Contribution of Weight Gain and Its Association with Insulin Resistance and Dyslipidaemia in Rural Adolescents in Polycystic Ovarian SyndromeA Prospective Cross-Sectional Study

Abstract

BACKGROUND Polycystic ovarian syndrome (PCOS) is the most complex and common endocrinological disorder involving 5-11% of women in their reproductive age. This prevalence ranges from 2.2% to 26% in adult women in 18-45 years age group. In a recent study, the prevalence of a confirmed diagnosis of PCOS in adolescents aged 10 to 19 years was 5-15%, which increased to 10-22% when undiagnosed cases with documented symptoms qualifying for PCOS according to NIH (National institute of Health) criteria were included. PCOS is a complex endocrine disorder which is most common in women of reproductive age. PCOS may first present in adolescence, but the incidence of PCOS in adolescence is not known, as diagnostic criteria for PCOS in their adolescent age is still not defined. PCOS symptoms tend to overlap with normal pubertal changes making the diagnosis even more challenging. The objective is to study prevalence and symptomatology of polycystic ovary syndrome (PCOS) in adolescent girls. In adolescents with PCOS, dyslipidaemia, diabetes as well as obesity are all potent cardiovascular risk factors in their future reproductive life. It is a metabolic disorder which may not be related with obesity only, in lean PCOS also we can see its manifestations. METHODS It was prospective, cross sectional study carried out from April 2018 to March 2019. 85 adolescents (10-19) with PCOS were enrolled in my study. In all participants enrolled in my study we measured body mass index (BMI) & their waist/hip (W/H) ratio. In participants, their fasting glucose, as well as fasting insulin and fasting lipid profiles were measured. In our study, definition of Insulin resistance is, fasting glucose-to-insulin ratio should be < 4.5. After blood reports, we found the relation of obesity markers with their insulin resistance status and their lipid parameters. After this, statistical analysis was done by using SPSS & Mann Whitney U tests. RESULTS In my study, out of 85 PCOS adolescents, 60 adolescents had insulin resistance. We found that there was no correlation between BMI and W/H ratio depending on their various lipid parameters. Surprisingly we observed that in participants with PCOS with insulin resistance, thei lipid profile was significantly abnormal, as compared to insulin-sensitive girls with PCOS. In the two groups, we found that total cholesterol (p = 0.002), as well as triglycerides (p = <0.001) and their HDL (p = <0.001) difference was statistically significant but it was not statistically significant for low-density lipoprotein (LDL)(P=0.09). CONCLUSIONS In adolescents with PCOS, insulin resistance is responsible for dyslipidaemia, which is independent of obesity markers.

The Association Between Polycystic Ovary Syndrome and Metabolic Syndrome in Adolescents: a Systematic Review and Meta-analysis

“…Even at a young age, adolescents with PCOS manifest significant insulin resistance and impaired glucose tolerance [ 33 ] and have increased risk factors for cardiovascular disease compared with controls [ 26 , 34 ]. Furthermore, insulin resistance might have adverse effects on lipid metabolism [ 35 ], including reducing lipid mobilization and attenuating fat oxidation, and lead to metabolic inflexibility in obese adolescents with PCOS [ 36 ].…”