Clinical features, reproductive endocrine and metabolic abnormalities of adolescent girls with polycystic ovary syndrome
Objective: To investigate the clinical features, reproductive endocrine and metabolic abnormalities in adolescent girls with polycystic ovary syndrome (PCOS).
Methods: A total of 325 adolescent girls with normal menstruation, 18 obese (OB-CON) and 307 non-obese (NOB-CON), were enrolled as controls from multiple middle schools in Shanghai, China. A total of 167 adolescent girls with PCOS, 90 obese (OB-PCOS) and 77 non-obese (NOB-PCOS), were also recruited. All cases were evaluated for their clinical manifestations, reproductive endocrine and metabolic parameters. Hyperandrogenism was determined by serum testosterone (T), free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEA-S). Insulin sensitivity was measured by fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR).
Results: (1) Menarche was significantly earlier in adolescent PCOS than in controls. The incidence of obesity was significantly higher in adolescent PCOS than that in control group. (2) T, FAI and DHEA-S were significantly higher in adolescent PCOS group than those in control group. FAI was higher in OB-PCOS group than in NOB-PCOS group. LH and LH/FSH were higher in PCOS groups than those in controls. LH and LH/FSH were also much higher in NOB-PCOS group than those in OB-PCOS group. (3) HOMA-IR and FINS were significantly higher in PCOS group than those in control group. Incidence of acanthosis nigricans, FINS, HOMA-IR and triglyceride were significantly higher in OB-PCOS group than those in NOB-PCOS group. (4) 95.21% PCOS girls presented with an ultrasonic morphological evidence of polycystic ovarian.
Conclusions: The essential features of adolescent PCOS are an earlier onset of menarche, a persistent menstrual disorder over 2 years after menarche, a higher incidence of obesity, marked hyperandrogenism and insulin resistance and disorderly gonadotropin secretion in comparison with control subjects. Hyperandrogenism and insulin resistance are much more severe in obese adolescent PCOS.