Polycystic Ovary Syndrome Among Female Adolescents With Congenital Adrenal Hyperplasia

Abstract

Objectives: Polycystic ovary syndrome is a common endocrine disease in adolescent females that is usually diagnosed based on clinical and hormonal abnormalities. Female adolescents with poorly controlled congenital adrenal hyperplasia are at increased risk of developing polycystic ovary syndrome. This study aimed to determine the prevalence of polycystic ovary syndrome and assess its relationship with hormonal control among adolescents with congenital adrenal hyperplasia. Methods: This retrospective descriptive study included 40 pubertal female adolescents aged between 12 and 20 years with at least two years after menarche diagnosed with classical congenital adrenal hyperplasia since birth who were screened routinely for polycystic ovary syndrome via pelvic ultrasonography between 2012 and 2020 at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia. Serum adrenocorticotropic hormone, 17-hydroxy -progesterone, testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, and follicle-stimulating hormone levels were measured. Results: Polycystic ovary syndrome was detected via routine pelvic ultrasonography in 12/40 (30%) females. The median age of the affected females was 16.6 years, with the youngest female aged 12.5 years. The bone age of the patients had advanced ≤3 years. Further, serum adrenocorticotropic hormone was determined to be an independent factor affecting polycystic ovary syndrome development, indicating poor hormonal control (P = 0.005). Conclusion: Polycystic ovary disease is likely a complication of poorly controlled congenital adrenal hyperplasia disease. Therefore, increasing the awareness of polycystic ovary disease among congenital adrenal hyperplasia females via routine ultrasonography screening is advisable to facilitate the early diagnosis and improve disease management.

Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

“…Early onset adiposity has been implicated in the pathogenesis of PCOS and can be predictive of a more severe phenotype. It is also linked to the development of low-grade inflammation, greater cardiometabolic dysfunction and future risk of atherosclerosis [ 12 - 15 ]. Our data shows that as an indicator of visceral fat function, VAI correlates well with severity of menstrual dysfunction and ovarian dysmorphology, and seems to be predictive of impaired glucose tolerance, thus indicating propensity for development of diabetes in the future.…”

“…Recent studies have also shown that visceral adiposity is linked to the severity of anovulation, insulin resistance and cardiometabolic risk in women with PCOS [ 12 , 16 , 17 ]. We noted that increasing VAI was associated with longer menstrual cycles.…”