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Precocious signs of polycystic ovaries in obese girls
Author(s) -
Sampaolo P.,
Livieri C.,
Montanari L.,
Paganelli A.,
Salesi A.,
Lorini R.
Publication year - 1994
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.1994.04040310.x
Subject(s) - medicine , polycystic ovary , hirsutism , endocrinology , estrone , luteinizing hormone , dehydroepiandrosterone sulfate , testosterone (patch) , sex hormone binding globulin , hyperandrogenism , hormone , follicle stimulating hormone , obesity , androgen , insulin resistance
As several studies have reported that 35% of patients with polycystic ovary syndrome are obese and that this syndrome seems to originate during the early phase of sexual maturation, we undertook a study of such subjects. We studied ultrasound and hormonal findings in 49 obese girls aged from 7.9 to 19.10 years, with a mean excess weight of 44%; 23 premenarcheal girls and 26 postmenarcheal girls with mean gynecological age of 2.5 years. As controls, we studied 18 girls in the pubertal phase and 17 healthy girls with regular menses, matched for age and gynecological age. Pelvic ultrasonography was carried out in all girls and estrone, estradiol, progesterone, prolactin, follicle stimulating hormone, luteinizing hormone, sex hormone binding globulin (SHBG), testosterone, free testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA‐S), androstenedione and 17‐hydroxyprogesterone (17‐OHP) were measured by radioimmunoassay in 11 of the 18 postmenarcheal girls. Five girls (10.2%) with excess weight of > 40% presented with mild or severe hirsutism based on Ferriman and Gallway scores; six (12.2%) presented with acne and 14 (28.5%) presented with acanthosis nigricans. Hormonal evaluation showed elevated levels of estrone ( p < 0.005) and testosterone ( p < 0.01) but lower than normal levels of SHBG ( p < 0.05) and estradiol ( p <0.05). On the basis of our results, 23%) of the postmenarcheal obese subjects showed clinical, hormonal and ultrasonographic signs of polycystic ovaries, and 23% of postmenarcheal obese girls showed multifollicular ovaries. Six of these, at 1 year after menarche, showed a uterine cross‐sectional area larger than normal jar gynecological age (21.92 ± 5.64 cm 2 vs. 16.36 ± 2.34 cm 2 ). Further serial echographic studies and a careful follow‐up will demonstrate if both multifollicular ovaries and increased uterine cross‐sectional area in obese girls are precocious signs of polycystic ovaries.