Polycystic Ovary Syndrome In Adolescents Research Articles

Letter to the Editor From de Zegher and Ibáñez: "Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome".

Letter to the Editor From de Zegher and Ibáñez: "Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome".

Response to Letter to the Editor from de Zegher and Ibáñez: "Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome".

Response to Letter to the Editor from de Zegher and Ibáñez: "Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome".

Comparative Management Methods for Adolescents With Polycystic Ovarian Syndrome: A Systemic Review.

Polycystic ovarian syndrome (PCOS) is a common endocrinological disorder affecting many adolescents and women of reproductive age worldwide. A diagnosis of PCOS in adolescence relies upon investigating each medical history independently and noting commonly associated symptoms, including obesity, insulin resistance, acne, menstrual abnormalities, and hirsutism. Many researchers are aiming to discover a methodology to help manage the symptoms associated with PCOS, especially in adolescents. This review will investigate management methods possible for adolescents with PCOS. Although the most preferred way to help reduce symptoms is through lifestyle modifications such as vigorous exercise and dietary regimens low in carbohydrates, pharmaceuticals are also offering promising results to adolescents with PCOS. Metformin, oral contraceptives, gonadotropin-releasing hormone (GnRH) antagonists, and other alternatives, including finasteride, eflornithine, fibroblast growth factors (FGFs), and vitamin D, are all shown to help improve insulin sensitivity and regulate menstrual cycles and reduce hirsutism. Epilatory and surgical measurements are also available; however, they are reserved for when all other methods fail and once adulthood or an appropriate age is reached. Although there are many pharmaceuticals available, it is necessary to evaluate each adolescent with PCOS uniquely and prescribe the appropriate pharmacotherapy regarding their symptoms.

Association of anti-Müllerian hormone and insulin resistance in adolescent girls with polycystic ovary syndrome.

Insulin resistance (IR) is confirmed as an important feature among polycystic ovary syndrome (PCOS) patients. Anti-Müllerian hormone (AMH), a vital marker of ovarian dysfunction, is proposed for inclusion in the diagnosis of PCOS in adolescents. We sought to investigate the relationship between the AMH level and IR in Chinese girls with PCOS. 92 girls with PCOS aged 14-18 years were enrolled and divided into 2 subgroups: PCOS with IR group (n = 25) and PCOS without IR group (n = 67). A homeostasis model assessment-insulin resistance (HOMA-IR) value ≥ 2.5 was defined as IR. Clinical data and biochemical indexes were compared between the 2 groups. Multivariate logistic regression analysis and multivariate linear regression analysis were performed to determine which clinical variables were independently associated with IR and AMH level, respectively. PCOS girls with IR had higher levels of AMH than those of PCOS girls without IR (p < 0.01). Moreover, body mass index, triglyceride, and AMH values were shown to be independent risk factors for HOMA-IR after multivariate analysis. Meanwhile, age, insulin, and follicle-stimulating hormone levels were significantly related to AMH levels in those girls. Our findings show that AMH is an independent determinant of IR in PCOS adolescents, and the fasting insulin level is closely associated with the AMH level, which indicates that the AMH pathway might play a role in the development of IR in PCOS adolescents. The interaction between AMH and IR in PCOS girls warrants further large-scale evaluation.

