SUN-025 Obesity Severity and Polycystic Ovary Syndrome in an Ethnically Diverse Cohort of Adolescent Girls

Abstract

INTRODUCTION: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting young women and may present as early as adolescence. Early recognition is important, as polycystic ovary syndrome (PCOS) is associated with increased cardiometabolic risk and type 2 diabetes mellitus. The risk of PCOS increases with obesity, but fewer studies have explored the burden of PCOS in children with obesity within healthcare settings. In this study, we examined the proportion of adolescent girls with obesity who also had diagnosed PCOS and the relationship between PCOS and obesity severity.METHODS: From an existing cohort of nearly 8000 children age 3-17 with obesity (Body Mass Index, BMI ≥95th percentile) who were seen at pediatric well-child visits and identified for weight management based on BMI, we classified the subgroup of girls age 12-17 years who had moderate (BMI 100-119% of the 95th percentile) and severe (BMI ≥120% of the 95th percentile) obesity by PCOS status. Diagnosed PCOS was identified based on a visit diagnosis code for PCOS (ICD-9 256.4) within one year of the well child visit.RESULTS: We identified 1478 adolescent girls (age 12-17) with obesity, among whom 76 (5%) had a PCOS diagnosis. The burden of PCOS varied by race, including 4% among white, 7% among black, 5% among Hispanic, and 8% among Asians, respectively. The proportion with diagnosed PCOS was greater in severely obese patients (9%) compared to moderately obese (3%). By race/ethnicity, the proportion with PCOS among moderately obese/severely obese girls were as follows: white 2%/8%, black 4%/10%, and Hispanic 2%/9%, respectively. The Asian population had a higher proportion of PCOS (10%) among girls with moderate obesity, as fewer Asian girls had severe obesity overall.CONCLUSION: Among adolescent girls with obesity, the burden of PCOS varied by race/ethnicity and level of obesity. Increasing severity of obesity was associated with a greater proportion of girls having diagnosed PCOS, a trend that was reflected in white, black and Hispanic adolescent girls but not Asians, the latter due to their lower range BMI. These data highlight the prevalence of PCOS among adolescent girls with obesity and support the need for early identification and management prior to adulthood.