Whooten Rachel C, Rifas-Shiman Sheryl L, Perng Wei, Chavarro Jorge E, Oken Emily, Hivert Marie-France
Division of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.
Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
J Pediatr Adolesc Gynecol. 2025 Aug;38(4):509-514. doi: 10.1016/j.jpag.2025.04.011. Epub 2025 Apr 30.
To assess how moderate-vigorous physical activity (MVPA) may modify the association of early adolescent adiposity with late adolescent polycystic ovary syndrome (PCOS).
Within the Project Viva prospective cohort, we assessed the association of body mass index z-score (BMIz) at early adolescence (mean age 13.1 years) with later PCOS (self-reported diagnosis or oligo-anovulation with clinical/biochemical hyperandrogenism) at mean age 17.7 years. We stratified our analyses by tertile of actigraphy-assessed moderate-vigorous physical activity (MVPA) during early adolescence . In multivariable logistic regression models, we adjusted for maternal education and PCOS, child race and ethnicity, and child health behaviors.
Among 341 female adolescents, n = 47 (14%) met criteria for PCOS in late adolescence. In early adolescence (∼13 years old), mean (SD) BMIz was 0.32 (1.10) units and mean (SD) MVPA was 27.1 (17.9) min/day. After adjusting for covariates, early adolescent BMIz was associated with later PCOS (OR=1.72 95% CI = 1.15, 2.56 per unit increase in BMIz). In stratified analyses, the association of early adolescent BMIz with later PCOS was apparent for those in the lowest tertile of MVPA (OR 3.22; 95% CI 1.25, 8.31) however was weaker among those more active (MVPA tertile 2 OR = 1.65; 95% CI 0.74, 3.67 and tertile 3 OR = 1.34; 95% CI = 0.63, 2.86, respectively).The interaction term p-value was non-significant (P = .36).
Our findings suggest that the detrimental effect of adiposity in relation to PCOS risk is most apparent only among those with lower MVPA. Maintaining adequate MVPA during the early teen years may mitigate PCOS risk associated with excess adiposity.
评估中等强度至剧烈强度的身体活动(MVPA)如何改变青少年早期肥胖与青少年晚期多囊卵巢综合征(PCOS)之间的关联。
在“活力计划”前瞻性队列研究中,我们评估了青少年早期(平均年龄13.1岁)的体重指数z评分(BMIz)与平均年龄17.7岁时的晚期PCOS(自我报告诊断或伴有临床/生化高雄激素血症的少排卵)之间的关联。我们根据青少年早期通过活动记录仪评估的中等强度至剧烈强度身体活动(MVPA)的三分位数对分析进行分层。在多变量逻辑回归模型中,我们对母亲教育程度和PCOS、儿童种族和民族以及儿童健康行为进行了调整。
在341名女性青少年中,n = 47(14%)在青少年晚期符合PCOS标准。在青少年早期(约13岁),平均(标准差)BMIz为0.32(1.10)单位,平均(标准差)MVPA为27.1(17.9)分钟/天。在调整协变量后,青少年早期BMIz与晚期PCOS相关(BMIz每增加一个单位,OR = 1.72,95%CI = 1.15,2.56)。在分层分析中,青少年早期BMIz与晚期PCOS之间的关联在MVPA最低三分位数的人群中明显(OR 3.22;95%CI 1.25,8.31),然而在活动量较大的人群中较弱(MVPA三分位数2,OR = 1.65;95%CI 0.74,3.67;三分位数3,OR = 1.34;95%CI = 0.63,2.86)。交互项p值无统计学意义(P = 0.36)。
我们的研究结果表明,肥胖对PCOS风险的有害影响仅在MVPA较低的人群中最为明显。在青少年早期保持足够的MVPA可能会减轻与肥胖相关的PCOS风险。