title: Clinical Variability in Cardiovascular Disease Risk Factor Screening and Management in Adolescent and Young Adult Women with Polycystic Ovary Syndrome.
abstract: OBJECTIVE
  To review the clinical presentation, evaluation, and management of normal-weight (NW), overweight (OW), and obese (OB) adolescent and young adult women with polycystic ovary syndrome (PCOS) during a 2-year follow-up.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  One hundred seventy-three adolescent and young adult women, aged 12-22 years, diagnosed with PCOS.
  
  
  METHODS
  Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2-year follow-up. Subjects were classified as NW, OW, or OB. Longitudinal data were analyzed using repeated-measures analysis of variance.
  
  
  METHODS
  Body mass index, self-reported concerns, and lifestyle changes.
  
  
  RESULTS
  Most patients (73%) were OW or OB. Family history of type 2 diabetes was greater in OW (38%) and OB (53%) patients compared with NW (22%) patients (P = .002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients but not in NW patients (0%; P < .001). OW and OB patients had higher fasting insulin (P < .001) and lower high-density lipoprotein cholesterol (P = .005) levels than NW patients, although screening rates were low. Body mass index Z-scores decreased in both OW and OB patients over time (0.07 unit/yr, P < .001).
  
  
  CONCLUSIONS
  Most patients with PCOS were OW or OB. Substantial clinical variability existed in cardiovascular disease (CVD) screening; among those screened, OW and OB patients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW and OB patients, no clinically significant change in body mass index percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: tamara.baer@childrens.harvard.edu.
authors.forename: Tamara E
authors.initials: TE
authors.lastname: Baer
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Carly E
authors.initials: CE
authors.lastname: Milliren
authors.affiliation: Decision Resources, LLC, Burlington, Massachusetts.
authors.forename: Courtney
authors.initials: C
authors.lastname: Walls
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of Pediatric and Adolescent Gynecology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Amy D
authors.initials: AD
authors.lastname: DiVasta
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006946:Hyperinsulinism; D007333:Insulin Resistance; D008403:Mass Screening / Q000379:methods; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Adolescents; Cardiovascular risk factors; Insulin resistance; Obesity; PCOS