Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls

Jessica Rieder, Nanette Santoro, Hillel W. Cohen, Paul R. Marantz, Susan M. Coupey

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To determine whether key associated features of hyperandrogenic anovulation (HA) in predominately Caribbean Hispanic (CH) adolescent girls can be combined to improve the early diagnosis of HA. Methods: Unselected observational sample of females aged 12 to 21 years (mean 17.5 ± 2.4 years), (64% CH, 28% African American). One hundred twenty subjects provided a menstrual history, had a physical examination, and a follicular phase fasting blood drawn for LH, FSH, testosterone, sex hormone binding globulin (SHBG), 17-OH progesterone (17-OHP), androstenedione (Δ4A), glucose, and insulin. We prospectively categorized subjects into four groups: G I (n = 42) had normal menses and normal physical exam; G II (n = 41) had normal menses and abnormal physical exam, that is, signs indicating possible hyperandrogenism and/or insulin resistance, including at least one of obesity, hirsutism, acne, or acanthosis nigricans; G III (n = 15) had abnormal menses and normal physical exam, and G IV (n = 22) had HA with BOTH abnormal menses and abnormal physical exam, that is, girls most likely to develop polycystic ovary syndrome. Hormonal levels and additional clinical and physical characteristics of interest were compared among the four groups. Results: Group IV subjects had significantly higher waist circumference measurements, independent of overweight status, than all other groups. As hypothesized, Group IV subjects had significantly higher androgen levels and significantly lower SHBG levels than all other groups. FAI, SHBG, and waist circumference had the highest diagnostic accuracy for predicting Group IV status (i.e., HA phenotype). Conclusions: Markers of insulin resistance and hyperandrogenemia, including waist circumference, FAI, and SHBG, best associate with irregular menstrual cycles and the HA phenotype in ethnic minority adolescent girls.

Original languageEnglish (US)
Pages (from-to)115-124
Number of pages10
JournalJournal of Adolescent Health
Volume43
Issue number2
DOIs
StatePublished - Aug 2008

Fingerprint

Anovulation
Body Size
Sex Hormone-Binding Globulin
Menstruation
Insulin Resistance
Waist Circumference
Hispanic Americans
Acanthosis Nigricans
Phenotype
Hyperandrogenism
Hirsutism
Follicular Phase
Androstenedione
Polycystic Ovary Syndrome
Acne Vulgaris
Menstrual Cycle
African Americans
Androgens
Physical Examination
Progesterone

Keywords

  • Adolescents
  • Hyperandrogenemia
  • Hyperandrogenic anovulation
  • Overweight
  • PCOS

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls. / Rieder, Jessica; Santoro, Nanette; Cohen, Hillel W.; Marantz, Paul R.; Coupey, Susan M.

In: Journal of Adolescent Health, Vol. 43, No. 2, 08.2008, p. 115-124.

Research output: Contribution to journalArticle

@article{29fc39833e2c408d941ce369a41fa9a8,
title = "Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls",
abstract = "Purpose: To determine whether key associated features of hyperandrogenic anovulation (HA) in predominately Caribbean Hispanic (CH) adolescent girls can be combined to improve the early diagnosis of HA. Methods: Unselected observational sample of females aged 12 to 21 years (mean 17.5 ± 2.4 years), (64{\%} CH, 28{\%} African American). One hundred twenty subjects provided a menstrual history, had a physical examination, and a follicular phase fasting blood drawn for LH, FSH, testosterone, sex hormone binding globulin (SHBG), 17-OH progesterone (17-OHP), androstenedione (Δ4A), glucose, and insulin. We prospectively categorized subjects into four groups: G I (n = 42) had normal menses and normal physical exam; G II (n = 41) had normal menses and abnormal physical exam, that is, signs indicating possible hyperandrogenism and/or insulin resistance, including at least one of obesity, hirsutism, acne, or acanthosis nigricans; G III (n = 15) had abnormal menses and normal physical exam, and G IV (n = 22) had HA with BOTH abnormal menses and abnormal physical exam, that is, girls most likely to develop polycystic ovary syndrome. Hormonal levels and additional clinical and physical characteristics of interest were compared among the four groups. Results: Group IV subjects had significantly higher waist circumference measurements, independent of overweight status, than all other groups. As hypothesized, Group IV subjects had significantly higher androgen levels and significantly lower SHBG levels than all other groups. FAI, SHBG, and waist circumference had the highest diagnostic accuracy for predicting Group IV status (i.e., HA phenotype). Conclusions: Markers of insulin resistance and hyperandrogenemia, including waist circumference, FAI, and SHBG, best associate with irregular menstrual cycles and the HA phenotype in ethnic minority adolescent girls.",
keywords = "Adolescents, Hyperandrogenemia, Hyperandrogenic anovulation, Overweight, PCOS",
author = "Jessica Rieder and Nanette Santoro and Cohen, {Hillel W.} and Marantz, {Paul R.} and Coupey, {Susan M.}",
year = "2008",
month = "8",
doi = "10.1016/j.jadohealth.2008.02.003",
language = "English (US)",
volume = "43",
pages = "115--124",
journal = "Journal of Adolescent Health",
issn = "1054-139X",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls

AU - Rieder, Jessica

AU - Santoro, Nanette

AU - Cohen, Hillel W.

