The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents
Relevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogeni...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/6/1831 |
| _version_ | 1797565522801328128 |
|---|---|
| author | Elena Khashchenko Elena Uvarova Mikhail Vysokikh Tatyana Ivanets Lyubov Krechetova Nadezhda Tarasova Iuliia Sukhanova Fatima Mamedova Pavel Borovikov Ivan Balashov Gennady Sukhikh |
| author_facet | Elena Khashchenko Elena Uvarova Mikhail Vysokikh Tatyana Ivanets Lyubov Krechetova Nadezhda Tarasova Iuliia Sukhanova Fatima Mamedova Pavel Borovikov Ivan Balashov Gennady Sukhikh |
| author_sort | Elena Khashchenko |
| collection | DOAJ |
| description | Relevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. The aim of the present study was to characterize the pivotal clinical and hormonal features of PCOS in adolescents and to establish the age-specific thresholds of the most essential hormonal parameters. Design: A case-control study. Methods: The study included 130 girls with PCOS according to the complete Rotterdam criteria, aged 15 to 17 years. The control group consisted of 30 healthy girls with a regular menstrual cycle of the same age. A complete clinical and laboratory examination, hormonal assays, and ultrasound of the pelvic organs were performed. The serums anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, prolactin, estradiol, 17α-OH progesterone (17α-OHP), androstenedione, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), leptin, and free androgen index (FAI) were analyzed. The diagnostic accuracy of AMH, FAI, LH/FSH, T, and androstenedione levels in predicting PCOS in adolescents was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC). Results: The serum levels of LH (9.0 (5.4–13.8) vs. 3.7 (2.5–4.7) IU/L; <i>p</i> < 0.0001), LH/FSH (1.6 (1.0–2.3) vs. 0.7 (0.5–1.1); <i>p</i> < 0.0001), 17α–OHP (4.1 (3.2–5.1) vs. 3.4 (2.7–3.8) nmol/L; <i>p</i> = 0.0071), cortisol (464.0 ± 147.6 vs. 284.0 ± 129.7 nmol/L; <i>p</i> < 0.0001), prolactin (266.0 (175.0–405.0) vs. 189.0 (142.0–269.0) mIU/L; <i>p</i> = 0.0141), T (1.9 (1.2–2.5) vs. 0.8 (0.7–1.1) nmol/L; <i>p</i> < 0.0001), androstenedione (15.8 (11.6–23.2) vs. 8.3 (6.5–10.8) ng/mL; <i>p</i> < 0.0001), AMH (9.5 (7.5–14.9) vs. 5.8 (3.8–6.9) ng/mL; <i>p</i> < 0.0001), FAI (5.5 (2.8–7.0) vs. 1.6 (1.1–2.3); <i>p</i> < 0.0001), SHBG (37.0 (24.7–55.5) vs. 52.9 (39.0–67.6) nmol/L; <i>p</i> = 0.0136), DHEAS (6.8 ± 3.2 vs. 5.1 ± 1.5 μmol/L; <i>p</i> = 0.0039), and leptin (38.7 ± 27.1 vs. 23.7 ± 14.0 ng/mL; <i>p</i> = 0.0178) were significantly altered in the PCOS patients compared to the controls. Multivariate analysis of all studied hormonal and instrumental parameters of PCOS in adolescents revealed as the most essential: AMH level > 7.20 ng/mL, FAI > 2.75, androstenedione > 11.45 ng/mL, total T > 1.15 nmol/L, LH/FSH ratio > 1.23, and the volume of each ovary > 10.70 cm<sup>3</sup> (for each criterion sensitivity ≥ 75.0–93.0%, specificity ≥ 83.0–93.0%). The diagnostic accuracy of PCOS determination was 90.2–91.6% with the combined use of either four detected indexes, which was significantly higher than the use of each index separately. The accuracy of PCOS diagnostics reached 92% using AMH and leptin concentrations when the value of the logistic regression function [85.73 − (1.73 × AMH) − (0.12 × Leptin)] was less than 70.72. Conclusions: The results of the study estimate the threshold for AMH, FAI, androstenedione, testosterone, LH/FSH, and ovarian volume, which could be suggested for use in the PCOS diagnostics in adolescents with a high sensitivity and specificity. Moreover, the combination of either four determined indexes improved the diagnostic accuracy for the PCOS detection in adolescents. |
| first_indexed | 2024-03-10T19:14:24Z |
| format | Article |
| id | doaj.art-c559d4c065d246d1ad190313be0667ab |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:14:24Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c559d4c065d246d1ad190313be0667ab2023-11-20T03:34:09ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0196183110.3390/jcm9061831The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in AdolescentsElena Khashchenko0Elena Uvarova1Mikhail Vysokikh2Tatyana Ivanets3Lyubov Krechetova4Nadezhda Tarasova5Iuliia Sukhanova6Fatima Mamedova7Pavel Borovikov8Ivan Balashov9Gennady Sukhikh10FSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaFSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation, 4, Oparina Street, 117997 Moscow, RussiaRelevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. The aim of the present study was to characterize the pivotal clinical and hormonal features of PCOS in adolescents and to establish the age-specific thresholds of the most essential hormonal parameters. Design: A case-control study. Methods: The study included 130 girls with PCOS according to the complete Rotterdam criteria, aged 15 to 17 years. The control group consisted of 30 healthy girls with a regular menstrual cycle of the same age. A complete clinical and laboratory examination, hormonal assays, and ultrasound of the pelvic organs were performed. The serums anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, prolactin, estradiol, 17α-OH