Tamara E Baer1, Carly E Milliren2, Courtney Walls3, Amy D DiVasta4. 1. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: tamara.baer@childrens.harvard.edu. 2. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts. 3. Decision Resources, LLC, Burlington, Massachusetts. 4. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of Pediatric and Adolescent Gynecology, Boston Children's Hospital, Boston, Massachusetts.
Abstract
STUDY OBJECTIVES: To review the clinical presentation, evaluation, and management of normal-weight (NW), overweight (OW), and obese (OB) adolescent and young adult women with polycystic ovary syndrome (PCOS) during a 2-year follow-up. DESIGN: Retrospective chart review. PARTICIPANTS: One hundred seventy-three adolescent and young adult women, aged 12-22 years, diagnosed with PCOS. INTERVENTIONS: Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2-year follow-up. Subjects were classified as NW, OW, or OB. Longitudinal data were analyzed using repeated-measures analysis of variance. MAIN OUTCOME MEASURES: Body mass index, self-reported concerns, and lifestyle changes. RESULTS: Most patients (73%) were OW or OB. Family history of type 2 diabetes was greater in OW (38%) and OB (53%) patients compared with NW (22%) patients (P = .002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients but not in NW patients (0%; P < .001). OW and OB patients had higher fasting insulin (P < .001) and lower high-density lipoprotein cholesterol (P = .005) levels than NW patients, although screening rates were low. Body mass index Z-scores decreased in both OW and OB patients over time (0.07 unit/yr, P < .001). CONCLUSIONS: Most patients with PCOS were OW or OB. Substantial clinical variability existed in cardiovascular disease (CVD) screening; among those screened, OW and OB patients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW and OB patients, no clinically significant change in body mass index percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS.
STUDY OBJECTIVES: To review the clinical presentation, evaluation, and management of normal-weight (NW), overweight (OW), and obese (OB) adolescent and young adult women with polycystic ovary syndrome (PCOS) during a 2-year follow-up. DESIGN: Retrospective chart review. PARTICIPANTS: One hundred seventy-three adolescent and young adult women, aged 12-22 years, diagnosed with PCOS. INTERVENTIONS: Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2-year follow-up. Subjects were classified as NW, OW, or OB. Longitudinal data were analyzed using repeated-measures analysis of variance. MAIN OUTCOME MEASURES: Body mass index, self-reported concerns, and lifestyle changes. RESULTS: Most patients (73%) were OW or OB. Family history of type 2 diabetes was greater in OW (38%) and OB (53%) patients compared with NW (22%) patients (P = .002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients but not in NW patients (0%; P < .001). OW and OBpatients had higher fasting insulin (P < .001) and lower high-density lipoprotein cholesterol (P = .005) levels than NW patients, although screening rates were low. Body mass index Z-scores decreased in both OW and OBpatients over time (0.07 unit/yr, P < .001). CONCLUSIONS: Most patients with PCOS were OW or OB. Substantial clinical variability existed in cardiovascular disease (CVD) screening; among those screened, OW and OBpatients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW and OBpatients, no clinically significant change in body mass index percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS.
Authors: Mark R Palmert; Catherine M Gordon; Alex I Kartashov; Richard S Legro; S Jean Emans; Andrea Dunaif Journal: J Clin Endocrinol Metab Date: 2002-03 Impact factor: 5.958
Authors: Miriam E Silfen; Michelle R Denburg; Alexandra M Manibo; Rogerio A Lobo; Richard Jaffe; Michel Ferin; Lenore S Levine; Sharon E Oberfield Journal: J Clin Endocrinol Metab Date: 2003-10 Impact factor: 5.958