Prevalence and clinical features of polycystic ovarian syndrome in adolescents with previous childhood growth hormone deficiency
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Alessandro Ciresi
Abstract
Background: Growth hormone (GH) plays a role in the regulation of ovarian function but there are limited data in women with GH deficiency (GHD). Our aim was to evaluate the features of polycystic ovarian syndrome (PCOS) in women with previous GHD.
Methods: Data of 22 adolescents previously GH-treated (group A) were compared with those of 22 women with classical PCOS (group B) and 20 controls (group C).
Results: Group A showed higher testosterone (p=0.048) and prevalence of menstrual irregularities (p<0.001) than group C. Compared to the group B, group A showed lower diastolic blood pressure (p=0.004), degree of hirsutism (p=0.005), testosterone (p=0.003) and prevalence of polycsytic ovaries (POC) morphology (p=0.024), with higher HDL-cholesterol (p=0.035) and 17-β-estradiol (p=0.009).
Conclusions: Adolescents with previous GHD show a higher prevalence of PCOS than controls, but with milder metabolic and hormonal features than adolescents with classical PCOS. A careful long-term follow-up is advisable in these patients.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89:2745–9.10.1210/jc.2003-032046Suche in Google Scholar PubMed
2. Xu LZ, Li R, Sun ZJ, Han DW, Qiu DS. The relationship between leptin, insulin-like growth factor-1 (IGF-1) and hyperinsulinemia of patients with polycystic ovarian syndrome. Sichuan Da Xue Xue Bao Yi Xue Ban 2006;37:882–5.Suche in Google Scholar
3. Holly JM, Eden JA, Alaghband-Zadeh J, Carter GD, Jemmott RC, et al. Insulin-like growth factor binding proteins in follicular fluid from normal dominant and cohort follicles, polycystic and multicystic ovaries. Clin Endocrinol (Oxf) 1990;33:53–64.10.1111/j.1365-2265.1990.tb00465.xSuche in Google Scholar PubMed
4. Poretsky L, Grigorescu F, Seibel M, Moses AC, Flier JS. Distribution and characterization of insulin and insulin-like growth factor I receptors in normal human ovary. J Clin Endocrinol Metab 1985;61:728–34.10.1210/jcem-61-4-728Suche in Google Scholar PubMed
5. Hull KL, Harvey S. Growth hormone and reproduction: a review of endocrine and autocrine/paracrine interactions. Int J Endocrinol 2014;2014:234014.10.1155/2014/234014Suche in Google Scholar PubMed PubMed Central
6. Hull KL, Harvey S. Growth hormone: roles in female reproduction. J Endocrinol 2001;168:1–23.10.1677/joe.0.1680001Suche in Google Scholar PubMed
7. Kaltsas GA, Androulakis II, Tziveriotis K, Papadogias D, Tsikini A, et al. Polycystic ovaries and the polycystic ovary syndrome phenotype in women with active acromegaly. Clin Endocrinol (Oxf) 2007;67:917–22.10.1111/j.1365-2265.2007.02987.xSuche in Google Scholar PubMed
8. Hara M, Ichikawa K, Minemura K, Kobayashi H, Suzuki N, et al. Acromegaly associated with Chiari-I malformation and polycystic ovary syndrome. Intern Med 1996;35:803–7.10.2169/internalmedicine.35.803Suche in Google Scholar PubMed
9. Goto J, Otsuka F, Inagaki K, Tsukamoto N, Suzuki J, et al. Effects of growth hormone reduction in a patient with polycystic ovary syndrome complicated with acromegaly. Endocr J 2009;56:157–60.10.1507/endocrj.K08E-215Suche in Google Scholar
10. Growth Hormone Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society. J Clin Endocrinol Metab 2000;85:3990–3.10.1210/jc.85.11.3990Suche in Google Scholar
11. Hecht Baldauff N, Arslanian S. Optimal management of polycystic ovary syndrome in adolescence. Arch Dis Child 2015;100:1076–83.10.1136/archdischild-2014-306471Suche in Google Scholar PubMed
12. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Hum Reprod 2004;19:41–7.10.1093/humrep/deh098Suche in Google Scholar PubMed
13. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Suche in Google Scholar PubMed
14. Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999;22:1462–70.10.2337/diacare.22.9.1462Suche in Google Scholar PubMed
15. Utzschneider KM, Prigeon RL, Faulenbach MV, Tong J, Carr DB, et al. Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels. Diabetes Care 2009;32:335–41.10.2337/dc08-1478Suche in Google Scholar PubMed PubMed Central
16. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. 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). J Am Med Assoc 2001;285:2486–97.10.1001/jama.285.19.2486Suche in Google Scholar PubMed
17. Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010;33:920–2.10.2337/dc09-1825Suche in Google Scholar PubMed PubMed Central
18. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961;21:1440–7.10.1210/jcem-21-11-1440Suche in Google Scholar PubMed
19. Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, et al. The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr 2015;83:376–89.10.1159/000375530Suche in Google Scholar PubMed
20. Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, et al. Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society. Hum Reprod Update 2014;20:334–52.10.1093/humupd/dmt061Suche in Google Scholar PubMed
21. Nicandri KF, Hoeger K. Diagnosis and treatment of polycystic ovarian syndrome in adolescents. Curr Opin Endocrinol Diabetes Obes 2012;19:497–504.10.1097/MED.0b013e32835a1a03Suche in Google Scholar PubMed
22. Brewer M, Pawelczak M, Kessler M, Shah B. A review of polycystic ovarian syndrome in adolescents. Minerva Pediatr 2010;62:459–73.Suche in Google Scholar
23. de Boer JA, Schoemaker J, van der Veen EA. Impaired reproductive function in women treated for growth hormone deficiency during childhood. Clin Endocrinol (Oxf) 1997;46:681–9.10.1046/j.1365-2265.1997.1800999.xSuche in Google Scholar
24. Lee M. Growth hormone deficiency as the only identifiable cause for primary amenorrhea. J Pediatr Adolesc Gynecol 2000;13:93.10.1016/S1083-3188(00)00025-5Suche in Google Scholar
25. Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010;203:201.e1-5.10.1016/j.ajog.2010.03.008Suche in Google Scholar
26. Legro R, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565–92.10.1210/jc.2013-2350Suche in Google Scholar
27. Drosdzol-Cop A, Sidło-Stawowy A, Sajdak D, Skrzypulec-Plinta V. Diagnosing polycystic ovary syndrome in adolescent girls. Ginekol Pol 2014;85:145–8.10.17772/gp/1705Suche in Google Scholar
28. Agapova SE, Cameo T, Sopher AB, Oberfield SE. Diagnosis and challenges of polycystic ovary syndrome in adolescence. Semin Reprod Med 2014;32:194–201.10.1055/s-0034-1371091Suche in Google Scholar
29. Gambineri A, Fanelli F, Prontera O, Repaci A, Di Dalmazi G, et al. Prevalence of hyperandrogenic states in late adolescent and young women: epidemiological survey on italian high-school students. J Clin Endocrinol Metab 2013;98:1641–50.10.1210/jc.2012-3537Suche in Google Scholar
30. Hull KL, Harvey S. GH as a co-gonadotropin: the relevance of correlative changes in GH secretion and reproductive state. J Endocrinol 2002;172:1–9.10.1677/joe.0.1720001Suche in Google Scholar
31. Genazzani AD, Petraglia F, Volpogni C, Gastaldi M, Pianazzi F, et al. Modulatory role of estrogens and progestins on growth hormone episodic release in women with hypothalamic amenorrhea. Fertil Steril 1993;60:465–70.10.1016/S0015-0282(16)56162-7Suche in Google Scholar
32. Ovesen P, Møller J, Møller N, Christiansen JS, Orskov H, et al. Growth hormone secretory capacity and serum insulin-like growth factor I levels in primary infertile, anovulatory women with regular menses. Fertil Steril 1992;57:97–101.10.1016/S0015-0282(16)54783-9Suche in Google Scholar
33. Piaditis GP, Kounadi TG, Rangou DB, Trovas GP, Kaklas NA, et al. Dysfunction of the growth hormone/insulin-like growth factor-I axis in women with polycystic ovarian syndrome. Clin Endocrinol (Oxf) 1995;42:635–40.10.1111/j.1365-2265.1995.tb02691.xSuche in Google Scholar
34. Lanzone A, Villa P, Fulghesu AM, Pavone V, Caruso A, et al. The growth hormone response to growth hormone-releasing hormone is blunted in polycystic ovary syndrome: relationship with obesity and hyperinsulinaemia. Hum Reprod 1995;10:1653–7.10.1093/oxfordjournals.humrep.a136150Suche in Google Scholar
35. Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015;149:R219–227.10.1530/REP-14-0435Suche in Google Scholar
36. Vélez LM, Motta AB. Association between polycystic ovary syndrome and metabolic syndrome. Curr Med Chem 2014;21:3999–4012.10.2174/0929867321666140915141030Suche in Google Scholar
37. Conway G, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Franks S, et al. The polycystic ovary syndrome: a position statement from the European society of endocrinology. Eur J Endocrinol 2014;171:P1–29.10.1530/EJE-14-0253Suche in Google Scholar
38. Chandrashekar V, Zaczek D, Bartke A. The consequences of altered somatotropic system on reproduction. Biol Reprod 2004;71:17–27.10.1095/biolreprod.103.027060Suche in Google Scholar
39. Bachelot A, Monget P, Imbert-Bolloré P, Coshigano K, Kopchick JJ, et al. Growth hormone is required for ovarian follicular growth. Endocrinology 2002;143:4104–12.10.1210/en.2002-220087Suche in Google Scholar
40. Ahumada-Solórzano SM, Carranza ME, Pedernera E, Rodríguez-Méndez AJ, Luna M, et al. Local expression and distribution of growth hormone and growth hormone receptor in the chicken ovary: effects of GH on steroidogenesis in cultured follicular granulosa cells. Gen Comp Endocrinol 2012;175:297–310.10.1016/j.ygcen.2011.11.027Suche in Google Scholar
