Evaluation of Hyperinsulinemia in Polycystic Ovary Syndrome Phenotypes in 14-18 Year-old High School Girls in Shiraz, Iran

Document Type : Original Article (s)

Authors

1 Instructor, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

2 Instructor, Department of Midwifery, Marvdasht Health Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Associate Professor, Endocrine and Metabolism Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

4 Assistant Professor, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

5 Assistant Professor, Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: About one-third of obese patients with polycystic ovary syndrome (PCOS) have impaired glucose tolerance and 7.5-10 percent has type II diabetes. Type II diabetes and impaired glucose tolerance are seen in 10% and 1.5% of non-obese women with PCOS as well. In addition to the abnormal glucose metabolism, adolescents with PCOS have been shown to have hyperandrogenism and obesity. The aim of this study was to assess hyperinsulinemia in different phenotypes of PCOS in the 14-18 year-old high school girls in Shiraz, Iran. Methods: The present cross-sectional study was conducted on 3200 girls aged 14-18 years in Shiraz high schools in 2009-2010. Information was collected using a questionnaire that included demographic data, clinical manifestations of hyperandrogenism (acne, hirsutism, and alopecia), and oligomenorrhea. We used the ultrasound diagnostic criteria described by Adams et al. for the diagnosis of PCOS. Fasting and 2-hour post prandial blood glucose levels were measured according to the WHO criteria. Findings: The mean post-prandial glucose was higher in patients with different phenotypes of PCOS compared with the non-PCOS individuals. Mean fasting plasma glucose in hyperandrogenic patients with PCOS phenotypes was non-significantly higher than non-PCOS individuals (P > 0.05). 10 patients (3/33%) with clinical phenotype of oligomenorrhea and hyperandrogenism, 14 patients (32.6%) with oligomenorrhea and PCOS, and 18 patients (41.9%) with clinical Hyperandrogenism and PCOS had hyperinsulinemia. Fisher's test in all three PCOS phenotypes and non-PCOS participants had not produced significant values (P > 0.05). 10.3% of subjects (327 cases) were overweight and 6.2% (82 people) were obese. Conclusion: No case of diabetes mellitus was found in our study population and all participants had normal fasting glucose. However, regarding the study population age (14-18 years) and the risk of development of glucose metabolism disorders, lifestyle modification should be encouraged in this group of patients. Keywords: Hyperinsulinism, Polycystic ovary syndrome, Phenotype, Diabetes