, ⌬4-androstenedione (⌬4-A), dehydroepiandrosterone sulfate (DHEAS), LH, FSH, IGF-I, IGF binding protein-1, free IGF-I, and lipids were measured. Six of the 11 nonobese PCOS subjects, 11 of the 22 obese PCOS subjects, and six of the 15 controls underwent standard oral glucose tolerance testing. The insulin response to the oral glucose tolerance test was measured by the insulin area under the curve (I AUC120). Measures of insulin sensitivity were calculated as the fasting glucose to insulin ratio, quantitative insulin sensitivity check index, and composite insulin sensitivity index. The nonobese adolescents with PCOS demonstrated higher levels of LH, SHBG, ⌬4-A, DHEAS, dihydrotestosterone, free IGF-I, and high-density lipoprotein, and lower low-density lipoprotein, compared with the obese PCOS group. Fasting levels of insulin and proinsulin, I AUC120 , and log I AUC120 were higher, and the fasting glucose to insulin ratio, quantitative insulin sensitivity check index, and composite insulin sensitivity index were lower in the obese compared with the nonobese PCOS subjects. Greater levels of LH and androgens, including total and free testosterone, ⌬4-A, and DHEAS, and lower SHBG levels were found in the obese PCOS group compared with the obese controls. Adolescents with PCOS manifest clinical, metabolic, and endocrine features similar to those of adult women, and differences between nonobese and obese women with PCOS may be detected in adolescence. Our findings indicate a more pronounced alteration in the hypothalamo-pituitary-adrenal axis in nonobese adolescents with PCOS and a more marked dysregulation of insulin levels and impairment of insulin sensitivity in their obese counterparts. Our data also suggest differences in the IGF system between nonobese and obese adolescents with PCOS.
International Journal of Africa Nursing Sciences, 2015
Introduction: Adipose tissue distribution is effective in metabolic complications resulting from obesity. The present study aimed to determine the prevalence of obesity and android obesity based on various phenotypes of Polycystic Ovarian Syndrome (PCOS) in 14-18 year old high-school female students in Shiraz in 2009. Methods: This descriptive study was conducted on 14-18 years old high-school girl in Shiraz in 2009. 3190-Subject sample size was determined. After obtaining written informed consents, demographic information questionnaire was completed and the participants were examined regarding hirsutism, acne, alopecia, and menstrual disorders. Besides, the criteria proposed by Adams et al. were employed to diagnose PCOS in sonography. Android obesity and BMI were evaluated. Then, the data were entered into the SPSS software (v. 11.5) and analyzed. Results: The participants' mean weight, mean height, and mean waist circumference were 54.14 ± 9.99 kg, 160.20 ± 5.76 cm, and 65.24 ± 7.34 cm, respectively. In addition, 616 participants (20.5%) were underweight, 234 (9.5%) were overweight, and 110 (3.5%) were obese. Also, 15 participants (0.5%) had android obesity. The results of independent t-test showed no significant difference among various phenotypes of PCOS regarding mean android obesity and BMI (P > 0.05). Overall, 16.6% of the study participants (514 subjects) suffered from menstrual disorders and oligomenorrhea. Also, 99 participants (3.1%) had BMI P 26. Conclusion: The results revealed no significant relationship between female adolescents' obesity and various phenotypes of PCOS. However, adolescents should be informed about the long-term hyperandrogenic outcomes which are accompanied by insulin secretion and endanger their health after the age of 40 years.
International Journal of Public Health Science (IJPHS), 2017
Adipose tissue distribution is effective in metabolic complications resulting from obesity. Fat accumulation in the body, particularly increase in visceral fat, is a major risk factor of diabetes and cardiovascular diseases. The present study aimed to determine the prevalence of obesity and android obesity based on various phenotypes of Polycystic Ovarian Syndrome (PCOS) in 14-18 year old high-school girl students in Shiraz in 2009. This descriptive study was conducted on 14-18 year old high-school girl students in Shiraz in 2009. Considering the confidence coefficient of 95% and loss rate of 20%, a 3190-subject sample size was determined for the study. The participants were selected through purposive sampling. After obtaining written informed consents, demographic information questionnaire was completed and the participants were examined regarding hirsutism, acne, alopecia, and menstrual disorders. Besides, the criteria proposed by Adams et al. were employed to diagnose PCOS in sonography. Android obesity and Body Mass Index (BMI) were evaluated, as well. The results of independent t-test showed no significant difference among various phenotypes of PCOS regarding mean android obesity and BMI (P>0.05). The results of the present study revealed no significant relationship between girl adolescents' obesity and various phenotypes of PCOS. However, adolescents should be informed about the long-term hyperandrogenic outcomes which are accompanied by insulin secretion and endanger their health after the age of 40 years.