Management of Adolescent PCOD: A Real Challenge

Background: Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting 5-10% of women worldwide, characterized by irregular menstrual cycles and cysts on the ovaries. Its exact cause is unknown, but early identification and intervention can reduce the risk of complications like diabetes and heart disease. PCOS manifests in various ways, impacting reproductive, cosmetic, metabolic, and psychological aspects. Prevalence is higher in certain ethnic groups, and diagnosis can occur in adolescence but is often delayed. Despite its global impact, most studies focus on developed countries. Aim of the study: The study aims to explore the diagnosis and treatment procedures for managing adolescent PCOD in Bangladesh. Methods: This study, conducted at the Holly lab hospital &amp;Missionary Hospital Brahmanbaria, Bangladesh. The study spanned one year from January 2023 to December 2023. Diagnosis relied on clinical and biochemical evidence of hyperandrogenism and persistent menstrual irregularities. A one-on-one interview gathered comprehensive medical information. Inclusion criteria covered females aged 10 to 19, while exclusions involved specific medical conditions and ongoing treatments. Statistical analyses using SPSS included expressing variables and logistic regression to identify metabolic syndrome risk factors. The significance level was set at p ≤ 0.05 for statistical relevance. Result: The study involves 107 adolescent participants with Polycystic Ovary Syndrome (PCOD). Most were aged 10-15 (55.14%) with an average age of 16.8. BMI analysis showed high prevalence of overweight (29.70%) and obesity (39.40%). Abdominal obesity was normal in 76.60%, while 20.00% were pre-hypertensive, and 3.40% had hypertension. Glycemic status varied, with 76.00% normoglycemic, 21.10% prediabetic, and 2.90% diabetic. Dyslipidemia was present in 90.90%, and metabolic syndrome in 42.30%. Biochemical hyperandrogenism was observed in 33.70%. PCOD features included hirsutism (94.90%) and menstrual irregularities (oligomenorrhea 87.85%). Ovarian morphology showed diverse patterns. Hyperandrogenism, ovulatory dysfunction, ovarian morphology, and metabolic factors were primary contributors to PCOD diagnosis. Treatment approaches varied, including classical interventions (34.58%), lifestyle changes (14.95%), combined oral contraception (12.15%), and antiandrogens (7.48%). Therapeutic treatments included N-acetylcysteine, Inositol, Vitamin D supplementation, and Chromium supplementation. Conclusion: Managing adolescent Polycystic Ovary Syndrome (PCOS) is challenging due to the high prevalence of metabolic complications. Diagnostic complexity emphasizes careful evaluation to prevent premature labelling and psychological stress. Treatment involves lifestyle interventions, hormonal contraceptives, and anti-androgen medications. Standardized diagnostic criteria and a multidisciplinary approach are crucial. Early intervention and continuous monitoring are essential for mitigating long-term health risks. Further research on PCOS in diverse populations is recommended for tailored interventions and a nuanced understanding.

A Complete Overview of the Polycystic Ovarian Syndrome with Recent Advancement in Clinical Trial

Background: Polycystic ovarian syndrome (PCOS) has emerged as one of the most common endocrine and metabolic disorders seen in women of childbearing age throughout the whole world. The complex pathophysiology, different diagnostic criteria, and various manifestations attached to several environmental factors, including lifestyle influences, have made it one of the most difficult disorders to treat in recent times. In addition, inadequate knowledge among patients and a lack of dedicated approved medications have only enhanced the difficulties in treating such a heterogeneous disorder. Objective: The main objective of this review-type paper is to provide a detailed overview of PCOS along with the current concept of a clinical stance in this complex multigenic disorder. Method: The following databases were used for literature searches: PubMed, Frontiers, Science Direct, Springer, Wiley, and MDPI. For the purpose of finding pertinent articles and contents, the keywords “PCOS; hirsutism; psychological burden; obesity” and others of a similar nature were utilized. Conclusion: PCOS is a complicated hormonal, metabolic, and psychological condition with many different clinical manifestations. It is among the most prevalent causes of infertility. Before considering any medication choices, lifestyle modifications should be considered the primary therapeutic prescription for PCOS-related infertility. According to recent studies, PCOS does not affect the risk of ovarian or breast cancer, but it does raise the risk of endometrial cancer in women of all ages. These results suggest that PCOS may increase the risk of gynaecological cancer morbidity. The following stage is ovulation stimulation, which is best accomplished with letrozole and is followed by clomiphene citrate. Women who had not responded to the first-line oral ovulatory medicine were given gonadotropins as a backup. Early detection of girls with a high propensity to develop PCOS will be made possible by a comprehensive knowledge of the condition's etiology. Adolescent PCOS will be better managed overall, related comorbidities will be prevented, and quality of life will increase with customized therapeutic approaches.

