ESPE Abstracts

Background: Polycystic ovary syndrome (PCOS) and non-classical congenital adrenal hyperplasia (NCCAH) are the most common hyperandrogenic disorders in adolescent girls. Though their etiology and pathogenesis differ, there is a significant overlap between physiological, clinical and hormonal findings and physiological phenomena. Adult patients with PCOS have increased prevalence of obesity, metabolic disturbances, increased cardiovascular risk, risk of impaired fertility, obstetric and gynecological complications some of which are potentially preventable with timely diagnosis, life-style and pharmacological interventions.

Objectives: To compare clinical, metabolic and hormonal parameters between adolescent girls with hyperandrogenism and healthy controls.

Materials and Methods: After ethical approval, 50 adolescent girls consented to participate in the study. The mean age was 16.1 (±2.4) years. Patients were divided into 3 groups. Group 1 included 20 NCCAH patients diagnosed with standard ACTH test, group 2 - 20 PCOS patients, fulfilling the ICPE 2017 diagnostic criteria for adolescent PCOS, group 3 - 10 age and BMI-matched controls without menstrual irregularities and hyperandrogenism. Same auxological, physical, metabolic and hormonal parameters were obtained in all groups. Pelvic US was performed by one experienced echographist. SPSS was used for the statistical analysis.

Results: Weight, BMI and waist circumference were significantly higher in PCOS, compared to NCCAH group (P=0.008, 0.04 and 0.014). Ferriman-Gallwey score was significantly higher in hyperandrogenic groups, compared to controls (P<0.001), without a significant difference between PCOS and NCCAH. The incidence of menstrual irregularities was significantly higher in PCOS group, compared to the other two groups (P<0.001). Insulin levels and HOMA-IR were significantly higher in PCOS group, compared to NCCAH group (P=0.04 and 0.023). LH was significantly higher in PCOS group, compared to NCCAH group (P=0.047); testosterone and androstendione were significantly higher in the hyperandrogenic groups, compared to controls (P=0.007, 0.007, 0.002 and <0.001), without a significant difference between PCOS and NCCAH. AMH was highest in the PCOS group but without statistical significance; SHBG was significantly lower in PCOS group, compared to the other two groups (P=0.014 and <0.001) and in the NCCAH group, compared to controls (P=0.003). Free Androgen Index was significantly higher in PCOS group, compared to the other two groups (P=0.026 and 0.005). No significant differences in the presence of US polycystic ovarian morphology were found between the groups.

Conclusions: There is a significant prevalence of obesity, metabolic disturbances, menstrual irregularities and hyperandrogenism in the PCOS girls. SHBG seems to be a useful biomarker for the diagnosis and differential diagnosis of hyperandrogenic disorders.