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Early metabolic derangement, obesity observed in adolescents with PCOS
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Socioeconomic status, ethnicity and a family history of diabetes are factors most likely to affect metabolic parameters in adolescents with polycystic ovary syndrome, according to study findings presented at the annual Pediatric Academic Societies Meeting in Baltimore.
“Studies on [PCOS] and its associated comorbidities, such as obesity and metabolic disease in adolescents, are limited with small sample sizes,” Shrinkhala Srivastava, MD, fellow in training in the division of pediatric endocrinology at Connecticut Children’s Medical Center in Hartford, and colleagues wrote. “The aims of our study were to better characterize adolescent PCOS patients who were overweight/obese and examine how weight and metabolic parameters (including glucose metabolism, lipids, blood pressure) change over time.”
Srivastava and colleagues analyzed data from 144 children and adolescents aged 12 to 19 years diagnosed with PCOS between June 2012 and June 2014 with BMI in the 85th percentile or higher for their age (mean age, 16 years; mean years since menarche, 3.9; mean BMI, 35 kg/m²). Researchers analyzed clinical and laboratory data at diagnosis and 10 to 15 months later to assess BMI and metabolic changes; 62 patients had follow-up data.
Researchers found that hirsutism (71.5%), acne (57.1%), hypertension (25%) and low HDL levels (55.8%) were common in the cohort. In addition, 68.6% of patients had a family history of diabetes, which predicted a higher BMI at presentation (P < .01). Patients receiving state health insurance (36.8%) also had a higher BMI at diagnosis (P < .01). Hispanic patients were more likely to have a fasting blood glucose level greater than 100 mg/dL (P = .01). No patients had type 2 diabetes.
The most commonly prescribed therapies at diagnosis were lifestyle counseling (85%), metformin (25%) and oral contraception (51%); average BMI change was 0.04 kg/m2 at 1 year. Patients with a lower BMI at diagnosis were more likely to experience weight loss (P < .01), as were patients prescribed metformin (P < .01). Metabolic parameters did not change at 1 year, regardless of metformin therapy.
“These patients are frequently overweight/obese at diagnosis and can have signs of metabolic derangement even at this early stage,” the researchers wrote. “Additional factors may impact degree of obesity (socioeconomic status) and degree of metabolic derangement (ethnicity). Lower BMI at diagnosis and metformin therapy were significantly associated with improved weight loss at 1 year.” – by Regina Schaffer
Reference:
Srivastava S, et al. Poster #29. Presented at: Pediatric Academic Societies Meeting; April 30-May 3, 2016; Baltimore.
Disclosure: Srivastava reports no relevant financial disclosures.