PCOS prevalence increased in adolescents with idiopathic central precocious puberty

medwireNews: Adolescents with a history of idiopathic central precocious puberty (ICPP) may be at increased risk of polycystic ovary syndrome (PCOS), researchers report.

In their study of 94 post-menarcheal girls with ICPP and a mean chronological age of 15.6 years, 12% were diagnosed with PCOS during adolescence, between 2000 and 2012. This was 2.5-fold higher on average when compared with the risk for similarly aged girls without ICPP from a separate study.

PCOS was defined “according to criteria specific for the adolescent population”, say Andrea Josefina Arcari and colleagues, from Hospital De Niños Ricardo Gutiérrez in Buenos Aires, Argentina, in Hormone Research in Paediatrics.

These criteria were having a menstrual cycle disorder with persistent intervals of more than 45 days or amenorrhea, clinical hyperandrogenism (hirsutism and/or acne vulgaris or severe comedones) and biochemical hyperandrogenism with the exclusion of other pathologies as a cause.

The participants had a mean body mass index of 23.6 kg/m2, with only 4% of girls classed as obese, 29% had menstrual disorders, 36% had clinical hyperandrogenism and 23% had biochemical hyperandrogenism.

In all, 63 girls were receiving gonadotropin-releasing hormone analogue (GnRHa) treatment, and Arcari et al highlight that there was no significant difference in the rate of PCOS between those who did and did not receive treatment, at 10% and 16%, respectively.

The researchers also note that the proportion of adolescents with clinical hyperandrogenism was significantly lower among those with ICPP who were receiving GnRHa treatment, at 29% versus 52%.

“Based on our findings, we consider that there is no evidence that GnRHa treatment predisposes to the development of PCOS”, they say.

Other significant differences between those receiving and not receiving GnRHa treatment included an older chronological age among the treated than the non-treated participants, at an average of 16.2 versus 14.3 years, and delayed age at menarche of 11.9 versus 9.4 years, respectively

Speculating on the possible underlying mechanisms for the association between ICPP and PCOS, the researchers refer to a previous study of theirs that showed increased luteinising hormone (LH) secretion with accelerated pulse frequency among adolescents with ICPP. Based on this, they infer that “in some ICPP girls, the premature activation of GnRH leads to an increment of LH pulsatility”, adding that “[i]f this continues in adulthood, it might favor the development of PCOS.”

By Lucy Piper

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2023 Springer Healthcare Ltd, part of the Springer Nature Group

Horm Res Paediatr 2023; doi:10.1159/000531264
Martin Savage
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