Impact of Polycystic Ovary Syndrome on Periodontal Status of Women of Adolescent and Adult Age Groups: A Cross-Sectional Study

Objective: Polycystic ovary syndrome (PCOS) is identified as the most common endocrine disorder in reproductive-aged women, and symptoms of PCOS appear during the early pubertal age. There is a gap in knowledge in recognizing the status of gingival inflammation/periodontal destruction and high-sensitivity C-reactive protein levels (hsCRP) in adolescents versus adults with PCOS. This study aimed to observe the impact of PCOS on periodontal status and systemic inflammation in adolescents and compared them with adults with PCOS. Methods: A total of 100 newly diagnosed female subjects with PCOS were enrolled into two groups: adolescents (11–19 years, n = 50) and adult females (20–40 years, n = 50). Periodontal parameters, anthropometric parameters, PCOS phenotype, hirsutism score, and serum hsCRP levels were recorded. Results: High levels of mean hsCRP, gingival index, and bleeding on probing % were observed in adolescent and adult PCOS groups, though nonsignificant between the groups (p > 0.05). Significantly more sites with probing pocket depth 3–4 mm, higher mean clinical attachment level (CAL) and sites with CAL 1–2 mm, and high frequency of patients (n = 11) with periodontitis (stage 1) were observed in adults with PCOS compared to adolescents (p ≤ 0.05). Similar and predominant prevalence of PCOS phenotype A (66%) and moderate hirsutism (46% adolescents vs. 58% adults) were observed in both groups. Conclusion: Similar levels of hsCRP and periodontal inflammation were found in adolescents and adults with PCOS. More periodontal tissue destruction was observed in adults with PCOS as compared to adolescents with PCOS.

Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a heterogenous clinical syndrome defined by hyperandrogenism and irregular menses. In adult women with PCOS, discrete metabolic and reproductive subgroups have been identified. We hypothesize that distinct phenotypes can be distinguished between adolescent girls who are lean (LN-G) and girls with obesity (OB-G) at the time of PCOS diagnosis. Data were extracted from the CALICO multisite PCOS database. Clinical data collected at the time of diagnosis were available in 354 patients (81% with obesity) from 7 academic centers. Patients with body mass index (BMI) < 85th percentile for age and sex were characterized as lean (LN-G) and those with BMI percentile ≥ 95th percentile as obese (OB-G). We compared metabolic and reproductive phenotypes in LN-G and OB-G. Reproductive phenotypes differed between the groups, with LN-G having higher total testosterone, androstenedione, and LH levels, while OB-G had lower sex hormone binding globulin (SHBG) and higher free testosterone. Metabolic profiles differed as expected, with OB-G having higher hemoglobin A1c, alanine aminotransferase, and serum triglycerides and more severe acanthosis nigricans. LN-G with PCOS had a distinct reproductive phenotype characterized by increased LH, total testosterone, and androstenedione levels, suggesting neuroendocrine-mediated ovarian androgen production. In contrast, phenotypes in OB-G suggest hyperandrogenemia is primarily driven by insulin resistance with low SHBG levels. These observations support the existence of distinct metabolic and reproductive subtypes in adolescent PCOS characterized by unique mechanisms for hyperandrogenemia.

Is There a Difference in Hirsutism Score in Adolescents with Polycystic Ovary Syndrome on the Basis of Ethnicity and Race?

BackgroundThe complex correlation between ethnicity and race, clinical hyperandrogenism as signified by hirsutism, and biochemical androgen concentrations in Polycystic Ovary Syndrome (PCOS) is poorly understood. Study ObjectiveThe study aims to define the correlation between ethnicity/race and hirsutism score in patients with PCOS. MethodsWe conducted a retrospective chart review of a total of 251 patients with PCOS at the time of diagnosis. Patients were categorized by their ethnicity and race into five main groups: Asian (n=19, 7.6%), Black or African American (n=11, 4.4%), Hispanic or Latino (n=26, 10.3%), White (n=177, 70.5) and others (n=18, 7.2%). General Linear Model was applied using BlueSky Software. ResultsFor the entire study population, the mean age at diagnosis was (15.6±1.7), the mean body mass index (BMI) was (30.6±9.8), the mean hirsutism score using the modified Ferriman-Gallwey (mFG) score chart was (6.2±3.8), and the mean total testosterone was (40.1±20). The hirsutism score was the highest in Asian population (mean=9.1, p=0.002) and Hispanic or Latino population (mean=7.8, p=0.02) followed by others (mean=7.4, p=0.04) and Black or African American population (mean=7.1, p=0.2) compared to White population (mean=5.4). This correlation remained significant despite accounting for BMI and androgen levels (p<0.001). ConclusionThere are factors likely related to hair follicle sensitivity or endogenous response to circulating free androgens that differ between ethnicities and races, such that similar biochemical concentrations lead to differing severity of hirsutism, despite accounting for differences in BMI and androgen levels. More research is needed in this realm to understand the pathophysiologic basis of this interaction.

