Polycystic Ovarian Morphology in Normocyclic Non-hyperandrogenic Adolescents

Fulghesu, Anna Maria; Canu, Elena; Casula, Laura; Melis, Federica; Gambineri, Alessandra

doi:10.1016/j.jpag.2021.02.004

Cited by 17 publications

(12 citation statements)

References 27 publications

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“…Even though pelvic ultrasound and PCOM are part of the Rotterdam diagnostic criteria for PCOS in adult women [ 20 ] it is not recommended for the diagnosis of PCOS during adolescence as it can cause over diagnosis of PCOS during this life stage [ 3 , 32 ]. This is supported by previous evidence summarized in adolescent international guidelines [ 17 , 25 , 30 ] and more recent evidence ( Figure 3 ) [ 32 , 45 , 85 ]. Please note that the international evidence-based guidelines recommended not to use pelvic ultrasound for the diagnosis of PCOS in those with gynecological age of <8 years [ 17 ].…”

Section: Main Criteria To Diagnose Pcos During Adolescencesupporting

confidence: 86%

“…The second reason for avoiding using pelvic ultrasound during adolescence is the presence of PCOM in healthy adolescents, which can be a transient condition [ 52 , 85 , 91 ]. There is also significant overlap of PCOM in healthy adolescents and in adolescents with PCOS [ 32 , 45 , 52 , 71 , 85 , 91 , 92 , 93 , 94 ]. PCOM has been demonstrated in healthy adolescents using transabdominal ultrasound and irrespective of the PCOM criteria used [ 92 ].…”

Section: Main Criteria To Diagnose Pcos During Adolescencementioning

confidence: 99%

“…The prevalence of PCOM according to Rotterdam Consensus (ovarian volume larger than 10 cm 3 or more than 12 follicles [ 20 ]) was 34.3%; according to Androgen Excess-PCOS Society (ovarian volume larger than 10 cm 3 [ 95 ]) was 25.3%; and according to the international adolescent PCOS consensus (ovarian volume larger than 12 cm 3 [ 25 ]) was 12.8% [ 92 ]. Higher prevalence of PCOS up to 57% has been reported using Rotterdam criteria in healthy adolescents [ 85 ]. A recent cross-sectional population-based study of 257 healthy adolescents showed that PCOM with normal ovarian stromal to total area ratio is more likely to occur 1–3 years post-menarche and PCOM with increased stromal to total area ratio more likely to occur four years after menarche [ 85 ].…”

Section: Main Criteria To Diagnose Pcos During Adolescencementioning

confidence: 99%

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Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review

2022

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Polycystic ovary syndrome (PCOS) is one of the most common endocrine conditions in women. PCOS may be more challenging to diagnose during adolescence due to an overlap with the physiological events of puberty, which are part of the diagnostic criteria in adult women. This review focuses on the evidence available in relation to PCOS diagnostic criteria for adolescents. Adolescent PCOS should be diagnosed using two main criteria irregular -menstrual cycles (relative to number of years post-menarche) and hyperandrogenism (clinical and/or biochemical); after excluding other conditions that mimic PCOS. Accurate definitions of the two main criteria will decrease challenges/controversies with the diagnosis and provide timely diagnosis during adolescence to establish early management. Despite the attempts to create accurate diagnostic criteria and definitions, this review highlights the limited research in this area, especially in the follow up of adolescents presenting with one diagnostic feature that are called “at risk of PCOS”. Studies in adolescents continue to use the Rotterdam diagnostic criteria that uses pelvic ultrasound. This is inappropriate, because previous and emerging data that show many healthy adolescents have polycystic ovarian morphology in the early years post-menarche. In the future, anti-Müllerian hormone levels might help support PCOS diagnosis if adolescents meet two main criteria.

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Section: Main Criteria To Diagnose Pcos During Adolescencesupporting

confidence: 86%

Section: Main Criteria To Diagnose Pcos During Adolescencementioning

confidence: 99%

Section: Main Criteria To Diagnose Pcos During Adolescencementioning

confidence: 99%

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Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review

2022

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“…However, the ovarian blood flow changes periodically, and the measurement of blood flow parameters is highly dependent on the skills of ultrasound instruments and operators, so this method has poor repeatability. In 2001, foreign researchers found that the ratio of ovarian interstitial ultrasound measurement area S to total area A > 0.34 could be used as a hyperparameter with good repeatability for the diagnosis of PCOS, and the coefficient difference between different ultrasound observers was less than 5% [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Endocrine and Metabolic Changes in Polycystic Ovary Syndrome by Ultrasonic Imaging Features under an Intelligent Algorithm