41. Apa R, Caruso A, Andreani CL, Miceli F, Lazzarin N, et al. Growth hormone stimulates androsterone synthesis by rat theca-interstitial cells. Mol Cell Endocrinol 1996; 118:95–101.10.1016/0303-7207(96)03769-0Suche in Google Scholar
42. Cara JF, Rosenfield RL. Insulin-like growth factor I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian thecal-interstitial cells. Endocrinology 1988;123:733–9.10.1210/endo-123-2-733Suche in Google Scholar PubMed
43. Tapanainen J, Martikainen H, Voutilainen R, Orava M, Ruokonen A, et al. Effect of growth hormone administration on human ovarian function and steroidogenic gene expression in granulosa-luteal cells. Fertil Steril 1992;58:726–32.10.1016/S0015-0282(16)55319-9Suche in Google Scholar
©2016 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Review
- Resistance to thyroid hormone α, revelation of basic study to clinical consequences
- Original Articles
- Improved molecular diagnosis of patients with neonatal diabetes using a combined next-generation sequencing and MS-MLPA approach
- Safety and metabolic impact of Ramadan fasting in children and adolescents with type 1 diabetes
- Waist-to-height ratio as a marker of low-grade inflammation in obese children and adolescents
- Classification and clinical characterization of metabolically “healthy” obese children and adolescents
- Long-term BH4 (sapropterin) treatment of children with hyperphenylalaninemia – effect on median Phe/Tyr ratios
- Compound heterozygous mutations (p.T561M and c.2422delT) in the TPO gene associated with congenital hypothyroidism
- Prevalence and clinical features of polycystic ovarian syndrome in adolescents with previous childhood growth hormone deficiency
- Urate crystals deposition in the feet of overweight juveniles and those with symptomatic hyperuricemia: a dual-energy CT study
- A novel ALMS1 homozygous mutation in two Turkish brothers with Alström syndrome
- Novel AVPR2 mutation causing partial nephrogenic diabetes insipidus in a Japanese family
- Pituitary gigantism: a retrospective case series
- Case Reports
- A novel OTX2 gene frameshift mutation in a child with microphthalmia, ectopic pituitary and growth hormone deficiency
- A novel nonsense mutation in the WFS1 gene causes the Wolfram syndrome
- A 33-year-old male patient with paternal derived duplication of 14q11.2–14q22.1~22.3: clinical course, phenotypic and genotypic findings
- Familial Turner syndrome: the importance of information
- De novo mutation of PHEX in a type 1 diabetes patient
- Congenital hypothyroidism and thyroid dyshormonogenesis: a case report of siblings with a newly identified mutation in thyroperoxidase
Artikel in diesem Heft
- Frontmatter
- Review
- Resistance to thyroid hormone α, revelation of basic study to clinical consequences
- Original Articles
- Improved molecular diagnosis of patients with neonatal diabetes using a combined next-generation sequencing and MS-MLPA approach
- Safety and metabolic impact of Ramadan fasting in children and adolescents with type 1 diabetes
- Waist-to-height ratio as a marker of low-grade inflammation in obese children and adolescents
- Classification and clinical characterization of metabolically “healthy” obese children and adolescents
- Long-term BH4 (sapropterin) treatment of children with hyperphenylalaninemia – effect on median Phe/Tyr ratios
- Compound heterozygous mutations (p.T561M and c.2422delT) in the TPO gene associated with congenital hypothyroidism
- Prevalence and clinical features of polycystic ovarian syndrome in adolescents with previous childhood growth hormone deficiency
- Urate crystals deposition in the feet of overweight juveniles and those with symptomatic hyperuricemia: a dual-energy CT study
- A novel ALMS1 homozygous mutation in two Turkish brothers with Alström syndrome
- Novel AVPR2 mutation causing partial nephrogenic diabetes insipidus in a Japanese family
- Pituitary gigantism: a retrospective case series
- Case Reports
- A novel OTX2 gene frameshift mutation in a child with microphthalmia, ectopic pituitary and growth hormone deficiency
- A novel nonsense mutation in the WFS1 gene causes the Wolfram syndrome
- A 33-year-old male patient with paternal derived duplication of 14q11.2–14q22.1~22.3: clinical course, phenotypic and genotypic findings
- Familial Turner syndrome: the importance of information
- De novo mutation of PHEX in a type 1 diabetes patient
- Congenital hypothyroidism and thyroid dyshormonogenesis: a case report of siblings with a newly identified mutation in thyroperoxidase
