ESPE Abstracts

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women. The diagnosis of PCOS in adolescent patients can be difficult because characteristics of normal puberty often overlap with signs and symptoms of PCOS. Irregular menstrual cycles and ultrasound display of multiple follicles are common finding during puberty. In recent years new diagnostic criteria for PCOS in adolescent females were introduced. These new criteria include the specification of irregular menstrual cycles and hyperandrogenism, with the exclusion of polycystic ovarian morphology. The study aimis to verify whether diagnosis of PCOS based on adoelscent specific criteria is associated with an increased risk of metabolic disorders in adulthood.

Methods: We conducted a retrospective analysis of the medical records of adolescent patients with PCOS (meeting adolescent or Rotterdam criteria). Subsequently, after 4 - 11 years from the first visit, 35 women were reassessed. 19 of them meeting the adolescent criteria (study group, SG), 16 not meeting adolescent criteria (control group, CG). In all subjects physical examination was performed. Lipids, carbohydrates parameters and liver enzymes were assessed in the fasting stat.

Results: In SG, 8 out of 19 patients (42%) were obese, in CG 4 out of 16 (25%). The disparity in BMI values between the groups in this cohort did not attain statistical significance (SG 32.13±8.69 vs. CG 26±3.86 kg/m²; P = 0.16). However, analyzed data revealed a significant increase in BMI between the first and second assessment in SG (Δ=2.8±3.7 kg/m²; P = 0.009), which was not observed in CG (Δ=1.4±3.9 kg/m²; P = 0.17). Significant differences were identified in AST (SG 23.4±5.9 vs. CG 19.3±3.6U/L; P = 0.02) and ALT (SG 24.0±14.2 vs. CG 15.9±6.2U/L; P = 0.04) levels. There was no significant difference in lipids levels between the groups, but triglyceride/HDL ratio wassignificantly higher in SG (2.46 vs. 1.24; P = 0,03). Glucose levels were comparable in the study groups, but patients in SG showed higher insulin levels (SG 13.0±8.5 vs. CG 7.9±3.8μIU/ml; P = 0.03), HOMA-IR (SG 2.1±1.8 vs. CG 1.4±0.8; P = 0,03), and lower triglyceride-glucose index [TyG ] (SG 1.67 vs. CG 8.49; P <0,001), and triglyceride glycemic-body mass index [TyG-BMI] (SG 37.18 vs. CG 248.46; P <0,001).

Conclusion: Patients diagnosed with PCOS using adolescent criteria, reveals a significant increase in BMI over time, resulting in significantly higher insulin resistance. These findings emphasize the importance of addressing and managing of PCOS during adolescence using adolescent criteria to mitigate potential metabolic risks in adulthood.