Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls

Rieder, Jessica; Santoro, Nanette; Cohen, Hillel W.; Marantz, Paul R.; Coupey, Susan M.

doi:10.1016/j.jadohealth.2008.02.003

Cited by 13 publications

(5 citation statements)

References 38 publications

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“…6.1% exhibited the best diagnostic performance. Although these values are higher than those previously reported by other groups [19][20][21], they are similar to reports of PCOS in obese adolescents [22]. A cautious analysis of the assay of androgens should be performed in girls without clinical hyperandrogenism.…”

Section: Discussionsupporting

confidence: 85%

Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents

Villarroel

López

Merino

et al. 2015

Gynecological Endocrinology

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We evaluated the association of hirsutism and oligomenorrhea (persistent menstrual cycles > 45 days) as screening criteria for the detection of biochemical hyperandrogenism (BH) and polycystic ovaries (PCOM) during adolescence and determined which androgens, granulosa cell hormone, ultrasonographic parameters have the best association with polycystic ovary syndrome (PCOS). Hirsute girls with oligomenorrhea (N = 26 Hirs/Oligo group) and non-hirsute girls with regular cycles (N = 63, C group) were studied. Prevalence of BH and PCOM, diagnostic performance of androgens and ultrasound parameters for PCOS diagnosis were analyzed. BH and PCOM prevalence were higher in the Hirs/Oligo girls than in the C girls (76.9% versus 25.5%; 92.3% versus 33.3%, respectively; p < 0.0001). A complete PCOS phenotype (Hirs/Oligo with BH and PCOM) was observed in 73.1% of the Hirs/Oligo group. The presence of both BH and PCOM was observed in 7.9% of the C group. The parameters with the best diagnostic performance were free androgen index ≥6.1, testosterone ≥2.4 nmol/L, follicle number ≥12 and ovarian volume ≥10 ml anti-Müllerian hormone (AMH) exhibited a low diagnostic accuracy. Hirsutism and persistent menstrual cycle over 45 days are highly associated with BH and PCOM suggesting that the presences of both criteria are necessary for the diagnosis of PCOS during adolescence.

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Section: Discussionsupporting

confidence: 85%

Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents

Villarroel

López

Merino

et al. 2015

Gynecological Endocrinology

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“…Hyperandrogenemia was defined as total testosterone >41ng/dL and/or free testosterone >3.9pg/mL, according to our clinical laboratory’s reference ranges. Control subjects, matched for age and BMI, had regular monthly menstrual cycles, defined as ≥10 menses per year (14), and no clinical evidence of hyperandrogenism. Subjects were excluded if they were taking any hormonally active medication including insulin sensitizers or oral contraceptive pills, were pregnant, or had other endocrine disorders.…”

Section: Methodsmentioning

confidence: 99%

Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls

Kenigsberg

Agarwal

Sin

et al. 2015

Fertility and Sterility

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Objectives Evaluate ovarian morphology using 3-dimensional MRI in adolescent girls with and without PCOS. Compare the utility of MRI versus ultrasonography (US) for diagnosis of PCOS Design Cross-sectional Setting Urban academic tertiary-care children’s hospital Patients Thirty-nine adolescent girls with untreated PCOS and 22 age/BMI-matched controls. Intervention MRI and/or transvaginal/transabdominal US Main Outcome Measure Ovarian volume (OV); follicle number per section (FNPS); correlation between OV on MRI and US; proportion of subjects with features of polycystic ovaries on MRI and US. Results MRI demonstrated larger OV and higher FNPS in subjects with PCOS compared to controls. Within the PCOS group, median OV was 11.9 (7.7) cm3 by MRI, compared with 8.8 (7.8) cm3 by US. Correlation coefficient between OV by MRI and US was 0.701. Due to poor resolution, FNPS could not be determined by US or compared with MRI. ROC curve analysis for MRI demonstrated that increasing volume cut-offs for polycystic ovaries from 10cm3 to 14cm3, increased specificity from 77% to 95%. For FNPS on MRI, specificity increased from 82% to 98% by increasing cut-offs from ≥12 to ≥17. Using Rotterdam cut-offs, 91% of subjects with PCOS met polycystic ovary criteria on MRI, while only 52% met criteria by US. Conclusions US measures smaller OV than MRI, cannot accurately detect follicle number, and is a poor imaging modality for characterizing polycystic ovaries in adolescents with suspected PCOS. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI should be considered as a diagnostic imaging modality.

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“…The problem to define biochemical HA during adolescence is related to the physiological increase in androgen levels during puberty, which is associated with lower SHBG levels, thus increasing free androgens (29,34). The presence of signs of insulin resistance (higher waist circumference and lower SHBG) as well as hyperandrogenemia (increased FAI) has been associated with irregular menstrual cycles and with an hyperandrogenic phenotype in a group of Hispanic adolescents (34).…”

Section: Arq Bras Endocrinol Metab 2011;55/8mentioning

confidence: 99%

A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

Merino

Codner

Cassorla

2011

Arq Bras Endocrinol Metab

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SUMMARYPolycystic ovarian syndrome (PCOS) is a lifelong disorder characterized by hyperandrogenism and ovulatory dysfunction, with a wide spectrum of clinical symptoms and signs. Three different sets of diagnostic criteria have been established in order to define this disease in adult women, but there is controversy regarding the use of these criteria in adolescence. During puberty, the adult criteria for ovulatory dysfunction does not seem applicable, because an irregular menstrual pattern and a decreased ovulatory rate is a physiologic event during this period of life. Also, a higher prevalence of polycystic ovarian morphology (PCOM) may be observed during this period, so PCOM is not a useful criterion to define PCOS in young women. These findings suggest that a key factor to diagnose to PCOS during adolescence is hyperandrogenism. In addition, since PCOM is not clearly associated with hyperandrogenism during this period of life, the term "polycystic ovarian syndrome" during adolescence creates confusion and may be misleading. Arq Bras Endocrinol Metab. 2011;55(8):590-8 Keywords Hyperandrogenism; hirsutism; polycystic ovarian syndrome; adolescence; diagnosis; puberty; polycystic ovarian morphology; menstrual irregularities; anti-Müllerian hormone SUMáRio A síndrome dos ovários policísticos (SOP) é uma desordem que afeta pacientes por toda a vida e é caracterizada por hiperandrogenismo e disfunção ovariana, com um amplo leque de sintomas e sinais clínicos. Três diferentes conjuntos de critérios diagnósticos foram estabelecidos para definir essa doença em mulheres adultas, mas existem controvérsias relacionadas ao uso desses critérios na adolescência. Durante a puberdade, o critério de disfunção ovariana usado em adultos não parece aplicável, porque um padrão menstrual irregular e uma menor taxa de ovulação são eventos fisiológicos nesse período da vida. Além disso, uma maior prevalência de morfologia ovariana policística (MOP) pode ser observada nesse período, de forma que a MOP não é um critério útil para se definir a SOP em mulheres jovens. Esses achados sugerem que o hiperandrogenismo é um fator-chave para o diagnóstico da SOP na adolescência. Além disso, como a MOP não está claramente associada com o hiperandrogenismo durante esse período da vida, o termo "síndrome dos ovários policísticos" durante a adolescência cria confusão e pode ser errôneo. Arq Bras Endocrinol Metab. 2011;55(8):590-8 Descritores

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Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls

Abstract: Purpose-To determine whether key associated features of hyperandrogenic anovulation (HA) in predominately Caribbean-Hispanic (CH) adolescent girls can be combined to improve the early diagnosis of HA.

Cited by 13 publications

References 38 publications

Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents

Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents

Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls

A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

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