PCOS in adolescence and type 2 diabetes.
Polycystic ovary syndrome is a frequent disorder in women of reproductive age that consists of a heterogeneous combination of hyperandrogenism, chronic anovulation, and polycystic ovaries. Hyperandrogenism and anovulation are clearly linked to insulin resistance and compensatory hyperinsulinism, with an ovarian androgenic hyperresponsiveness to circulating insulin. Evidence is increasing that suggests that lipotoxicity, which is a key mechanism in the development of insulin resistance and type 2 diabetes, could also explain the androgen overproduction. During adolescence, diagnosis of polycystic ovarian syndrome (PCOS) may be difficult but is of importance because PCOS increases future risk of type 2 diabetes and metabolic complications. Metabolic perturbations begin early in adolescence and also exist in adolescent relatives of women with PCOS, even before clinical signs of PCOS. Screening for impaired glucose tolerance or type 2 diabetes is also important in this population, and treatment should focus on PCOS clinical manifestations as well as long-term metabolic risk.
Division of Endocrinology, Department of Medicine, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, Quebec, J1H 5 N4, Canada.
Anne-Marie
AM
Carreau
Jean-Patrice
JP
Baillargeon
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D003937:Diagnosis, Differential; D005260:Female; D006628:Hirsutism / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D017588:Hyperandrogenism / Q000175:diagnosis* / Q000378:metabolism; D006946:Hyperinsulinism / Q000175:diagnosis* / Q000378:metabolism; D007333:Insulin Resistance; D050356:Lipid Metabolism; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging
D001786:Blood Glucose