progesterone (17α-OHP), androstenedione, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), leptin, and free androgen index (FAI) were analyzed. The diagnostic accuracy of AMH, FAI, LH/FSH, T, and androstenedione levels in predicting PCOS in adolescents was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC). Results: The serum levels of LH (9.0 (5.4–13.8) vs. 3.7 (2.5–4.7) IU/L; <i>p</i> < 0.0001), LH/FSH (1.6 (1.0–2.3) vs. 0.7 (0.5–1.1); <i>p</i> < 0.0001), 17α–OHP (4.1 (3.2–5.1) vs. 3.4 (2.7–3.8) nmol/L; <i>p</i> = 0.0071), cortisol (464.0 ± 147.6 vs. 284.0 ± 129.7 nmol/L; <i>p</i> < 0.0001), prolactin (266.0 (175.0–405.0) vs. 189.0 (142.0–269.0) mIU/L; <i>p</i> = 0.0141), T (1.9 (1.2–2.5) vs. 0.8 (0.7–1.1) nmol/L; <i>p</i> < 0.0001), androstenedione (15.8 (11.6–23.2) vs. 8.3 (6.5–10.8) ng/mL; <i>p</i> < 0.0001), AMH (9.5 (7.5–14.9) vs. 5.8 (3.8–6.9) ng/mL; <i>p</i> < 0.0001), FAI (5.5 (2.8–7.0) vs. 1.6 (1.1–2.3); <i>p</i> < 0.0001), SHBG (37.0 (24.7–55.5) vs. 52.9 (39.0–67.6) nmol/L; <i>p</i> = 0.0136), DHEAS (6.8 ± 3.2 vs. 5.1 ± 1.5 μmol/L; <i>p</i> = 0.0039), and leptin (38.7 ± 27.1 vs. 23.7 ± 14.0 ng/mL; <i>p</i> = 0.0178) were significantly altered in the PCOS patients compared to the controls. Multivariate analysis of all studied hormonal and instrumental parameters of PCOS in adolescents revealed as the most essential: AMH level > 7.20 ng/mL, FAI > 2.75, androstenedione > 11.45 ng/mL, total T > 1.15 nmol/L, LH/FSH ratio > 1.23, and the volume of each ovary > 10.70 cm<sup>3</sup> (for each criterion sensitivity ≥ 75.0–93.0%, specificity ≥ 83.0–93.0%). The diagnostic accuracy of PCOS determination was 90.2–91.6% with the combined use of either four detected indexes, which was significantly higher than the use of each index separately. The accuracy of PCOS diagnostics reached 92% using AMH and leptin concentrations when the value of the logistic regression function [85.73 − (1.73 × AMH) − (0.12 × Leptin)] was less than 70.72. Conclusions: The results of the study estimate the threshold for AMH, FAI, androstenedione, testosterone, LH/FSH, and ovarian volume, which could be suggested for use in the PCOS diagnostics in adolescents with a high sensitivity and specificity. Moreover, the combination of either four determined indexes improved the diagnostic accuracy for the PCOS detection in adolescents.https://www.mdpi.com/2077-0383/9/6/1831polycystic ovary syndromeadolescentshyperandrogenismfree androgen indexanti-Müllerian hormoneleptin |
| spellingShingle | Elena Khashchenko Elena Uvarova Mikhail Vysokikh Tatyana Ivanets Lyubov Krechetova Nadezhda Tarasova Iuliia Sukhanova Fatima Mamedova Pavel Borovikov Ivan Balashov Gennady Sukhikh The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents Journal of Clinical Medicine polycystic ovary syndrome adolescents hyperandrogenism free androgen index anti-Müllerian hormone leptin |
| title | The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents |
| title_full | The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents |
| title_fullStr | The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents |
| title_full_unstemmed | The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents |
| title_short | The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents |
| title_sort | relevant hormonal levels and diagnostic features of polycystic ovary syndrome in adolescents |
| topic | polycystic ovary syndrome adolescents hyperandrogenism free androgen index anti-Müllerian hormone leptin |
| url | https://www.mdpi.com/2077-0383/9/6/1831 |
| work_keys_str_mv | AT elenakhashchenko therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT elenauvarova therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT mikhailvysokikh therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT tatyanaivanets therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT lyubovkrechetova therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT nadezhdatarasova therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT iuliiasukhanova therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT fatimamamedova therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT pavelborovikov therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT ivanbalashov therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT gennadysukhikh therelevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT elenakhashchenko relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT elenauvarova relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT mikhailvysokikh relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT tatyanaivanets relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT lyubovkrechetova relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT nadezhdatarasova relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT iuliiasukhanova relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT fatimamamedova relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT pavelborovikov relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT ivanbalashov relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents AT gennadysukhikh relevanthormonallevelsanddiagnosticfeaturesofpolycysticovarysyndromeinadolescents |