Childhood adiposity could predict future PCOS
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Key takeaways:
- Increased adiposity could predict PCOS in growing females.
- Higher levels of insulin in adolescence do not indicate elevated PCOS risk.
Childhood adiposity could predict future polycystic ovary syndrome in girls, according to a study published in Pediatrics.
According to Rachel C. Whooten, MD, attending pediatric endocrinologist at Mass General Hospital for Children in Boston, recent guidelines define polycystic ovary syndrome (PCOS) “as having irregular periods, along with having high levels of androgens, and that can either be high levels of androgens based on blood work or high levels of androgen based on clinical signs of that which would be either having excess hair growth or acne.”
“PCOS is pretty common among adult women, but we don’t really know about PCOS prevalence in adolescents,” Whooten told Healio.
She said PCOS is thought to be “a vicious cycle of three things: related to high levels of insulin, high levels of androgen, and/or increased levels of adiposity. Among those three things, we don't really know which one kind of kicks it off.”
Whooten and colleagues assessed data from patients who were part of Project Viva, a collection of longitudinal cohort studies that began in a large health care system in Massachusetts around the turn of the 2000s and involves visits with mothers and children from pregnancy and early infancy all the way to the late teen years. Whooten said they began by defining participants who had PCOS, based on guidance.
“The second part of the study was those who may not have reported that they had diagnosed PCOS but reported that they had irregular periods, and then had evidence of hyperandrogenism,” Whooten said. “That could have either been from a blood sample or from doing pictorial representations of picking basically a validated scoring system looking at hair growth.”
Among the 417 females included in the study, 13% met PCOS criteria. Whooten and colleagues ultimately determined that the odds of PCOS were higher per 1-SD increase in truncal fat at midchildhood (OR = 1.42; 95% CI, 1.03-1.95) and early teen visits (OR = 1.61; 95% CI, 1.14-2.28) and lower per 1-SD increase in adiponectin/leptin ratio at the midteen visit (OR = 0.14; 95% CI, 0.03-0.58).
“Even knowing that adiposity was a predictor of later PCOS, we did find that PCOS occurred throughout the BMI spectrums,” Whooten said. “I think it's hypothesized that overall, that's because people are more aware of the association between obesity and PCOS. But I do want to highlight that we did find PCOS to almost the same extent among those with BMI less than the 85th percentile.”
Whooten said she is interested in future research that examines PCOS in general populations.
“A lot of the research that has been done on PCOS risk has been looking at those populations that we already know, which can be girls with early puberty, girls who have a mother with PCOS or girls with obesity,” Whooten said. “I think repeating this in a more prospective nature with general risk populations would be great.”
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