Background: Polycystic ovary syndrome (PCOS), characterized by hyperandrojenemia, anovulatory periods and polycystic ovaries, is a disorder in which metabolic and reproductive abnormalities overlap. The etiopathogenesis is currently unclarified. Besides the evidence of genetic causes, environmental factors are considered to be involved in development of phenotype. Phthalates are widely used industrial chemicals and have several known untoward effects on human reproductive health.
Objective and hypotheses: In this study, we aimed to investigate a possible role of phthalates (MEHP and DEHP) in PCOS etiopathogenesis. We also wished to evaluate the relationship between phthalates and metabolic disturbances in adolescents with PCOS.
Method: A total of 173 adolescents (112 PCOS, 61 controls, mean age: 15.2±1.4 age range: 1319 years) were included in the study. Physical examination and anthropometric measurements were performed in all participants. Hormonal and metabolic parameters and serum MEHP and DEHP levels measured by HPLC method were determined. OGTT was performed in PCOS and obese control groups. Insulin resistance was evaluated using HOMA-IR, QUICK-I, fasting glucose/insulin ratio, Matsuda index and total insulin levels during OGTT. Participants were further subdivided into lean and obese subgroups according to BMI.
Results: Serum MEHP and DEHP levels were not significantly different between PCOS and control groups (mean MEHP levels: 0.29±0.2 vs 0.36±0.3 μg/ml; mean DEHP levels: 2.6±0.3 vs 2.7±0.4 μg/ml in PCOS and control groups respectively, P>0.05). Serum MEHP levels were positively correlated with waist circumference, glucose, total cholesterol, insulin, and HOMA-IR. Serum DEHP levels were positively correlated with insulin, HOMA-IR, triglyceride, total cholesterol and negatively correlated with QUICK-I and Matsuda index.
Conclusion: Serum MEHP and DEHP concentrations were not different between adolescent girls with or without PCOS. However, these phthalates are associated with metabolic disturbances such as dyslipidemia and insulin resistance in this population.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology