Characterizing the Adolescent Premature Ovarian Insufficiency Phenotype: A Case Control Study

Abstract

To characterize the skeletal, cardiometabolic, cognitive, and mental health phenotype of adolescents with idiopathic premature ovarian insufficiency (POI) DESIGN: Case control SETTING: Pediatric tertiary referral center in Cincinnati, Ohio PARTICIPANTS: Nine adolescents (ages 11-18.99 years) with newly diagnosed POI and 9 normally menstruating controls, matched by age and body mass index MAIN OUTCOME MEASURES: Between-group comparisons of bone characteristics assessed by dual energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), psychosocial health (anxiety, depression, and quality of life), and cognition and memory by questionnaire RESULTS: Adolescents with POI had lower bone density Z-scores by DXA (lumbar spine -1.93vs 0.80; whole body less head -2.05vs 0.00; total hip -1.03vs 0.83; and femoral neck -1.23vs 0.91; all P < .001), as well as lower trabecular volumetric bone mineral density (tibia 3% site 226vs 288mg/mm3, P < .001; radius 3% site 200vs 251, P=.001), smaller cortical area (tibia 66% site 251vs 292 mm2, P=.028), and thickness (tibia 66% site 3.56vs 4.30mm, P=.001) than controls. No abnormalities in cardiometabolic biomarkers were detected in POI cases. Adolescents with POI were also more likely to report low energy (78% vs 22%, P=.02). Estrogen deficiency adversely affects bone health in adolescents with POI. However, we did not find associations with cardiometabolic, mental health, or cognitive outcomes in this small sample.