Polycystic ovary syndrome in adolescents suffering from excessive body weight and insulin resistance

Objective. Evaluate the features of phenotypic variants of PCOS during adolescence with regard to body mass index and insulin resistance (IR). Materials and methods. A study in parallel groups was conducted. The total of 95 girls with PCOS from 15 to 17 years old were divided into four groups according to the presence or absence of IR and excessive body weight. The control group consisted only of lean healthy girls without IR with regular menstrual cycle. All participants underwent full clinical and instrumental examination, assessment of the level of С-reactive protein, leptin. Results. The obese insulin resistant PCOS group in comparison with lean nonIR PCOS group was characterized with the most unfavorable atherogenic lipid prof ile and biochemical hyperandrogenism due to the decreased level of sex hormone binding protein (SHBP), more pronounced pro-inflammatory activation according to higher levels of CRP (p = 0.0011), leptin (p= 0.0004) and white blood cell count (p=0.0235), platelets (p = ft. 0012), neutrophils (p = 0.0440) and ESR (p = 0.0036). The obese insulin resistant PCOS group compared with the control group characterized not only by significantly higher values of HOMA-IR (p = 0.0026), fasting glucose (p = 0.0021), higher TG levels (p = 0.0237), atherogenic coefficient (p = 0.0010) and cardiovascular risk by the VAI index (p = ft. 0105), lower HDL content (p = ft. 0459), and higher value of CRP (p = ft. 0239) and leptin (p = 0.0034) levels. Lean PCOS insulin resistant group significantly differed from lean nonIR PCOS group with a higher iron content (p = 0.0423), higher TG (p = ft. 0056) and atherogenic coefficient values (p = ft. 0262), lower levels of HDL (p = 0.0391), which proved dyslipidemia, despite the normative В ML in this group. Lean PCOS insulin resistant group differed significantly from the control group with higher levels of total and direct bilirubin (p = 0.0076 and p = 0.0155, respectively) and iron (23.8 ± 8.0 versus 16.6 ± 6, 8, p = 0.0343), and higher atherogenic coefficient values (p = 0.0206). Obese PCOS nonLR group differed from lean PCOS nonLR group with higher levels of CRP (p = 0.0226) and leptin (p = 0.0267), which indicates thatproinflammatory activation occurs in PCOS patients with excessive weight already in adolescence even in the absence of metabolic disorders. Lean PCOS nonLR group differed from the control group with a higher content of total protein (p = 0.0431) and direct bilirubin (p = ft. 0251). Conclusions: the combination of excessive body weight and metabolic disorders since adolescence is associated with increasing dyslipidemia and atherosclerosis, proinflammatory activation as well as an unfavorable cardiovascular risk.

polycystic ovary syndrome, insulin resistance, excessive body weight, systemic inflammation, leptin