Extent of metabolic risk in adolescent girls with features of polycystic ovary syndrome
Fertility and Sterility, 2011
Objective: To determine prevalence of metabolic syndrome in adolescents with polycystic ovary syndrome (PCOS) and derive features suggestive of propensity for development of metabolic syndrome. Design: Prospective cohort study. Setting: Population-based cohort of adolescents in Western Australia. Participant(s): Metabolic data from 1,377 children aged 14 years, features of PCOS obtained from 244 girls aged 14 to 17 years. Intervention(s): Assessment for features of PCOS and subsequent fasting blood samples. Main Outcome Measure(s): Relationship between features of PCOS and features of metabolic syndrome.
Texila International Journal of Public Health, 2024
Polycystic Ovary Syndrome (PCOS) is a complex and multifactorial condition, involving a combination of genetic, hormonal, and environmental factors, and its etiology is unknown. PCOS poses a diagnostic challenge in adolescents, and assessing the status of biomarkers in adolescents and middle-aged women will elucidate the aetiology of PCOS. To evaluate the clinical biomarkers - SHBG, testosterone, AMH, insulin, and leptin - in both adolescence and middle-aged groups. This cross-sectional study was conducted at Sree Balaji Medical College and Hospital and involved a total of 200 subjects. The participants were divided into two groups, each having two subgroups. Adolescent females with regular periods made up Group 1(a), whereas those with irregular cycles and ages ranging from 18 to 19 made up Group 1(b). Middle-aged women with PCOS made up Group 2(a), whereas control subjects between the ages of 30 and 38 made up Group 2(b). The data were presented in the form of mean ± SD. To assess the variance in the data among multiple groups, a one-way analysis of variance (ANOVA) was employed to identify the least significant difference during group-wise comparisons. Statistical Package for the Social Sciences (SPSS) was used for all statistical analyses, with a significance threshold of P<0.05. The values of SHBG and AMH were significantly different between the four groups, and the value of insulin was significant between controls and oligomenorrhea in the adolescent group. This study reveals the sequential expression of physiological and clinical biochemical variations, suggesting that compensatory hyperinsulinemia may play a role in initiating PCOS pathogenesis.
Minimal difference in phenotype between adolescents and young adults with polycystic ovary syndrome
Fertility and Sterility, 2018
Objective: To test the hypothesis that the polycystic ovary syndrome (PCOS) phenotype, or its component features, is less severe in adolescents than in young adult patients, in a referred (clinical) population. Design: Cross-sectional study. Setting: Tertiary-care academic medical center. Patient(s): Two hundred seventy-four adolescents and young adults aged 13.0-24.9 years with PCOS according to the National Institute of Health 1990 criteria. Patients were categorized as adolescents (AD: 13.0-18.9 years; n ¼ 91) and young adults (YA: 19.0-24.9 years; n ¼ 183). Adolescents were further categorized as early adolescents (Early-AD: 13.0-15.9 years; n ¼ 31) and late adolescents (Late-AD: 16.0-18.9 years; n ¼ 60). Intervention(s): History, physical examination, hormonal assays with the use of standardized protocols. Main Outcome Measure(s): Unadjusted and adjusted odds ratios (ORs; adjusted for body mass index [BMI] when applicable) were calculated for biochemical hyperandrogenism (HA), hirsutism (HIR), acne, and degree of oligo/amenorrhea (OA). PCOS phenotypes were classified as HIRþHAþOA, HAþOA, and HIRþOA. Result(s): Our analysis demonstrated minimal significant difference in the prevalence of the three PCOS phenotypes, or component features, between AD and YA patients. The risks for obesity were higher for YA versus AD, and the risk of acne was lower for YA versus AD. There was no significant difference between Early-AD and Late-AD. BMI-adjusted models did not significantly modify the main findings. Conclusion(s): The present study suggests that the PCOS phenotype is established in early adolescence, remains constant into adulthood, and is not related to BMI.