Excess Androgen in Obese Adolescent Girls

The four- to fivefold upswing in overweight among children and adolescents in recent years has been accompanied by a marked increase in the prevalence of both type II diabetes and the metabolic syndrome (MBS) in these age groups. The subsequent increase in androgen levels and increased risk of cardiovascular disease have become topics of concern.

Recently, Dr. A. D. Coviello and colleagues at Northwestern University Feinberg School of Medicine, Chicago, reported that of a group of adolescent girls with polycystic ovary syndrome (PCOS), as many as 63% of girls who were obese also had MBS. In comparison, in the NHANES-III study, 32% of obese girls had MBS (J Clin Endocrinol Metab 2006; 91:393).

After adjusting for body mass index, girls with PCOS were four times as likely to show features of MBS. The odds of MBS characteristics being present were four times higher for each quartile increase in plasma unbound testosterone. Thus, there was strong evidence that teens with PCOS have a higher prevalence of MBS and that above-normal androgen levels increase the risk for MBS, independent of obesity and insulin resistance.