Measuring Hormone Could Support PCOS Diagnosis in Teens

Marcia Frellick

September 19, 2016

Measuring blood levels of the recently discovered hormone irisin may reduce the numbers of teenage girls wrongly diagnosed with polycystic ovary syndrome (PCOS), a small study indicates.

Adolescents and women with PCOS are more likely to have irregular periods, excessive levels of male hormones, and excessive hair growth and may find it difficult to conceive because of irregularities in the ovaries. If not treated, PCOS can lead to diabetes and heart disease.

Previous studies have shown elevated levels of irisin, a novel myokine, in adults with PCOS, but diagnosing the syndrome in teens is more difficult because some of the symptoms look much like those brought on by puberty.

Flora Bacopoulou, MD, PhD, from the Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care and First Department of Pediatrics, University of Athens Medical School, Greece, and colleagues say more accurate diagnoses could reduce unnecessary treatments for healthy girls or better prepare them for the complications.

Dr Bacopoulou and colleagues presented the results September 12 at the 2016 Annual European Society for Paediatric Endocrinology Meeting in Paris.

The researchers compared the hormones of 23 lean teenagers diagnosed with PCOS with 17 lean healthy teens (median age 17 years) with matched ages and body mass index (BMI).

They found those with PCOS had significantly higher irisin levels than those in the control group (1.71±1.03 μg/mL vs 1.04±0.35 μg/mL; P < .001), and this was associated with higher levels of testosterone, a key marker of PCOS.

The cause of PCOS is not known, and there is no cure. The most effective treatment when a person with PCOS is overweight or obese is to reduce weight by about 5% to 10%, Dr Bacopoulou told Medscape Medical News .

"In many cases that reverses the signs of the syndrome," she said. Other treatments are oral contraceptive pills or metformin, but if a patient stops taking the pills, the symptoms return.

"There's no optimal treatment at the moment," she said.

The researchers focused on lean adolescents for their study to eliminate obscuring effects, she said. "We think that lean adolescents who have the syndrome are more likely to have a true syndrome because they don't have the obesity factor that makes things worse."

If results are confirmed in larger trials, Dr Bacopoulou said, measuring irisin will give physicians more confidence when they are unsure of a PCOS diagnosis.

If the teen has irregular cycles, has enlarged ovaries of about 10 to 12 mL, higher androgen levels, or modestly excessive body hair, then a raised irisin level may be the deciding factor, she said.

Following adolescents who are diagnosed with PCOS is very important, she notes, because the most dangerous complications are metabolic, and "these women, when they get older, are at great risk of diabetes and insulin resistance," she said. "They should not get lost to follow-up."

If discovered early, PCOS may not last a lifetime, which is why she advises physicians not to label adolescents right away. Some effects can be reversed, she notes.

Dr Bacopoulou has no relevant financial relationships.

For more diabetes and endocrinology news, follow us on Twitter and on Facebook.

2016 Annual European Society for Paediatric Endocrinology Meeting. September 12, 2016. Abstract EC7.2


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.