Wei

Zhang

et al. 2022

Computational and Mathematical Methods in Medicine

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To explore the application of intelligent algorithm-based ultrasound in the evaluation of polycystic ovary syndrome (PCOS) and the endocrine and metabolic changes of PCOS, 44 patients diagnosed with PCOS were recruited and rolled into three groups regarding detection methods. Backpropagation algorithm-based ultrasonic detection was adopted for the patients in the experimental group. The patients in the control group were tested by conventional ultrasound. In addition, 18 healthy volunteers were selected as the normal group. The results showed that the images processed by the backpropagation algorithm were substantially better than the traditional ultrasound images ( P < 0.05 ), and the image display was clearer. S, A, and S/A ratios measured by two different detection methods were 7.8 mm2, 3.5 mm2, and 0.449 in the experimental group, respectively, which were significantly different from 6.3 mm2, 2.6 mm2, and 0.413 in the control group ( P < 0.05 ). The PI and RI values of the interstitial ovarian artery in the experimental group were lower than those in the control group, and the systolic peak velocity (PSV) and end diastolic velocity (EDV) values were higher than those in the control group ( P < 0.05 ). Compared with the control group, the ovarian volume, interstitial vascularization-flow index (VFI), and flow index (FI) in the experimental group were substantially increased, and the total number of detected follicles was more ( P < 0.05 ). The level of follicle-stimulating hormone (FSH) in PCOS patients was substantially lower than that in normal controls ( P < 0.05 ). The LH, E2, P, and T of PCOS patients were substantially higher than those of normal controls ( P < 0.05 ). Ultrasound on account of the backpropagation algorithm can directly display the three-dimensional structure of the ovary and follicle and accurately measure the ovarian volume and follicle number. Endocrine and metabolic indicators can provide objective information for the clinical diagnosis of PCOS and can be used as a way of clinical evaluation of PCOS.

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“…Hyperandrogenism was defined as total testosterone (tT) at >0.7 ng/mL (>2.43 nmol/L), and 17-hydroxyprogesterone (17OHP) at >1.4 ng/mL, (>4.45 nmol/L), and delta-4-androstenedione (A) at >3.5 ng/mL (>12.2 nmol/L). These cut-offs were previously validated in adult women with the use of assays established in our laboratory [ 55 ]…”

Section: Methodsmentioning

confidence: 99%

Urinary Metabolites Reveal Hyperinsulinemia and Insulin Resistance in Polycystic Ovarian Syndrome (PCOS)

et al. 2021

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The identification of insulin resistance and hyperinsulinemia in polycystic ovary syndrome (PCOS) is not a minor issue. The homeostasis model assessment of insulin resistance index (HOMA) is the most used index of IR (Insulin Resistance), validated in overweight and obese patients but not in normal-weight PCOS subjects, who can still present with increased insulin secretion by an oral glucose tolerance test [OGTT]. The evaluation of insulin secretion and resistance represents a still unresolved problem. The aim of this study is to identify a possible yet noninvasive method to properly evaluate the insulin metabolism in young non-diabetic subjects. Girls aged 14–22 years, afferent to the center of Gynecological Diseases in Childhood and Adolescence of Cagliari (Italy), were screened for PCOS. A total of 42 subjects comprised the study group. Hormonal assays, OGTT, transabdominal (TA) or transvaginal (TV) US, and urine collection for 1H-NMR analysis were assayed in the early follicular phase. A 1H-NMR coupled multivariate statistical analysis was performed. The OPLS model indicated that the NMR profile of urine had a good fit and prediction ability for the AUC OGTT with R2 = 0.813. Metabolomics can be a promising tool to the potential identification of biomarkers of an exaggerated insulin response to OGTT and can encourage substantial progress for a more accurate and early diagnosis in PCOS.

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Polycystic Ovarian Morphology in Normocyclic Non-hyperandrogenic Adolescents

Cited by 17 publications

References 27 publications

Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review

Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review

Evaluation of Endocrine and Metabolic Changes in Polycystic Ovary Syndrome by Ultrasonic Imaging Features under an Intelligent Algorithm

Urinary Metabolites Reveal Hyperinsulinemia and Insulin Resistance in Polycystic Ovarian Syndrome (PCOS)

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