Spectrum of metabolic dysfunction in relationship with hyperandrogenemia in obese adolescent girls with polycystic ovary syndrome

Abstract

ObjectivePolycystic ovary syndrome (PCOS) in adult women is associated with increased risk of metabolic syndrome (MS) and atherosclerosis. We evaluated the spectrum of metabolic dysfunction in relationship with hyperandrogenemia (HA) in adolescent girls with PCOS.Materials and methodsOvulatory function, acne, hirsutism (HS), body mass index (BMI), body composition, fasting lipids, glucose, insulin, free testosterone (FT), high-sensitivity C-reactive protein (hs-CRP), and HbA1c were evaluated in 103 girls. The homeostatic assessment model equations (HOMA-IR and HOMA-%B) were used for determination of insulin resistance and β-cell function respectively.ResultsThe oligo-ovulation (Oligo)+HA+HS (n=44), Oligo+HA (n=28), and Oligo+HS (n=31) phenotypes had similar BMI. However, hyperandrogenemic phenotypes had higher prevalence of acanthosis nigricans (AN) and acne (P<0.01) and higher insulin, HOMA-IR, HOMA-%B, HbA1c, and hs-CRP levels than Oligo+HS group (P<0.01). Serum FT was correlated with HOMA-IR (r=0.38,P<0.01), HOMA-%B (r=0.49,P<0.01), hs-CRP (r=0.42,P<0.01), AN (r=0.39,P<0.01), and HbA1c (r=0.27,P<0.01). Furthermore, 34% of girls met diagnostic criteria for MS displaying higher BMI, FT, HOMA-%B, HOMA-IR, hs-CRP, and HbA1c than subjects without MS (P<0.01). Using combined HOMA-IR≥4.0 and hs-CRP>3.0 cut-off values, 71.4% of MS versus 23.5% non-MS group were considered at risk of diabetes and atherosclerosis (P<0.0001).ConclusionsHyperandrogenemic PCOS phenotypes have greatest degree of insulin resistance and inflammation. The use of insulin resistance and inflammatory markers may help identify adolescent girls with PCOS at risk of cardiometabolic syndrome.