Polycystic Ovary Syndrome in Adolescence

Baumann, Elizabeth; Rosenfield, Robert L.

doi:10.1097/00019616-200207000-00011

Cited by 24 publications

(10 citation statements)

References 138 publications

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“…We studied 75 subjects (23 obese and 21 nonobese adolescents with PCOS, 31 nonobese healthy controls). Based on the criteria derived from the 1990 National Institutes of Health (NIH) conference, the diagnosis of PCOS was made by the presence of chronic oligoanovulation ( 6 menses/year), hirsutism (Ferriman‐Gallwey score 8) in association with elevated circulating androgen levels and exclusion of other causes of hyperandrogenism 1,14,15 . The control group comprised of healthy adolescent girls with normal weight and regular menses who had no signs of clinical or biochemical hyperandrogenism.…”

Section: Methodsmentioning

confidence: 99%

“…Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorder in women of reproductive age. It seems to begin in the perimenarcheal period and the symptoms and signs of PCOS typically date back to adolescence 1 . Although, originally considered a gynaecological disorder, the syndrome is associated with a wide range of endocrine and metabolic abnormalities, including insulin resistance and dyslipidaemia.…”

Section: Introductionmentioning

confidence: 99%

“…It seems to begin in the perimenarcheal period and the symptoms and signs of PCOS typically date back to adolescence. 1 Although, originally considered a gynaecological disorder, the syndrome is associated with a wide range of endocrine and metabolic abnormalities, including insulin resistance and dyslipidaemia. PCOS is a risk factor for the early development of type 2 diabetes mellitus and associated cardiovascular risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Serum leptin, oxidized low density lipoprotein and plasma asymmetric dimethylarginine levels and their relationship with dyslipidaemia in adolescent girls with polycystic ovary syndrome

Demirel¹,

Bıdecı²,

Cınaz³

et al. 2007

Clinical Endocrinology

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Serum leptin, oxidized low density lipoprotein and plasma asymmetric dimethylarginine levels and their relationship with dyslipidaemia in adolescent girls with polycystic ovary syndrome

Demirel¹,

Bıdecı²,

Cınaz³

et al. 2007

Clinical Endocrinology

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“…P OLYCYSTIC OVARY SYNDROME (PCOS), a variable constellation of anovulatory hyperandrogenism with hyperinsulinemia and/or dyslipidemia, is the most frequent endocrine disorder of young women (1)(2)(3). One of the physical stigmata of women with PCOS, even if nonobese, is an excess of central fat and a deficit of lean mass, both of which seem to be reflections of the prolonged dysadipocytokinemia that accompanies hyperinsulinemic hyperandrogenism and that is aggravated by monotherapy with an oral estroprogestagen contraceptive (OC) even with an OC containing drospirenone (4 -8).…”

mentioning

confidence: 99%

Flutamide-Metformin plus Ethinylestradiol-Drospirenone for Lipolysis and Antiatherogenesis in Young Women with Ovarian Hyperandrogenism: The Key Role of Metformin at the Start and after More than One Year of Therapy

Ibáñez

Zegher

2005

The Journal of Clinical Endocrinology & Metabolism

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Flutamide (Flu)-metformin (Met) with ethinylestradiol-drospirenone is a combination therapy that reduces the total and abdominal fat excess, diminishes the lean mass deficit, and attenuates the dysadipocytokinemia of young and nonobese women with ovarian hyperandrogenism, a variant of polycystic ovary syndrome. We have now questioned the need: 1) to add Met at the start of Flu plus ethinylestradiol-drospirenone; and 2) to maintain Met after more than 1 yr on full combination therapy. The additive effects of Met (850 mg/d) were assessed in studies A and B, over 3 months, in young patients with hyperinsulinemic hyperandrogenism. In study A, all participants [n = 31; age approximately 16 yr; body mass index approximately 22 kg/m(2)] started on Flu (62.5 mg/d) and an oral contraceptive (ethinyl-estradiol + drospirenone), and they were randomized to receive Met in addition or not. In study B, all participants (n = 42; age approximately 19 yr; body mass index approximately 22 kg/m(2)) had been treated with Flu-Met plus the same contraceptive for a mean duration of 17 months, and they were randomized for discontinuation of Met or not. Fasting blood glucose, serum insulin, testosterone, lipid profile, adiponectin, and IL-6 were determined at the start and after 3 months, together with body composition, by dual energy x-ray absorptiometry. The results of studies A and B complemented each other; the addition of Met was found to have consistently (more) normalizing effects on IL-6 and adiponectin, on lean mass (mean Met benefit of +1.2 kg in study A and +0.6 kg in study B), and in particular on abdominal fat excess [Met benefit of -0.7 kg (A) and -0.3 kg (B)]. In conclusion, Met proved to be a pivotal component of a prime combination therapy that attenuates the dysadipocytokinemia, the lean mass deficit, and the central adiposity of young patients with polycystic ovary syndrome.

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“…The differential diagnosis of hyperandrogenism includes virilizing disorders and drugs as diverse as anabolic steroids and valproic acid (Box 2) [78,79]. The most common of these is nonclassic congenital adrenal hyperplasia caused by 21-hydroxylase deficiency [80].…”

Section: Differential Diagnosismentioning

confidence: 99%

Polycystic Ovary Syndrome in Adolescence

Driscoll

2003

Semin Reprod Med

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Polycystic ovary syndrome (PCOS) is a syndrome of variable combinations of menstrual irregularity, hirsutism or acne, and obesity. It can be diagnosed in adolescence and has early childhood antecedents. PCOS is the single most common endocrine cause of anovulatory infertility and a major risk factor for the metabolic syndrome and, in turn, development of type 2 diabetes mellitus (T2DM) in women. Thus, it appears that PCOS increases a woman's risk of developing cardiovascular disease. Therefore, identifying girls at risk for PCOS and implementing treatment early in the development of PCOS may be an effective means of preventing some of the long-term complications associated with this syndrome. This article reviews the definition, clinical features, diagnosis, and treatment of PCOS. Definition Classic polycystic ovary syndromeThe classic syndrome originally was described in 1935 by Stein and Leventhal as the association of amenorrhea with polycystic ovaries in women, of whom about two thirds were hirsute, and one half were obese [1]. The term PCOS was introduced upon recognition of a broader spectrum of clinical symptoms and ovarian histology, including stromal hyperplasia with multiple subcapsular follicles. Approximately two-thirds of patients with classic PCOS have hirsutism (or hirsutism equivalents, acne vulgaris or pattern alopecia), two-thirds have anovulatory symptoms (manifested as amenorrhea, oligomenorrhea, dysfunctional uterine bleeding, or unexplained infertility), and one-half are obese. Thus, only about one-third of classic cases have the full-blown clinical picture (Fig. 1). The laboratory diagnostic criteria for classic PCOS require biochemical evidence of hyperandrogenism with either a polycystic ovary by ultrasound or an increased serum level of luteinizing hormone (LH) or LH to follicle-stimulating hormone (FSH) ratio. These criteria have proven to not necessarily coincide (Fig. 2). Nonclassic and atypical polycystic ovary syndromeIn 1990, the National Institutes of Health (NIH) Conference on PCOS considered the implications of recent research findings for the diagnosis [2]. Fifty percent to 60% of those present concurred that the criteria for PCOS should consist of chronic anovulation with clinical or biochemical signs of hyperandrogenism that was not explained by other etiologies. This recognized the spectrum of the syndrome to include androgen excess in the absence of ultrasonographic and gonadotropic abnormalities (here termed nonclassic PCOS). NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe androgen excess of PCOS usually results from characteristic types of functional ovarian hyperandrogenism (FOH) or functional adrenal hyper-androgenism (FAH) [3,4]. FOH is gonadotropin-dependent excessive ovarian androgen production, and it occurs in most women with classic PCOS. It is also found in an equal number of hyperandrogenic women who do not meet the criteria for classic PCOS. It is characterized by 17-hydroxyprogesterone hyper-responsiveness to gonadotropin...

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Polycystic Ovary Syndrome in Adolescence

Cited by 24 publications

References 138 publications

Serum leptin, oxidized low density lipoprotein and plasma asymmetric dimethylarginine levels and their relationship with dyslipidaemia in adolescent girls with polycystic ovary syndrome

Serum leptin, oxidized low density lipoprotein and plasma asymmetric dimethylarginine levels and their relationship with dyslipidaemia in adolescent girls with polycystic ovary syndrome

Flutamide-Metformin plus Ethinylestradiol-Drospirenone for Lipolysis and Antiatherogenesis in Young Women with Ovarian Hyperandrogenism: The Key Role of Metformin at the Start and after More than One Year of Therapy

Polycystic Ovary Syndrome in Adolescence

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