Polycystic ovary syndrome in obese adolescents.
OBJECTIVE
As the prevalence of pediatric obesity escalates, polycystic ovary syndrome is an increasingly common morbidity for adolescent females. This review describes recent insights into the pathophysiology and treatment of polycystic ovary syndrome, with special attention given to the relationship between polycystic ovary syndrome and obesity.


RESULTS
Recent research has elucidated three key concepts in our understanding of polycystic ovary syndrome. First, patients may enter the hyperandrogenism-hyperinsulinism cycle of polycystic ovary syndrome via several pathways, including genetic polymorphisms that affect androgen synthesis, fetal programming that alters lipid and glucose metabolism, and obesity accompanied by insulin resistance. Second, obesity plays a significant role in the pathophysiology of polycystic ovary syndrome by increasing free androgen concentrations through multiple mechanisms. Finally, just as the etiology of polycystic ovary syndrome is multifactorial, successful treatment will probably require a combination of lifestyle modification and therapeutic interventions.


CONCLUSIONS
Obesity contributes to the pathophysiology of polycystic ovary syndrome and increases the likelihood of associated metabolic and cardiovascular morbidities.
Stanley
Takara
T
MassGeneral Hospital for Children and Harvard Medical School, Boston, Massachusetts 02114, USA. tstanley@partners.org
Misra
Madhusmita
M
D000293:Adolescent; D000311:Adrenal Glands / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D007986:Luteinizing Hormone / Q000378:metabolism; D008659:Metabolic Diseases / Q000453:epidemiology; D008954:Models, Biological; D009765:Obesity / Q000150:complications*; D010053:Ovary / Q000187:drug effects / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012738:Sex Hormone-Binding Globulin / Q000096:biosynthesis; D013256:Steroids / Q000096:biosynthesis
D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013256:Steroids; D007986:Luteinizing Hormone