Pregnancy and Early Life Complications of PCOS

This presentation delves into the wide-ranging effects of Polycystic Ovary Syndrome (PCOS) on women’s lives, specifically exploring its manifestations during adolescence and pregnancy. Starting with PCOS in early life, we delve into the hormonal shifts of puberty and their connection to PCOS development. Challenges of diagnosing PCOS in adolescents are discussed, along with the distinct cardiometabolic and psychological issues they face. The section concludes with pragmatic insights into the 2023 PCOS Guideline’s recommendations for managing PCOS during these pivotal years. Moving to PCOS during pregnancy, attention shifts to the complex hormonal and physiological adjustments the female body undergoes to support foetal growth. PCOS-related mechanisms that might contribute to pregnancy complications are examined. In addition, we present evidence from 2023 PCOS Guideline meta-analyses revealing the various pregnancy complications in this high-risk population. Concluding, we navigate antenatal care terrain aligned with the 2023 Guideline and present evidence on metformin’s role in PCOS pregnancies. This presentation provides a comprehensive view of PCOS from adolescence to pregnancy. By integrating up-to-date guidelines and evidence, it aims to equip healthcare professionals with practical insights for navigating PCOS’s complexities, ultimately improving patient care.

The Role of the Gut Microbiome in Youth with Polycystic Ovary Syndrome: A Systematic Review.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age and female adolescents. The diagnosis of PCOS is difficult during puberty due to overlapping of the criteria with normal variations of menstruation during this age period. There are insufficient data on the gut microbiome and PCOS and potential mechanisms linking the two. The present systematic review aimed to detect dysbiosis patterns in youth with PCOS, compared with healthy controls. One hundred seventy-eight studies were identified by a databases search and sixty-eight by a full-text assessment for eligibility; four were included in the systematic review and underwent quality control. The results of the study were controversial in accordance to findings from the literature. A change in gut microbiome α diversity was found in PCOS adolescents, with no significant alterations in β diversity. Almost all studies found Firmicutes, Bacteroidetes, and Actinobacteria in abundance in both groups, with changes in family composition and fluctuations at the phylum level. A statistically significant association between these changes and clinical or biochemical features of the syndrome was described. This systematic review confirmed gut microbiota dysbiosis in youth with PCOS. However, further data are needed to clarify these changes and to build a strategy to prevent the syndrome.

Eating behavior, physical activity, and exercise training in adolescent polycystic ovary syndrome

Eating behavior, physical activity, and exercise training in adolescent polycystic ovary syndrome

Adolescent polycystic ovary syndrome without obesity: HOTAIR rs1443512 genotype relates to fat mass and to the redistribution of fat mass on low-dose pioglitazone.

Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligo-amenorrhea, and often results from ectopic lipid storage due to a mismatch between early adipogenesis and later lipogenesis. Endogenous HOX transcript antisense RNA (HOTAIR) and exogenous pioglitazone are enhancers of subcutaneous adipogenesis, particularly in the gluteofemoral region. The A allele of HOTAIR rs1443512 is an equivalent of a natural knock-down and is, thus, a candidate to influence the distribution of fat mass, and also the redistribution of fat mass by pioglitazone in adolescent PCOS-without-obesity. We performed two post hoc analyses by HOTAIR rs1443512 genotype. In the first, we analyzed the pooled pre-treatment data (auxology; endocrinology; body composition by dual X-ray absorptiometry; abdominal fat distribution by magnetic resonance imaging) of 65 adolescent girls with PCOS-without-obesity in three reported studies (ISRCTN45546616; ISRCTN29234515; ISRCTN11062950). In the second, we analyzed the results of 24 adolescent girls with PCOS-without-obesity, who received pioglitazone (7.5 mg/d for 1 year) as part of a randomized combination treatment (with spironolactone and metformin) in two reported studies (ISRCTN29234515; ISRCTN11062950). All data had been obtained in a blinded-to-genotype way. The pre-treatment data disclosed that the girls-with-A-allele of HOTAIR rs1443512 had developed PCOS with a lower BMI (22.3 ± 2.3 kg/m2; N = 17) than the other girls (24.1 ± 2.7 kg/m2; N = 48), this difference being essentially attributable to a lower fat mass (mean difference 4.6 kg; P < 0.01). On low-dose pioglitazone, girls-with-A-allele (N = 12) raised their fat mass while the other girls (N = 12) did not (total fat mass + 2.2 ± 1.8 kg vs - 0.9 ± 2.2 kg; P < 0.001), particularly in the gynoid area (gluteofemoral fat + 0.6 ± 0.4 kg vs - 0.1 ± 0.5 kg; hip circumference + 2.3 ± 1.9 cm vs - 1.7 ± 3.1 cm; both P < 0.001). The present findings suggest that the HOTAIR rs1443512 genotype influences not only the distribution of fat mass in adolescent girls with PCOS-without-obesity but also the redistribution of fat mass during prolonged treatment with low-dose pioglitazone. ISRCTN45546616 ( https://doi.org/10.1186/ISRCTN45546616 ). ISRCTN29234515 ( https://doi.org/10.1186/ISRCTN29234515 ). ISRCTN11062950 ( https://doi.org/10.1186/ISRCTN11062950 ).

SAT352 Reliability Of Two- And Three-dimensional Ultrasonographic Assessments Of Ovarian Morphology In Adolescents

Abstract Disclosure: E. Rahman: None. B. Smith: None. H. Vanden Brink: None. N. Zaman: None. A. Malik: None. T. Burgert: None. R. Barral: None. M.E. Lujan: None. Background: Distinct features of ovarian morphology using transabdominal ultrasonography (TAUS) have been observed in adolescents with polycystic ovary syndrome (PCOS). Standardized approaches to assess ovarian morphology using transvaginal ultrasonography result in excellent reliability and close agreement among multiple raters, which can lead to more precise estimates of follicle counts and ovarian size. The degree to which these methods translate to TAUS is unknown. Establishing standardized methods to analyze ovarian features via TAUS are needed to clarify the utility of ovarian morphology in the clinical evaluation of PCOS in adolescence. Objectives: To determine the reliability of follicle counts and ovarian size assessments obtained using 2D and 3D TAUS in early adolescence. Methods: Three raters evaluated images of 30 ovaries garnered from adolescents via TAUS (n=19, 6 - 20 months post-menarche) for the following 2D parameters: follicle number per ovary (2D FNPO), follicle number per cross-section (FNPS), ovarian volume (2D OV), ovarian area (OA) and stromal area (SA). Three dimensional assessments of follicle counts (3D FNPO) and ovarian volume (3D OV) were also performed using SonoAVCantralTM and VOCALTM software (GE Healthcare), respectively. Intraclass correlation coefficients (ICCs) were used to determine interrater reliability for each variable. An ICC &amp;lt;0.5 was defined as poor, 0.50-0.75 as moderate, 0.75-0.90 as good, and &amp;gt;0.900 as excellent reliability. Results: Across 2D measures of ovarian morphology, interrater reliability was highest for 2D FNPO (ICC = 0.698), followed by OA (0.655), SA (0.619), and FNPS (0.516). Ovarian volume measurements by 2D methods demonstrated poor reliability (0.297). Three-dimensional assessments of follicle counts were not associated with improved interrater agreement (0.609). By contrast, better reliability was detected for 3D OV versus 2D OV - albeit 3D measures still met criteria for poor reliability (0.397 vs 0.297). Conclusions: Assessments of ovarian morphology using TAUS are associated with moderate-to-poor reliability using standardized approaches. Follicle counts per ovary were moderately reliable with 2D and 3D TAUS, in contrast to OV which demonstrated poor reliability across raters irrespectively of modality. Poor reliability for measures of OV is concerning given current practice guidelines for the ultrasonographic assessment of PCOS advocate for measures of OV over FNPO when using TAUS. Factors impacting reliability, such as gynecological age, body habitus, and image quality will be evaluated in subsequent investigations to refine training, image acquisition protocols, and method development. Presentation: Saturday, June 17, 2023

Hepatokine Profile in Adolescents with Polycystic Ovary Syndrome: A Case-Control Study.

