Endocrine Abstracts

Background: Adolescent polycystic ovarian syndrome (PCOS) is being diagnosed more frequently as the prevalence of childhood obesity increases. Adolescent PCOS has been associated with low birth weight (LBW), exaggerated adrenarche (EA) and metabolic syndrome in Mediterranean populations. This study describes the clinical phenotype of a cohort of northern European girls.

Methods: A retrospective study of adolescents with PCOS, diagnosed according to the Rotterdam criteria, seen in a single centre between 2005 and 2013.

Results: Data are presented as median (range).

Of 42 girls age 14.7 (11.8–17.9) years, 22/42 (52%) had hyperandrogenic anovulation (hyperandrogenism and oligo-anovulation), 15/42 (36%) classic PCOS (hyperandrogenism, oligo-anovulation and ultrasound changes), 4/42 (10%) non-hyperandrogenic PCOS (oligo-anovulation and US changes) and 1/42 (2%) girl had ovulatory PCOS (hyperandrogenism and ultrasound changes). 33/42 (79%) of girls presented with hirsuitism and 41/42 (98%) had menstrual irregularity. 5/42 (12%) girls had a history of EA.

Birth weight SDS was 0.19 (−3.28 to 2.76). BMI SDS at presentation was 2.67 (−0.55 to 4.22) and 31/42 (76%) of girls were overweight/obese (BMI SDS >1.75).

Androgen levels were elevated in 28/42 (67%) of girls, SHBG was low (<25 nmol/l) in 26/42 (62%) and LH: FSH ratio was >2 in 12/42 (29%).

28 (67%) girls underwent an oral glucose tolerance test of whom 4 (14%) had impaired glucose tolerance (glucose >7.8 mmol/l at 2 h). Fasting glucose and insulin was measured in 26/42 (62%) girls of whom 17 (65%) had insulin resistance (HOMA-IR >3). Fasting lipid profile was measured in 32 (76%) girls of whom 27 (84%) had an unfavourable profile in one or more parameters (cholesterol, triglycerides, HDL cholesterol and LDL cholesterol).

Conclusions: In our population PCOS is not associated with LBW however, obesity, insulin resistance and dyslipidaemia are common. Effective interventions need to be developed to mitigate the long-term burden of metabolic disease and infertility.