Adolescent PCOS: a postpubertal central obesity syndrome

Association between dietary patterns and premenstrual disorders: a cross-sectional analysis of 1382 college students in China

“…Participants provided information on their age and schools at recruitment and lifestyle factors associated with both PMDs and diet, e.g. , body mass index (BMI, calculated from self-reported weight and height) 8,30,31 and alcohol consumption (assessed as whether they had consumed alcohol at any point in the past 30 days). 32 Adverse childhood experiences (ACEs) that influence diet and PMDs 33,34 were evaluated using the Adverse Childhood Experiences International Questionnaire (ACE-IQ).…”

Letter to the Editor From de Zegher and Ibáñez: “Distinct Reproductive Phenotypes Segregate With Differences in Body Weight in Adolescent Polycystic Ovary Syndrome”

“…These unique numbers suggest that girls with obesity are approximately at a 75-fold higher risk of developing adolescent PCOS than lean girls. Such obesity-linked risk fits into the emerging concept that adolescent PCOS is essentially driven by ectopic fat and/or insulin resistance, both of which may ensue from a mismatch between the capacity and the demand to store lipids in subcutaneous adipose tissue [ 2 , 3 ].…”

“…Under “data collection,” Chen-Patterson et al mention that “medical information included birthweight” but they appear to share no results on this variable [ 1 ]. Birthweight data from lean girls with adolescent PCOS would be welcome, given that their average weight at term birth may have been below the mean for girls in a contemporary US cohort [ 2 , 3 ]. Birthweight data from adolescents with PCOS and obesity would also be welcome, given that these girls are at an 18-fold higher risk of developing type 2 diabetes [ 4 ], and that such development depends on interactions among genetic risk, prenatal weight gain, and postnatal BMI [ 5 ].…”

“…Chen-Patterson et al state that “combined oral contraceptive pills remain the first-line pharmacological treatment for PCOS based on current guidelines,” and that their identification of distinct subgroups within adolescent PCOS provides a rationale “for individualized treatment approaches” [ 1 ]. Distinct approaches are still under investigation (reviewed in [ 3 ]) but pilot evidence suggests that medications targeting a loss of ectopic fat and/or a gain of insulin sensitivity are capable of reversing the adolescent PCOS phenotype [ 6 , 7 ]. The first results are so promising that they may even suffice to concur that regulatory agencies should refrain from approving combined oral contraceptive pills as the first-line pharmacological treatment for adolescent PCOS, certainly in lean girls [ 3 , 6 ].…”

“…Distinct approaches are still under investigation (reviewed in [ 3 ]) but pilot evidence suggests that medications targeting a loss of ectopic fat and/or a gain of insulin sensitivity are capable of reversing the adolescent PCOS phenotype [ 6 , 7 ]. The first results are so promising that they may even suffice to concur that regulatory agencies should refrain from approving combined oral contraceptive pills as the first-line pharmacological treatment for adolescent PCOS, certainly in lean girls [ 3 , 6 ].…”