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 Marantz, Susan M. Coupey

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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

Keywords

  • Adolescents
  • Hyperandrogenemia
  • Hyperandrogenic anovulation
  • Overweight
  • PCOS

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Body Shape and Size and Insulin Resistance as Early Clinical Predictors of Hyperandrogenic Anovulation in Ethnic Minority Adolescent Girls'. Together they form a unique fingerprint.

Cite this