Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI.

Context: Polycystic ovary syndrome (PCOS) is a chronic condition with metabolic manifestations spanning the reproductive years.

Objective: We sought to examine glucose metabolism, irrespective of the presence of obesity in a cohort of adolescent girls with PCOS.

Design: One hundred adolescents were assessed for PCOS in a multi-specialty adolescent PCOS program. PCOS was diagnosed by Androgen Excess Society criteria. Oral glucose tolerance testing (OGTT), homeostatic model assessment of insulin resistance, and androgen and lipid profiles were performed for those meeting criteria.

Results: Sixty-six adolescents (mean age 15.8 ± 0.2 yrs, range 13.0-18.6) had confirmed PCOS, and were eligible for inclusion in our analysis. Abnormal glucose metabolism was present in 12 of 66 (18.2%) subjects: 2 (3.0%) impaired fasting glucose, 10 (15.2%) impaired glucose tolerance (IGT), and 1 (1.5%) type 2 diabetes. IGT was the most common abnormality, occurring with equal frequency in obese (OB, mean body mass index (BMI) 36.9 ± 0.8 kg/m(2) ) and non-obese (NOB, mean BMI 24.5 ± 0.6 kg/m(2) ) adolescents (p = 0.3). In a subgroup analysis, NOB adolescents with IGT (NOB-IGT) had similar mean 2-h insulin, high density lipoprotein, C-reactive protein, and testosterone levels to the OB cohort despite marked differences in BMI (p < 0.001) and % body fat (p = 0.002). However, the NOB-IGT group had a lower mean fasting insulin level than the OB cohort (p = 0.04).

Conclusion: Abnormal glucose metabolism is highly prevalent in adolescents with PCOS. In particular, IGT occurs across the spectrum of BMI. A screening OGTT should be considered for adolescents diagnosed with PCOS, independently of their BMI.