The current guidelines suggest routine screening for non-alcoholic fatty liver disease (NAFLD) in patients with polycystic ovary syndrome (PCOS). Hepatokines seem to be promising surrogate endpoints for the diagnosis and severity of NAFLD. PCOS has its onset in adolescence and its metabolic sequalae begin during the same period. There are scarce data on the hepatokine profile of adolescent PCOS patients. This case-control study examined the serum profile of the hepatokines sex hormone-binding globulin (SHBG), selenoprotein P, fibroblast growth factor 21 (FGF21), and fetuin A in a sample of adolescent PCOS patients, and their association to metabolic and hormonal parameters. The selenoprotein P and SHBG serum concentrations were significantly decreased in PCOS patients vs. the controls (median (IQR), 2.47 (0.40) vs. 2.66 (0.36) μg/mL, p = 0.025; mean ± SD, 41.71 ± 19.41 vs. 54.94 ± 22.12 nmol/L, p = 0.011, respectively), whereas selenoprotein P was significantly and positively associated with testosterone (r = 0.325, p = 0.007) and the free androgen index (r = 0.361, p = 0.002). The SHBG demonstrated multiple significant negative correlations with adverse metabolic parameters. Among the PCOS patients, the FGF21 concentrations were significantly higher in those with NAFLD, whereas a 1 pg/mL increase in the FGF21 concentration increased the odds of NAFLD diagnosis by liver ultrasound by 1%, suggesting FGF21 as a potential biomarker for hepatic disease in females with PCOS in adolescence. Fetuin A was the least differentiated hepatokine between the PCOS patients and controls with the least associations with metabolic and hormonal parameters.

Awareness of polycystic ovarian syndrome in adolescents: A cross-sectional study

Awareness of polycystic ovarian syndrome in adolescents: A cross-sectional study

Low-Calorie Ketogenic Diet: Potential Application in the Treatment of Polycystic Ovary Syndrome in Adolescents.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Hyperandrogenism, hyperinsulinism and insulin resistance (IR) are the main drivers of clinical, metabolic and reproductive phenotypes of PCOS. In adolescence, the cornerstones of PCOS treatment are lifestyle and dietary interventions. In particular, the quality and quantity of carbohydrates introduced with the diet play a crucial role in the benefits of diet on PCOS. Recently, the ketogenic diet (KD) has attracted significant interest for the treatment of IR and for the control of carbohydrate metabolism, which has proven to be beneficial for several dysmetabolic conditions, including PCOS. The goal of the KD is to induce a fasting-like metabolism with production of chetonic bodies. Ketosis is a good regulator of calorie intake and mimics the starvation effect in the body, leading to body weight control and consequent metabolism. Additionally, during ketogenesis, insulin receptor sensitivity is also promoted. We proposed a broad overview of the available literature regarding KD indications and considered its metabolic benefits useful for improving PCOS management. The reported data support that a low-calorie ketogenic diet (LCKD) plays a positive role as a regulator of control weight, IR, glucose and lipid homeostasis and hormonal profile. Unfortunately, the evidence concerning the benefits of the very LCKD in adolescents with PCOS and excessive body weight is still numerically scarce. Further studies are necessary to understand whether these effects are due to weight loss or to the nutritional characteristics of this diet. Considering the long-term consequences of PCOS, it is crucial to detect the prospects of nutritional interventions to protect fertility, starting in adolescence.

Prevalence of Polycystic Ovarian Syndrome in Girls with a History of Idiopathic Central Precocious Puberty

