Clinical review: Identifying children at risk for polycystic ovary syndrome.

Abstract

CONTEXT:

Polycystic ovary syndrome (PCOS) appears to arise as a complex trait with contributions from both heritable and nonheritable factors. Polygenic influences appear to account for about 70% of the variance in pathogenesis. In view of this evidence for congenital contributions to the syndrome, childhood manifestations may be expected.

OBJECTIVE:

The objective has been to review the evidence that risk factors for PCOS can be recognized in childhood.

DESIGN:

This study consisted of screening of the PCOS literature for articles pertaining to potential childhood and adolescent antecedents.

RESULTS:

Congenital virilizing disorders; above average or low birth weight for gestational age; premature adrenarche, particularly exaggerated adrenarche; atypical sexual precocity; or intractable obesity with acanthosis nigricans, metabolic syndrome, and pseudo-Cushing syndrome or pseudo-acromegaly in early childhood have been identified as independent prepubertal risk factors for the development of PCOS. During adolescence, PCOS may masquerade as physiological adolescent anovulation. Asymptomatic adolescents with a polycystic ovary occasionally (8%) have subclinical PCOS but often (42%) have a subclinical PCOS type of ovarian dysfunction, the prognosis for which is unclear.

CONCLUSION:

Identifying children at risk for PCOS offers the prospect of eventually preventing some of the long-term complications associated with this syndrome once our understanding of the basis of the disorder improves.

• Authors: Robert L Rosenfield
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 92 Issue 3 Pg. 787-96 (Mar 2007) ISSN: 0021-972X [Print] United States
• PMID: 17179197 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)

Topics

• Adolescent
• Adrenarche (physiology)
• Anovulation (etiology)
• Child
• Female
• Humans
• Hypothalamus (physiopathology)
• Models, Biological
• Obesity (etiology)
• Ovary (physiopathology)
• Pituitary Gland (physiopathology)
• Polycystic Ovary Syndrome (congenital, diagnosis, etiology, physiopathology)
• Puberty, Precocious (etiology)
• Risk Factors