Spectrum of metabolic dysfunction in relationship with hyperandrogenemia in obese adolescent girls with polycystic ovary syndrome

ObjectivePolycystic ovary syndrome (PCOS) in adult women is associated with increased risk of metabolic syndrome (MS) and atherosclerosis. We evaluated the spectrum of metabolic dysfunction in relationship with hyperandrogenemia (HA) in adolescent girls with PCOS.Materials and methodsOvulatory function, acne, hirsutism (HS), body mass index (BMI), body composition, fasting lipids, glucose, insulin, free testosterone (FT), high-sensitivity C-reactive protein (hs-CRP), and HbA1c were evaluated in 103 girls. The homeostatic assessment model equations (HOMA-IR and HOMA-%B) were used for determination of insulin resistance and β-cell function respectively.ResultsThe oligo-ovulation (Oligo)+HA+HS (n=44), Oligo+HA (n=28), and Oligo+HS (n=31) phenotypes had similar BMI. However, hyperandrogenemic phenotypes had higher prevalence of acanthosis nigricans (AN) and acne (P<0.01) and higher insulin, HOMA-IR, HOMA-%B, HbA1c, and hs-CRP levels than Oligo+HS group (P<0.01). Serum FT was correlated with HOMA-IR (r=0.38,P<0.01), HOMA-%B (r=0.49,P<0.01), hs-CRP (r=0.42,P<0.01), AN (r=0.39,P<0.01), and HbA1c (r=0.27,P<0.01). Furthermore, 34% of girls met diagnostic criteria for MS displaying higher BMI, FT, HOMA-%B, HOMA-IR, hs-CRP, and HbA1c than subjects without MS (P<0.01). Using combined HOMA-IR≥4.0 and hs-CRP>3.0 cut-off values, 71.4% of MS versus 23.5% non-MS group were considered at risk of diabetes and atherosclerosis (P<0.0001).ConclusionsHyperandrogenemic PCOS phenotypes have greatest degree of insulin resistance and inflammation. The use of insulin resistance and inflammatory markers may help identify adolescent girls with PCOS at risk of cardiometabolic syndrome.

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Polycystic ovary syndrome in overweight and obese adolescent girls and its association with insulin resistance and metabolic syndrome

Endocrine Abstracts ◽

10.1530/endoabs.35.p813 ◽

2014 ◽

Author(s):

Natalija Smetanina ◽

Raimondas Valickas ◽

Audrone Seibokaite ◽

Rasa Verkauskiene

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Polycystic Ovary Syndrome ◽

Adolescent Girls ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Obese Adolescent

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Ovarian imaging by magnetic resonance in obese adolescent girls with polycystic ovary syndrome: a pilot study

Fertility and Sterility ◽

10.1016/j.fertnstert.2005.04.039 ◽

2005 ◽

Vol 84 (4) ◽

pp. 985-995 ◽

Cited By ~ 36

Author(s):

R YOO ◽

C SIRLIN ◽

M GOTTSCHALK ◽

R CHANG

Keyword(s):

Pilot Study ◽

Magnetic Resonance ◽

Polycystic Ovary Syndrome ◽

Adolescent Girls ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Obese Adolescent

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Obesity, hormonal and metabolic abnormalities in adolescent girls with polycystic ovary syndrome

Orvosi Hetilap ◽

10.1556/oh.2013.29669 ◽

2013 ◽

Vol 154 (31) ◽

pp. 1226-1234

Author(s):

László Ságodi ◽

Béla Lombay ◽

Ildikó Vámosi ◽

László Barkai

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Birth Weight ◽

Low Birth Weight ◽

Polycystic Ovary Syndrome ◽

Adolescent Girls ◽

Polycystic Ovary ◽

Metabolic Abnormalities ◽

Ovary Syndrome

Introduction: Polycystic ovary syndrome is associated with metabolic abnormalities, such as dyslipidemia, obesity, glucose intolerance, which are also components of the metabolic syndrome. Central obesity and insulin resistance appear to play an important role in the pathogenesis of polycystic ovary syndrome, perhaps via subsequent steroidogenic dysregulation. Aim: The aim of the authors was to assess metabolic and hormonal abnormalities in adolescent girls with polycystic ovary syndrome. Method: The study included 52 adolescents diagnosed with polycystic ovary syndrome based on the Rotterdam criteria. Anthropometric, hormonal and metabolic parameters were evaluated among all subjects. 20 healthy, age-matched, non-obese, regularly menstruating girls were used as controls. Of the 52 patients, 15 patients were born with low-birth-weight and 37 patients were born with normal birth weight. Oral glucose tolerance test was performed in all patients and controls. The age of patients was 16.8±3.1 years, and the age of controls was 16.95±2.1 years. Results: Among patients with polycystic ovary syndrome the prevalence of overweight and obesity was 35% (n = 18), while impaired fasting glucose occurred in one patient, impaired glucose tolerance in 8 patients, insulin resistance in 25 patients and metabolic syndrome in 12 patients. Serum triglyceride levels in patients and controls were 1.4±0.8 and 0.9±0.3 mmol/l, respectively (p<0.05), while fasting blood glucose, total cholesterol, HDL and LDL cholesterol were not different in the two groups. Metabolic abnormalities and obesity were more severe and more frequent in patients with low-birth-weight compared to those born with normal weight. There was a negative correlation between birth weight and body mass index SDS values and a positive correlation between fasting insulin levels and body mass index SDS (r = 0.37) in patients born with low-birth-weight. Conclusions: Abnormal glucose metabolism is frequently present in adolescents with polycystic ovary syndrome. It is possible that early diagnosis of polycystic ovary syndrome in adolescences may prevent some of the long-term complications associated with this syndrome. Orv. Hetil., 2013, 154, 1226–1234.