Introduction: The prevalence of polycystic ovarian syndrome (PCOS) in adolescent girls is between 1 and 4.3%. It remains controversial whether women with a history of idiopathic central precocious puberty (ICPP) are at increased risk for PCOS. Our objective was to assess the prevalence of PCOS in adolescents with a history of ICPP compared with healthy adolescents and the prevalence of PCOS among ICPP girls who have received or not gonadotropin-releasing hormone analogue (GnRHa) treatment. Methods: We assessed post-menarcheal girls with a history of ICPP. Girls were evaluated at gynecological age ≥2.5 years. Data collected were age at menarche, menstrual cycle characteristics, BMI, clinical hyperandrogenism (HA), total and free testosterone levels. PCOS diagnosis was defined by criteria for adolescents. Subjects were also analyzed regarding whether or not they had received GnRHa treatment. Results: Ninety-four subjects were assessed, and 63 had been treated with GnRHa. Menstrual disorders were found in 29%, clinical HA in 36%, and biochemical HA in 23%. Twelve percent met the diagnostic criteria for PCOS. There was no difference in BMI or in the incidence of menstrual dysfunction or hyperandrogenemia between treated and untreated patients. A higher proportion of clinical HA was found in untreated patients when compared to treated girls. The relative risk (RR) of developing PCOS in ICPP girls was 2.5 compared to a population of healthy adolescents. This RR was not higher in patients who received treatment with GnRHa than in those who did not. Conclusion: Adolescent girls with a history of ICPP have an increased risk of PCOS. This risk seems not to be related to GnRHa treatment.

Probiotics and Polycystic Ovary Syndrome: A Perspective for Management in Adolescents with Obesity.

Polycystic ovary syndrome (PCOS) affects a considerable percentage of females of reproductive age. PCOS is an obesity-related condition and its effects are greatly amplified by obesity. Even though the pathogenesis of PCOS remains complex and has not been fully elucidated, a link between obesity, PCOS, and dysbiosis has been described. The potential role of the gut microbiota in the development and progression of PCOS and its associated symptoms has also been reported. The aim of this narrative review is to present a non-systematic analysis of the available literature on the topic of probiotics and PCOS in adolescents with obesity in order to revise the beneficial effects of probiotics/symbiotic supplementation on hormonal and metabolic profiles and inflammatory conditions. The effectiveness of probiotics/synbiotics in PCOS has been supported. The literature suggests that probiotic/symbiotic supplementation may ameliorate hormonal profiles, inflammatory indicators, and lipid metabolism disturbances caused by PCOS. Studies also show improvements in weight, BMI, insulin, and HOMA-IR, including a potential role it plays in protecting fertility. Even though further studies are needed to confirm these findings, particularly in adolescent patients, probiotic supplementation may be considered a solution for managing PCOS in adolescents with obesity.

Polycystic Ovarian Syndrome In Some Sample Of Iraqi Adolescents: Implementation Of Consensus Guidelines

Background: The diagnosis of polycystic ovarian syndrome (PCOS) in adolescent girls can be difficult because symptoms are shared with normal pubertal development. The updated consensus guideline for PCOS diagnosis in adolescents sought to encourage accurate and timely diagnosis, optimize therapy, and improve health outcomes. Aim: the present study aims to implement an updated consensus criteria in the diagnosis of PCOS in adolescents complaining of clinical features of hyperandrogenism or menstrual abnormalities. Methods: A total of 60 patients with clinical features of hyperandrogenism and/or menstrual abnormalities were studied. A detailed history followed by clinical examination was taken. Serum Thyroid Stimulating Hormone, Cortisol, Total Testosterone, Dehydroepiandrosterone, Luteinizing Hormone (LH), and Prolactin were performed for all patients. Consensus criteria were used for PCOS diagnosis. Results: Menstrual irregularity was reported by 20 (33.3%) and hyperandrogenism features in 21(35%) of the participants. PCOS was confirmed in 14 (23%) participants. Patients diagnosed with PCOS were shown to have substantially higher rates of menstrual irregularity, hirsutism, elevated serum testosterone, and LH (P0.001, P0.001, P=0.002, and P0.002 respectively). Seven patients (50%) had both clinical and biochemical hyperandrogenism. Association between testosterone rise was more significant with hirsutism (P&lt;0.001) than with acne (P=0.001). Morbid obesity was observed in 21% of patients, 7% had their diastolic blood pressure 90mm Hg, and 39% had and fasting blood sugar ≥100 mg/dL. Conclusion: PCOS was diagnosed in 23% of adolescent girls who had features of hyperandrogenism and menstrual irregularities. Obesity and family history were more frequent in PCOS adolescents. Concordant clinical and biochemical hyperandrogenism was confirmed in only half of PCOS patients. PCOS patients may be at higher risk of metabolic syndrome.