Metabolic and reproductive features before and during puberty in daughters of women with polycystic ovary syndrome.
BACKGROUND
A significant proportion of the first-degree female relatives of women with polycystic ovary syndrome (PCOS) may be at risk for developing PCOS. However, it is not known at which stage of pubertal development the hormonal and metabolic abnormalities ensue in PCOS.


OBJECTIVE
The aim of the study was to assess the reproductive and metabolic profiles of daughters of women with PCOS (PCOSd) during the peripubertal period, a stage during which the gonadal axis is activated and PCOS may become clinically manifest.


METHODS
Ninety-nine PCOSd [30 prepubertal and 69 pubertal (Tanner II-V)] and 84 daughters of control women (Cd) (20 prepubertal and 64 pubertal) were studied. An oral glucose tolerance test, a GnRH agonist test (leuprolide acetate, 10 microg/kg sc), and a transabdominal ultrasound were performed. Gonadotropins, sex steroids, SHBG, glucose, insulin, and lipids were determined.


RESULTS
Both groups had similar chronological ages and body mass index sd scores according to Tanner stage distribution. Ovarian volume and 2-h insulin were significantly higher in PCOSd compared to Cd at all Tanner stages. In Tanner stages IV and V, basal testosterone and poststimulated LH, testosterone, and 17-hydroxyprogesterone concentrations were significantly higher in PCOSd compared to Cd.


CONCLUSIONS
Hyperinsulinemia and an increased ovarian volume are present in PCOSd before the onset of puberty and persist during pubertal development. The biochemical abnormalities of PCOS appear during late puberty. Considering the early onset and the nature of the alterations, PCOSd constitute a high-risk group for metabolic and reproductive derangements.
Sir-Petermann
Teresa
T
Endocrinology and Metabolism Laboratory, Department of Medicine, West Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago 8320000, Chile. tsir@med.uchile.cl
Codner
Ethel
E
Pérez
Virginia
V
Echiburú
Bárbara
B
Maliqueo
Manuel
M
Ladrón de Guevara
Amanda
A
Preisler
Jessica
J
Crisosto
Nicolás
N
Sánchez
Fernando
F
Cassorla
Fernando
F
Bhasin
Shalender
S
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D016241:Child of Impaired Parents; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009679:Nuclear Family; D011085:Polycystic Ovary Syndrome; D011627:Puberty / Q000097:blood / Q000378:metabolism* / Q000502:physiology*; D012098:Reproduction / Q000502:physiology*; D013739:Testosterone / Q000032:analysis / Q000097:blood
D013739:Testosterone