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Body fat and insulin resistance independently predict increased serum C-reactive protein in hyperandrogenic women with polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje-09-0379 ◽

2009 ◽

Vol 161 (5) ◽

pp. 737-745 ◽

Cited By ~ 29

Author(s):

Flavia Tosi ◽

Romolo Dorizzi ◽

Roberto Castello ◽

Claudio Maffeis ◽

Giovanna Spiazzi ◽

...

Keyword(s):

Insulin Resistance ◽

Insulin Sensitivity ◽

Polycystic Ovary Syndrome ◽

Body Fat ◽

Polycystic Ovary ◽

C Reactive Protein ◽

Androgen Excess ◽

Ovary Syndrome ◽

Reactive Protein ◽

Hs Crp

ObjectiveIncreased serum C-reactive protein (CRP), an independent predictor of coronary heart disease, was reported in women with polycystic ovary syndrome (PCOS). It remains unclear whether this finding is due to the association between PCOS and either insulin resistance, obesity, or androgen excess, which are all common features of this condition. The aims of this study were to assess whether increased serum CRP is a specific feature of PCOS and to investigate the mechanisms underlying this association.Design and methodsSerum high-sensitivity CRP (hs-CRP) was measured in 86 hyperandrogenic women (age 21.6±4.2 years, body mass index (BMI) 23.6±3.5 kg/m2), 50 with PCOS and 36 with idiopathic hyperandrogenism (HA). Thirty-five BMI-matched healthy women were also studied as controls. In these subjects, endocrine and metabolic profiles were assessed. In all hyperandrogenic subjects and 14 controls, insulin sensitivity was measured by the glucose clamp technique. Body fat was measured by bioelectrical impedance.ResultsHs-CRP concentrations were higher in PCOS women (3.43±2.01 mg/l) than in HA subjects and healthy women (2.43±1.04, P<0.005; and 2.75±0.86 mg/l, P<0.05 respectively versus PCOS). In multiple regression analyses, increased serum hs-CRP was independently predicted by higher body fat and lower insulin sensitivity. However, in lean women, serum-free testosterone was an additional, negative, predictive variable.ConclusionsPCOS is accompanied by a low-grade chronic inflammation. Body fat appears the main determining factor of this finding, which is only partly explained by insulin resistance. At least in lean women, androgen excess per se seems to play an additional, possibly protective, role in this association.

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Adiposity and metabolic dysfunction in polycystic ovary syndrome

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2015-0008 ◽

2015 ◽

Vol 21 (2) ◽

Cited By ~ 7

Author(s):

Susan Sam

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Polycystic Ovary Syndrome ◽

Metabolic Disorders ◽

Polycystic Ovary ◽

Reproductive Age ◽

Metabolic Dysfunction ◽

Obese Women ◽

Ovary Syndrome ◽

Insulin Resistant

AbstractPolycystic ovary syndrome (PCOS) is the most common hormonal disorder among reproductive-age women and is associated with a high risk for metabolic disorders. Adiposity and insulin resistance are two prevalent conditions in PCOS and the likely culprits for the heightened metabolic risk. Up to 60% of women with PCOS are considered to be overweight or obese, and even among non-obese women with PCOS there is an increased accumulation of adipose tissue in abdominal depots. Insulin resistance in PCOS is unique and independent of obesity, as even non-obese women with this condition are frequently insulin resistant. However, obesity substantially aggravates the insulin resistance and the metabolic and reproductive abnormalities in women with PCOS. Recently, it has been shown that many aspects of adipose tissue function in PCOS are abnormal, and these abnormalities likely predispose to development of insulin resistance even in the absence of obesity. This review provides an overview of these abnormalities and their impact on development of metabolic disorders. At the end, an overview of the therapeutic options for management of adiposity and its complications in PCOS are discussed.

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