The Prevalence of Polycystic Ovarian Syndrome, Metabolic Abnormalities and Its Association With Obesity in Adolescents: A Cross-Sectional Study in an Urban Population in Iran
The diagnosis of polycystic ovary syndrome (PCOS) and metabolic syndrome (MS) in adolescents is clinically challenging. It is on the rise as consistent with the increasing trends in obesity rates. This study aimed to investigate the prevalence of PCOS in adolescents by the National Institutes of Health (NIH) criteria and compare the prevalence of insulin resistance (IR) and metabolic syndrome (MS) between obese (OB) and non-obese (NOB) adolescents with PCOS. This was cross-sectional research with multi-stage cluster random sampling. Participants were 15-18-year-old girls from high schools in Semnan, Iran. The ones who had a history of menstrual dysfunction underwent clinical and hormonal tests. From among a total of 900 participants, 74 girls (8.2%) had a history of menstrual dysfunction. The prevalence of PCOS was 6.44% by NIH criteria. The prevalence of abnormal glucose metabolism, MS, and IR in girls with PCOS were 8(13.7%), 6(10.3%), 24(41.4%), respectively. The OB-PCOS group with a mean BMI of 28.21±1.26 kg/m2 had a significantly greater prevalence of MS, high BP, waist circumference ≥88 cm, and higher IR than NOB-PCOS cases with a mean BMI of 20.54±2.97 kg/m2. Abnormal glucose metabolism was prevalent in adolescents with PCOS and occurred with equal frequency in OB and NOB PCOS groups. Obesity could worsen IR, MS, and some of the components of Mets in PCOS adolescents.
1. Zawadzki J, Dunaif A. Diagnostic criteria for polycystic syndrome: towards a rational approach. Dunaif A, Givens JR, Haseltine FP, and others, Eds Polycystic ovary syndrome Boston: Blackwell Scientific. 1992:337-84.
2. Franks S. Polycystic ovary syndrome. New England Journal of Medicine. 1995;333(13):853-61.
3. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and sterility. 2009;91(2):456-88.
4. ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and sterility. 2004;81(1):19-25.
5. Khan U. Polycystic ovary syndrome in adolescents. Journal of pediatric and adolescent gynecology. 2007;20(2):101-4.
6. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L etal. Human Reprod 2018;33(9): 1602-18
7. Lo JC, Feigenbaum SL, Yang J, Pressman AR, Selby JV, Go AS. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2006;91(4):1357-63.
8. Hashemipour M, Faghihimani S, Zolfaghary B, Hovsepian S, Ahmadi F, Haghighi S. Prevalence of polycystic ovary syndrome in girls aged 14–18 years in Isfahan, Iran. Hormone Research in Paediatrics. 2004;62(6):278-82.
9. Hickey M, Doherty D, Atkinson H, Sloboda D, Franks S, Norman R, et al. Clinical, ultrasound and biochemical features of polycystic ovary syndrome in adolescents: implications for diagnosis. Human Reproduction. 2011;26(6):1469-77.
10. Flannery CA, Rackow B, Cong X, Duran E, Selen DJ, Burgert TS. Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI. Pediatric diabetes. 2013;14(1):42-9.
11. Rossi B, Sukalich S, Droz J, Griffin A, Cook S, Blumkin A, et al. Prevalence of metabolic syndrome and related characteristics in obese adolescents with and without polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2008;93(12):4780-6.
12. Huang J, Ni R, Chen X, Huang L, Mo Y, Yang D. Metabolic abnormalities in adolescents with polycystic ovary syndrome in south China. Reproductive Biology and Endocrinology. 2010;8(1):142.
13. Hart R, Doherty DA, Mori T, Huang R-C, Norman RJ, Franks S, et al. Extent of metabolic risk in adolescent girls with features of polycystic ovary syndrome. Fertility and sterility. 2011;95(7):2347-53. e1.
14. Coviello AD, Legro RS, Dunaif A. Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. The Journal of Clinical Endocrinology & Metabolism. 2006;91(2):492-7.
15. Rahmanpour H, Jamal L, Mousavinasab SN, Esmailzadeh A, Azarkhish K. Association between polycystic ovarian syndrome, overweight, and metabolic syndrome in adolescents. Journal of pediatric and adolescent gynecology. 2012;25(3):208-12.
16. Roe AH, Prochaska E, Smith M, Sammel M, Dokras A. Using the Androgen Excess–PCOS Society criteria to diagnose polycystic ovary syndrome and the risk of metabolic syndrome in adolescents. The Journal of pediatrics. 2013;162(5):937-41.
17. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility: lippincott Williams & wilkins; 2005.
18. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112(17):2735-52.
19. Association AD. Standards of medical care in diabetes—2010. Diabetes care. 2010;33(Supplement 1):S11-S61.
20. Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.
21. Hosseinpanah F, Barzin M, Tehrani FR, Azizi F. The lack of association between polycystic ovary syndrome and metabolic syndrome: Iranian PCOS prevalence study. Clinical endocrinology. 2011;75(5):692-7.
22. Pfeifer SM, Kives S. Polycystic ovary syndrome in the adolescent. Obstetrics and gynecology clinics of North America. 2009;36(1):129-52.
23. Fazleen NE, Whittaker M, Mamun A. Risk of metabolic syndrome in adolescents with polycystic ovarian syndrome: A systematic review and meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2018;12(6):1083-90.
24. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. New England Journal of Medicine. 2004;350(23):2362-74.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.