Polycystic ovary syndrome in adolescence - a look at the problem
DOI:
https://doi.org/10.15574/SP.2022.124.65Keywords:
polycystic ovary syndrome, adolescent girlsAbstract
Purpose - to present a review of literature data on the etiology and pathogenesis of polycystic ovary syndrome (PCOS) in adolescents.
A review of the scientific literature on PCOS on the keywords «polycystic ovary syndrome - PCOS», «Stein Leventhal syndrome», «functional ovarian hyperandrogenism or functional ovarian hyperandrogenism», «hyperandrogenic chronic anovulation»; «ovarian dysmetabolic syndrome» using as a search engine PubMed.
Currently, PCOS is considered a heterogeneous and complex syndrome, which is accompanied by ovarian dysfunction (absence or irregularity of ovulation, increased secretion of androgens and estrogens), pancreas (insulin hypersecretion), adrenal cortex (hypersecretory adrenal androgens, hypothalamus and pituitary gland and and has negative reproductive and metabolic effects. The prevalence of PCOS in adolescents by various criteria ranges from 8% to 17%. Potential risk of PCOS are low or high birth weight, childhood obesity, prenatal androgenism, metabolic syndrome, genetic mutations in chromosome 18. The most reliable criteria for PCOS in young patients are: a combination of ultrasound (morphological) picture of the ovaries, (the ratio of sex hormones and hyperandrogenism), the dynamics of the menstrual cycle (amenorrhea), against the background of dysmetabolic disorders (obesity, hyperinsulinism, impaired glucose tolerance). An additional diagnostic criterion may be the level of antimullerian hormone.
Conclusions. Clinically, PCOS is a heterogeneous syndrome that manifests itself in all periods of life. The main physiological and pathological mechanism of PCOS is an excess of androgens, which disrupts the development of follicles and promotes the deposition of abdominal adipose tissue, causing insulin resistance and compensatory hyperinsulinism. Exposure to the fetus’ hyperinsulinemic and hyperandrogenic environment of the uterus leads to epigenetic changes, which, in addition to the genetic background, predispose to the development of metabolic disorders in the offspring of women with PCOS. This is a rational basis for finding PCOS at an early age, which will allow to diagnose it in time in adolescence. Not all aspects are covered in detail in this review due to limited scope. Problematic issues of clinically relevant markers of PCOS and its predictors in adolescent patients require in-depth study.
No conflict of interests was declared by the authors.
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