Endocrine Abstracts

Background: The prevalence of the metabolic syndrome (MS) is notably higher in patients with PCOS than in the general population. Presumably, this prevalence increases as a function of age but the subgroups of patients less than 20 yr. old studied so far are small.

Design: In order to further document this issue, we have selected for this study 498 patients with PCOS aged 12.5–38 yr (Rotterdam definition) and 188 control women aged 15.5–38.5 yr, that have been consecutively included in a database and in whom the required clinical, hormonal and ultrasound data were available. A metabolic score has been calculated according to the ATP-III classification and defined the MS when ≥3.

Results: The prevalence of the MS was significantly higher in the PCOS than in the control group (15.2% vs 4.8%, P<0.0001). It did not differ significantly (P=0.063) between the 3 subgroups of patients with PCOS according to age, i.e., 12.8% in patients aged ≤ 0 yr (n=47), 13.9% in patients aged 21–30 yr (n=301) and 18.7% in patients aged 31–40 yr (n=150). However, we observed that a metabolic score of 1 or 2 tended to be more frequent in the adolescent group than in the groups of older patients (cumulated rate 1+2: 66.0% vs 51.8% and 48.7%, respectively, P=0.09). In the patients having a score=1, a HDL-Cholesterol (HDL-C) <0.5 g/L was found in 57.1% adolescents vs 26.3% and 27% patients aged 21–30 and 31–40 yr, respectively (P=0.068). In the same group, a waist circumference (WC) >80 cm was found in 35.7% adolescents vs 69.7% and 70.3% patients aged 21–30 and 31–40 yr, respectively (P=0.047). In patients with a score=2, a HDL-C <0.5 g/L and a WC>80 cm were found in 100% of cases in every subgroup.

Conclusions: By requiring some items that reflect relatively late complications of insulin resistance (hypertriglyceridemia, hypertension, glucose intolerance or diabetes), the current definitions of the MS in adults underestimate the prevalence of nascent metabolic abnormality in adolescents. Our data indicate that a HDL-C <0.5 g/L is the most sensitive marker of such abnormality, while a WC >80 cm seems to be less sensitive than in adults.