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      Predictive factors of polycystic ovary syndrome in girls with precocious pubarche


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          The aim of this study is to clarify, in girls with premature pubarche (PP), the influence of premature androgenization on the prevalence of polycystic ovary syndrome (PCOS).

          Design and patients

          Ninety-nine PP girls, 63 who developed PCOS and 36 who did not develop PCOS, were retrospectively included. Clinical, anthropometric, and metabolic parameters were evaluated at the time of diagnosis of PP and after 10 years from menarche to find predictive factors of PCOS.


          Young females with PP showed a PCOS prevalence of 64% and showed a higher prevalence of familial history of diabetes ( P = 0.004) and a lower prevalence of underweight ( P = 0.025) than PP-NO-PCOS. In addition, girls with PP-PCOS showed higher BMI ( P < 0.001), waist circumference ( P < 0.001), total testosterone ( P = 0.026), visceral adiposity index (VAI) ( P = 0.013), total cholesterol ( P < 0.001), LDL-cholesterol ( P < 0.001), non-HDL cholesterol ( P < 0.001) and lower age of menarche ( P = 0.015), ISI-Matsuda ( P < 0.001), DIo ( P = 0.002), HDL cholesterol ( P = 0.026) than PP-NO-PCOS. Multivariate analysis showed that WC ( P = 0.049), ISI-Matsuda ( P < 0.001), oral disposition index (DIo) ( P < 0.001), VAI ( P < 0.001), total testosterone ( P < 0.001) and LDL-cholesterol ( P < 0.001) are independent predictive factors for PCOS in girls with PP.


          Our study established a strong association between multiple risk factors and development of PCOS in PP girls. These risk factors are predominantly related to the regulation of glucose, lipid, and androgen metabolism. Among these factors, WC, ISI-Matsuda, DIo, VAI, total testosterone, and LDL-cholesterol predict PCOS.

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          Most cited references44

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          Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

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            2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020

            The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee (https://doi.org/10.2337/dc20-SPPC), a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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              Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)

              Since the 1990 NIH-sponsored conference on polycystic ovary syndrome (PCOS), it has become appreciated that the syndrome encompasses a broader spectrum of signs and symptoms of ovarian dysfunction than those defined by the original diagnostic criteria. The 2003 Rotterdam consensus workshop concluded that PCOS is a syndrome of ovarian dysfunction along with the cardinal features hyperandrogenism and polycystic ovary (PCO) morphology. PCOS remains a syndrome and, as such, no single diagnostic criterion (such as hyperandrogenism or PCO) is sufficient for clinical diagnosis. Its clinical manifestations may include: menstrual irregularities, signs of androgen excess, and obesity. Insulin resistance and elevated serum LH levels are also common features in PCOS. PCOS is associated with an increased risk of type 2 diabetes and cardiovascular events.

                Author and article information

                Endocr Connect
                Endocr Connect
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                17 June 2021
                01 July 2021
                : 10
                : 7
                : 796-804
                [1 ]Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo , Palermo, Italy
                [2 ]Dipartimento di Promozione della Salute , Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Ostetricia e Ginecologia, Università di Palermo, Palermo, Italy
                [3 ]Dipartimento di Promozione della Salute , Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Gastroenterologia ed Epatologia, Università di Palermo, Palermo, Italy
                Author notes
                Correspondence should be addressed to C Giordano: carla.giordano@ 123456unipa.it
                Author information
                © The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                : 11 May 2021
                : 17 June 2021

                hyperandrogenism,insulin resistance,dyslipidemia,visceral obesity,precocious menarche


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