AU - Marantz, Paul R.

AU - Coupey, Susan M.

PY - 2008/8

Y1 - 2008/8

N2 - Purpose: To determine whether key associated features of hyperandrogenic anovulation (HA) in predominately Caribbean Hispanic (CH) adolescent girls can be combined to improve the early diagnosis of HA. Methods: Unselected observational sample of females aged 12 to 21 years (mean 17.5 ± 2.4 years), (64% CH, 28% African American). One hundred twenty subjects provided a menstrual history, had a physical examination, and a follicular phase fasting blood drawn for LH, FSH, testosterone, sex hormone binding globulin (SHBG), 17-OH progesterone (17-OHP), androstenedione (Δ4A), glucose, and insulin. We prospectively categorized subjects into four groups: G I (n = 42) had normal menses and normal physical exam; G II (n = 41) had normal menses and abnormal physical exam, that is, signs indicating possible hyperandrogenism and/or insulin resistance, including at least one of obesity, hirsutism, acne, or acanthosis nigricans; G III (n = 15) had abnormal menses and normal physical exam, and G IV (n = 22) had HA with BOTH abnormal menses and abnormal physical exam, that is, girls most likely to develop polycystic ovary syndrome. Hormonal levels and additional clinical and physical characteristics of interest were compared among the four groups. Results: Group IV subjects had significantly higher waist circumference measurements, independent of overweight status, than all other groups. As hypothesized, Group IV subjects had significantly higher androgen levels and significantly lower SHBG levels than all other groups. FAI, SHBG, and waist circumference had the highest diagnostic accuracy for predicting Group IV status (i.e., HA phenotype). Conclusions: Markers of insulin resistance and hyperandrogenemia, including waist circumference, FAI, and SHBG, best associate with irregular menstrual cycles and the HA phenotype in ethnic minority adolescent girls.

AB - Purpose: To determine whether key associated features of hyperandrogenic anovulation (HA) in predominately Caribbean Hispanic (CH) adolescent girls can be combined to improve the early diagnosis of HA. Methods: Unselected observational sample of females aged 12 to 21 years (mean 17.5 ± 2.4 years), (64% CH, 28% African American). One hundred twenty subjects provided a menstrual history, had a physical examination, and a follicular phase fasting blood drawn for LH, FSH, testosterone, sex hormone binding globulin (SHBG), 17-OH progesterone (17-OHP), androstenedione (Δ4A), glucose, and insulin. We prospectively categorized subjects into four groups: G I (n = 42) had normal menses and normal physical exam; G II (n = 41) had normal menses and abnormal physical exam, that is, signs indicating possible hyperandrogenism and/or insulin resistance, including at least one of obesity, hirsutism, acne, or acanthosis nigricans; G III (n = 15) had abnormal menses and normal physical exam, and G IV (n = 22) had HA with BOTH abnormal menses and abnormal physical exam, that is, girls most likely to develop polycystic ovary syndrome. Hormonal levels and additional clinical and physical characteristics of interest were compared among the four groups. Results: Group IV subjects had significantly higher waist circumference measurements, independent of overweight status, than all other groups. As hypothesized, Group IV subjects had significantly higher androgen levels and significantly lower SHBG levels than all other groups. FAI, SHBG, and waist circumference had the highest diagnostic accuracy for predicting Group IV status (i.e., HA phenotype). Conclusions: Markers of insulin resistance and hyperandrogenemia, including waist circumference, FAI, and SHBG, best associate with irregular menstrual cycles and the HA phenotype in ethnic minority adolescent girls.

KW - Adolescents

KW - Hyperandrogenemia

KW - Hyperandrogenic anovulation

KW - Overweight

KW - PCOS

UR - http://www.scopus.com/inward/record.url?scp=47049109557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47049109557&partnerID=8YFLogxK

U2 - 10.1016/j.jadohealth.2008.02.003

DO - 10.1016/j.jadohealth.2008.02.003

M3 - Article

C2 - 18639784

AN - SCOPUS:47049109557

VL - 43

SP - 115

EP - 124

JO - Journal of Adolescent Health

JF - Journal of Adolescent Health

SN - 1054-139X

IS - 2

ER -