title: Distinguishing characteristics of metabolically healthy versus metabolically unhealthy obese adolescent girls with polycystic ovary syndrome.
abstract: OBJECTIVE
  To investigate the key physical, metabolic, hormonal and cardiovascular characteristics of metabolically healthy obese (MHO) versus unhealthy obese (MUHO) girls with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Research center.
  
  
  METHODS
  Seventy obese girls with PCOS were divided into 19 MHO and 51 MUHO based on cutoff points for in vivo insulin sensitivity (within and < 2 SDs of the mean of the insulin sensitivity of the normal-weight girls, respectively).
  
  
  METHODS
  None.
  
  
  METHODS
  Body composition, abdominal fat, in vivo insulin sensitivity and secretion (hyperinsulinemic-euglycemic and hyperglycemic clamps respectively), hormonal profile, and cardiovascular disease risk markers.
  
  
  RESULTS
  MUHO-PCOS girls had higher waist circumference, visceral adipose tissue, leptin, and free testosterone, lower SHBG and E2, higher non-high-density lipoprotein (HDL) cholesterol and atherogenic lipoprotein particle concentrations, smaller HDL particle size, and higher high-sensitivity C-reactive protein compared with MHO-PCOS girls. Hepatic and peripheral insulin sensitivity were lower with higher first- and second-phase insulin secretion, but β-cell function relative to insulin sensitivity was lower in MUHO versus MHO. Pair matching of MHO and MUHO regarding age and body mass index revealed similar findings. MUHO-PCOS girls had larger visceral adiposity, lower insulin sensitivity and β-cell function, worse hormonal profile, and severely atherogenic lipoprotein concentrations compared with MHO-PCOS girls.
  
  
  CONCLUSIONS
  MHO-PCOS girls have favorable physical, metabolic, hormonal, and cardiovascular disease (CVD) characteristics and lower risk biomarkers for type 2 diabetes compared with their MUHO-PCOS peers. A greater understanding of the contrast in this risk phenotype in obese girls with PCOS may have important implications for therapeutic interventions, their outcomes, and their durability.
authors.affiliation: Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hala
authors.initials: H
authors.lastname: Tfayli
authors.affiliation: Human Performance and Exercise Science, Youngstown State University, Pittsburgh, Pennsylvania.
authors.forename: Sara F
authors.initials: SF
authors.lastname: Michaliszyn
authors.affiliation: Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Sojung
authors.initials: S
authors.lastname: Lee
authors.affiliation: Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: silva.arslanian@chp.edu.
authors.forename: Silva
authors.initials: S
authors.lastname: Arslanian
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006304:Health Status; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008659:Metabolic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*
chemical_list: D001786:Blood Glucose
keywords: PCOS; metabolic risk; obese adolescents