Polycystic ovaries in adolescents and the relationship with menstrual cycle patterns, luteinizing hormone, androgens, and insulin.
OBJECTIVE
To evaluate the possible role of inappropriate LH secretion, hyperandrogenism, and hyperinsulinemia in the development of polycystic ovaries (PCO) and the polycystic ovary syndrome.


METHODS
Observational.


METHODS
General population samples.


METHODS
58 adolescents with regular menstrual cycles, 50 with irregular menstrual cycles, and 29 with oligomenorrhea (age 16.7+/-0.9 years).


METHODS
Transabdominal pelvic ultrasonography and vena puncture.


METHODS
PCO; LH, androstenedione, and testosterone levels; overnight fasting insulin concentrations; and oligomenorrhea.


RESULTS
The prevalence of PCO increased significantly with the irregularity of the menstrual cycle pattern, as illustrated by the study, finding PCO in 9% of the girls with regular menstrual cycles, 28% of those with irregular menstrual cycles, and 45% of oligomenorrheic girls. The LH and androgen concentrations were significantly higher in girls with PCO; the insulin levels and the glucose-insulin ratio did not differ when the girls with PCO were compared with girls with normal ovaries. Oligomenorrheic girls with PCO had the highest androgen and LH concentrations; their insulin concentrations and glucose-insulin ratio were in the same range as girls with regular menstrual cycles and normal ovaries; and both their hip and waist girths were wider, although their waist-hip ratio was normal.


CONCLUSIONS
PCO in adolescents is associated with irregular menstrual cycles, oligomenorrhea, and/or high androgen and LH levels; but no relationship was found with the insulin level or glucose-insulin ratio. Thus, it is doubtful that hyperinsulinemia is an important factor in the development of PCO or polycystic ovary syndrome.
van Hooff
M H
MH
Division of Reproductive Endocrinology and Fertility, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. m.vanhooff@azvu.nl
Voorhorst
F J
FJ
Kaptein
M B
MB
Hirasing
R A
RA
Koppenaal
C
C
Schoemaker
J
J
D000152:Acne Vulgaris / Q000150:complications; D000293:Adolescent / Q000502:physiology*; D000728:Androgens / Q000097:blood*; D005260:Female; D006628:Hirsutism / Q000150:complications; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D007328:Insulin / Q000097:blood*; D007986:Luteinizing Hormone / Q000097:blood*; D008597:Menstrual Cycle; D009426:Netherlands / Q000453:epidemiology; D010388:Pelvis / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography
D000728:Androgens; D007328:Insulin; D007986:Luteinizing Hormone