Document Detail


Polycystic ovary syndrome in the pediatric population.
MedLine Citation:
PMID:  20939704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Polycystic ovary syndrome (PCOS) is a common disorder characterized by hyperandrogenism and disordered gonadotropin secretion, often associated with insulin resistance. The syndrome, which modulates both hormonal and metabolic processes, is the most common endocrinopathy in reproductive-age women and increases a woman's risk of infertility, endometrial pathology, and cardiometabolic disease. As it is currently defined, PCOS most likely encompasses several distinct diseases with similar clinical phenotypes but different underlying pathophysiological processes. However, hyperandrogenism remains the syndrome's clinical hallmark. The clinical manifestations of PCOS often emerge during childhood or in the peripubertal years, suggesting that the syndrome is influenced by fetal programming and/or early postnatal events. However, given that the full clinical spectrum of PCOS does not typically appear until puberty, a "two-hit" hypothesis has been proposed: (1) a girl develops hyperandrogenism via one or more of many different potential mechanisms; (2) the preexisting hyperandrogenism subsequently disturbs the hypothalamic–pituitary–ovarian axis, resulting in ovulatory dysfunction and sustained hyperandrogenism. No consensus guidelines exist regarding the diagnosis and management of PCOS in the pediatric population; however, because the syndrome is a diagnosis of exclusion, the clinical evaluation of girls suspected of having PCOS is aimed at excluding other causes of androgen excess and menstrual dysfunction. For the syndrome's management, emphasis is placed on lifestyle and symptom-directed treatment.
Authors:
Andrew A Bremer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Metabolic syndrome and related disorders     Volume:  8     ISSN:  1557-8518     ISO Abbreviation:  Metab Syndr Relat Disord     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-13     Completed Date:  2011-02-02     Revised Date:  2012-04-27    
Medline Journal Info:
Nlm Unique ID:  101150318     Medline TA:  Metab Syndr Relat Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-94     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Endocrinology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9170, USA. andrew.a.bremer@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Androgens / metabolism
Child
Comorbidity
Female
Hirsutism / complications
Humans
Hyperandrogenism / metabolism
Insulin / metabolism
Models, Biological
Ovary / metabolism
Pediatrics / methods*
Polycystic Ovary Syndrome / complications,  diagnosis*,  epidemiology*
Grant Support
ID/Acronym/Agency:
KL2 RR024144/RR/NCRR NIH HHS; UL1 RR024146/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Androgens; 0/Insulin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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