Yüksel Özlem, Atmaca Fatma Güliz, Dursun Fatma, Seymen Gülcan, Atla Pınar, Altun Esma Ebru, Yaşar Ayşe, Kırmızıbekmez Heves
University of Health Sciences Türkiye, Ümraniye Training and Research Hospital, Clinic of Pediatrics, İstanbul, Türkiye
University of Health Sciences Türkiye, Ümraniye Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Türkiye
J Clin Res Pediatr Endocrinol. 2025 Aug 22;17(3):318-325. doi: 10.4274/jcrpe.galenos.2025.2024-7-31. Epub 2025 Jan 31.
Obesity is associated with an increased risk of polycystic ovary syndrome (PCOS). It can be difficult to differentiate between PCOS and physiological oligomenorrhoea/anovulation in adolescent girls. To date, studies of the prevalence of PCOS in adolescents have predominantly used diagnostic criteria validated primarily in adult women. The aim of this study was to investigate the prevalence of PCOS in obese girls using the current diagnostic criteria for adolescents.
The diagnosis of PCOS was based on the presence of menstrual irregularity, clinical hyperandrogenism and hyperandrogenemia and the exclusion of other causes. Patients with one or two of these conditions were classified as “at risk for PCOS”. The control group consisted of patients with obesity alone but no other comorbidity.
A total of 421 patients were included in the study. The number of patients meeting the definition of PCOS was 35, representing a prevalence of 8.3%, while 200 patients (46%) were defined as “at risk for PCOS”. The diagnostic value of the free androgen index (FAI) was found to be adequate, while other tests were poor. The cut-off values were 11 for FAI and 0.44 ng/mL for total testosterone, with optimal sensitivity and specificity.
Despite the increasing number of studies, the diagnosis and management of PCOS in adolescents remains challenging. While efforts should be made to avoid overdiagnosis, it is also important to recognize that many more patients may be at risk of developing PCOS.
肥胖与多囊卵巢综合征（PCOS）风险增加相关。青春期女孩中，PCOS与生理性月经过少/无排卵难以区分。迄今为止，青少年PCOS患病率的研究主要使用主要在成年女性中验证的诊断标准。本研究的目的是使用当前青少年诊断标准调查肥胖女孩中PCOS的患病率。
PCOS的诊断基于月经不规律、临床高雄激素血症和高雄激素血症的存在以及其他病因的排除。有其中一或两种情况的患者被归类为“PCOS风险人群”。对照组由仅患有肥胖症但无其他合并症的患者组成。
本研究共纳入421例患者。符合PCOS定义的患者有35例，患病率为8.3%，而200例患者（46%）被定义为“PCOS风险人群”。发现游离雄激素指数（FAI）的诊断价值足够，而其他检测效果不佳。FAI的临界值为11，总睾酮的临界值为0.44 ng/mL，具有最佳的敏感性和特异性。
尽管研究数量不断增加，但青少年PCOS的诊断和管理仍然具有挑战性。虽然应努力避免过度诊断，但认识到更多患者可能有患PCOS的风险也很重要。
