Childhood Adiposity Linked to Polycystic Ovary Syndrome Risk later on, suggests study

PCOS is a common endocrine disorder among females, characterized by a range of metabolic and reproductive issues. Early detection of risk factors such as adiposity and hormonal imbalances can lead to more effective interventions and preventive measures. This study investigates the development of PCOS in a pediatric cohort and identifies potential early signs of the condition.

The prospective Project Viva cohort study included 417 females and assessed cardiometabolic biomarkers and adiposity at three visits: mid childhood (mean age 7.9 years), early teen (mean age 13.1 years), and midteen (mean age 17.8 years). PCOS was defined either through self-reported diagnosis or the presence of ovulatory dysfunction with hyperandrogenism in adolescence. Researchers used multivariable logistic regression to explore associations between metabolic and adiposity markers at each visit and the risk of developing PCOS.

The key findings of the study were:

Adolescents with PCOS (n = 56, 13%) had higher mean BMI z-scores and truncal fat mass compared to those without PCOS at all three visits.

At the early teen visit, PCOS patients had lower adiponectin-to-leptin ratios (0.65 [0.69]) compared to those without PCOS (1.04 [0.97]).

Logistic regression analyses revealed that higher truncal fat mass at mid childhood and early teen visits was associated with increased odds of developing PCOS.

• A lower adiponectin-to-leptin ratio at the midteen visit was associated with decreased odds of PCOS.

• The study found that at the mid childhood visit, patients with PCOS had a mean BMI z-score of 0.66 compared to 0.30 in those without PCOS.

• By the early teen visit, the mean BMI z-score of PCOS patients was 0.88 compared to 0.25 in those without PCOS.

• Truncal fat mass was higher in PCOS patients at all visits, with an average of 3.5 kg at mid childhood, 9.4 kg at the early teen visit, and 11.6 kg at the midteen visit.

• These values were notably higher than those in the non-PCOS group. Adiponectin-to-leptin ratio was found to be lower in PCOS patients compared to those without PCOS, especially at the midteen visit (0.33 vs. 0.75).

• The adjusted models indicated an odds ratio of 1.42 for mid childhood truncal fat mass and 1.61 for early teen truncal fat mass, suggesting a significant association with PCOS risk.

• The lower adiponectin-to-leptin ratio at the midteen visit was linked to a significantly lower odds ratio of 0.14 for developing PCOS.

Excess adiposity and adipose tissue dysfunction during childhood could serve as early indicators of future PCOS risk. By identifying these factors early, healthcare providers may be able to implement preventative measures and interventions to reduce the risk of developing PCOS in later life.

Reference:

Whooten, R. C., Rifas-Shiman, S. L., Perng, W., Chavarro, J. E., Taveras, E., Oken, E., & Hivert, M.-F. (2024). Associations of childhood adiposity and cardiometabolic biomarkers with adolescent PCOS. Pediatrics, e2023064894. https://doi.org/10.1542/peds.2023-064894