Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention.

Highlights

  • No significant differences were observed in other parameters of lipid profile, including small dense low-density lipoprotein cholesterol (sdLDL-C) levels and its percentage on lowdensity lipoprotein cholesterol (LDL-C), glucose concentration, liver and renal markers, and carotid intima–media thickness (cIMT) values between the two groups (p > 0.05)

  • Our findings suggest that obese Polycystic ovary syndrome (PCOS)-adolescents present with a cluster of CVR factors (CVRFs) predisposing them to early atherosclerosis

  • We observed that the greatest impact of CVRFs on obese PCOS-adolescents may be due to obesity and not to PCOS itself

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Summary

Introduction

Evidence-based diagnostic criteria and management plans are well-established in adults, PCOS in adolescence presents several unresolved challenges [1,2]. The significant overlap of PCOS features with normal puberty hinders a widespread consensus on diagnostic criteria [3]. A recent metanalysis calculated the prevalence rates of adolescent PCOS based on three sets of criteria (Rotterdam, NIH, or AEPCOS) as 11%, 3.4%, and 8%, respectively [4]. Clinicians serving this age group must appropriately recognize PCOS, record important clinical features, and assess the presence of serious comorbidities

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