ESPE Abstracts

Background: Non-classic congenital adrenal hyperplasia (NCCAH) and polycystic ovary syndrome (PCOS) present with similar hyperandrogenic symptoms in adolescent girls and may be associated with the development of cardiometabolic disorders.

Aim: The purpose of the study was to evaluate the prevalence and the association between the clinical and biochemical parameters of hyperandrogenism and metabolic disorders in girls with NCCAH and PCOS at the time of initial diagnosis.

Methods: A total of 114 girls (mean age 14.7±2.8 years), newly diagnosed with NCCAH (n = 59) or PCOS (n = 55) between 2016-2020, were included in the study. Anthropometry, full physical examination and ultrasound of the ovaries were performed; hormonal (total testosterone, 17OHProgesterone, DHEAS, androstendione, LH, FSH) and metabolic parameters (serum lipids, glucose, insulin, CRP) were assessed. The overweight/obesity prevalence was defined according to IOTF age- and gender-specific BMI cut-offs. Ethical clearance was provided by the Ethical commission at Medical university of Varna.

Results: The clinical symptoms of hyperandrogenism were significantly more common in NCCAH girls. Hirsutism was present in 84.7% of the NCCAH girls and 52.7% of the PCOS patients, P < 0.0001. Acne and alopecia were found in 33.9% and 18.6% of the NCCAH girls, respectively, compared to 9.1% (P = 0.001) and 3.6% (P = 0.012) of the PCOS participants. Menstrual disorders were significantly more common in PCOS girls (94.5% vs. 60%, P = 0.02). The overall prevalence of overweight/obesity among the participants was 41.2%, being twice higher among PCOS (56.4%) than in the NCCAH patients (27.1%), P = 0.001. Girls with PCOS had significantly higher body weight, height and BMI compared to NCCAH girls (P < 0.005 for all). The mean basal level of 17OHProgesteron in NCCAH and PCOS girls was 2.1±1.8 and 0.7±1.4 ng/ml, respectively, P < 0.0001. Testosterone (1.5±0.8 vs.1.2±0.7 nmol/l), androstendione (15.96±5.9 vs. 12.02±6.7 nmol/l) and LH (11.3±11.3 vs. 5.8±4.1 IU/l) were significantly higher in PCOS girls (P < 0.05). No differences between the groups were found in DHEAS and FSH levels. Testosterone level correlated significantly with the presence of menstrual disturbances (r = 0.642, P = 0.001). Polycystic ovarian morphology was observed in 32.5% of all participants, with a significantly higher prevalence among PCOS patients (56.4% vs. 10.2%, P < 0.0001). No significant differences were found in the parameters of lipid and glucose metabolism between the groups. Patients with PCOS had higher CRP values (P = 0.025).

Conclusion: The current results suggest that hirsutism and acne are the main clinical symptoms in NCCAH girls at diagnosis, while PCOS patients present more often with menstrual disorders and obesity.