Available online 17 November 2022
Author links open overlay panelAbstractStudy ObjectiveTo evaluate endometrial stripe (EMS) thickness and its association with menstrual pattern and insulin resistance in adolescent females with or at risk for polycystic ovarian syndrome (PCOS).
MethodsA retrospective case-control study of adolescent females ranging between 12-21 years old evaluated in the Adolescent Gynecology & Endocrinology Clinic (AGEC) at a tertiary children's hospital between 2017-2021. Transabdominal pelvic ultrasound (US) was obtained for evaluation of PCOS or acute pelvic pain. Unadjusted comparisons were performed between imaging measurements in the PCOS group and control (non-PCOS girls with acute pelvic pain) group, as well as analysis of the PCOS group adjusted for age, body mass index, race, and biochemical values. This study was approved by the Institutional Review Board.
ResultsIn our study 54 subjects met inclusion criteria for the PCOS group and 42 for the control group. EMS thickness was thinner in the PCOS group than control (0.55 ± 0.31 cm vs. 0.70 ± 0.23 cm, p<0.001). There was no difference in EMS thickness in the PCOS group when stratified by intermenstrual interval, insulin resistance and other biochemical factors.
ConclusionsOur findings support recommendations by the 2018 International Guidelines to avoid use of US for the establishment of PCOS diagnosis in adolescents. These results highlight the unique pathophysiology of adolescent PCOS in contrast to PCOS in adult women. Further large-scale prospective studies are needed to understand the role of EMS thickness as a prognostic marker in adolescent PCOS.
KeywordsPolycystic ovarian syndrome
PCOS
endometrium thickness
insulin resistance
pelvic ultrasonography
menstrual cycle
adolescents
endometrial hyperplasia
View full text© 2022 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
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