Background: Obesity and unfavorable metabolic profile (insulin resistance and/or dyslipidemia) are frequently observed in Polycystic Ovarian Syndrome in Adolescents (PCOS) girls regardless of weight.
Objective and hypotheses: To evaluate clinical features and metabolic profile in PCOS adolescents, before, during and after Oral Contraceptive (OC) treatment.
Method: We performed a retrospective study on 51 girls with PCOS diagnosed according to the Androgen Excess Society criteria. Menstrual history, BMI (BMISDS), clinical and biochemical hyperandrogenism and metabolic profile were analyzed at diagnosis (age 16±1.8 years). A group of 26 patients was assessed during OC treatment (etinilestradioldrospirenone) for at least 2 years and after treatment withdrawal.
Results: At diagnosis, all patients had menstrual disturbances (gynecological age: 4.0±2.0 years; 30 oligo-amenorrhea, 11 poly-oligomenorrhea, five primary amenorrhea, and five secondary amenorrhea). BMISDS 0.67±1.10 (40% overweight or obese). Hirsutism was present in 98% (FerrimanGallwey score 13±4), 67% had acne and 21% acanthosis nigricans. Forty-nine percent of patients had elevated serum testosterone and androstenedione (0.76±0.33 and 3.73±1.42 ng/ml respectively). BMISDS and HOMA-IR were positively associated to free androgen index (r=0.48 and r=0.53, P<0.001 respectively). Elevated HOMA-IR and dyslipidemia (low HDL and high triglyceride levels) were present in 31 and 12% respectively. BMI and HOMA-IR remained unchanged throughout and after treatment, whereas total cholesterol, LDL cholesterol and triglyceride levels increased during OC treatment (P<0.0001) and decreased (P<0.0001) upon OC withdrawal. HDL cholesterol increased during treatment (P<0.0001) and remained elevated after treatment.
Conclusion: Adolescent girls with PCOS may have overweight, insulin resistance and/or dyslipidemia at diagnosis. We strongly recommend the evaluation of metabolic profile in PCOS adolescents at diagnosis to further prevent future consequences. OC treatment in our cohort did not show a long term impact on BMI, insulin resistance or dyslipidemia.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology