Menstrual disorders in adolescence: a marker for hyperandrogenaemia and increased metabolic risks in later life? Finnish general population-based birth cohort study
Human Reproduction, 08/31/2012
Pinola P et al. – Information regarding menstrual disorders in adolescence is a good marker of hyperandrogenaemia and may be an early risk factor for the development of PCOS in adulthood. The association between obesity, hyperandrogenism and metabolic risks is already evident in adolescence, which strengthens the importance of noting menstrual disorders at an early stage.
- This population–based, cross–sectional study used postal questionnaires to targeting 15–16–year–old girls in the Northern Finland Birth Cohort 1986 (n= 4567).
- There were 3669 girls who answered the postal questionnaire and out of 3373 girls who also underwent clinical examinations and blood tests, 2448 were included in the analyses.
- The questionnaire included one question about the regularity and length of the menstrual cycle: ‘Is your menstrual cycle (the interval from the beginning of one menstrual period to the beginning of the next period) often (more than twice a year) longer than 35 days’
- The girls who answered ‘yes’ to this question were considered to be suffering from menstrual disorders and were classified as ‘symptomatic’.
- The girls who answered ‘no’ were defined as ‘non–symptomatic’.
- There were 709 (29%) girls who reported menstrual disorders (symptomatic girls) and 1739 who had regular periods (non–symptomatic girls).
- In the whole population and in both study groups, there were significant correlations between body mass index (BMI) (and waist–to–hip ratio), hyperandrogenaemia and metabolic parameters.
- Symptomatic girls exhibited significantly higher serum concentrations of testosterone (P= 0.010), lower levels of sex hormone–binding globulin (P =0.042) and higher free androgen indices [FAIs; geometric mean 3.38 (interquartile range (IQR): 2.27, 5.18) versus 3.08 (IQR: 2.15, 4.74), P= 0.002].
- The two groups had comparable BMI and insulin sensitivity, and serum levels of glucose, insulin and lipids.
- There was a significant linear trend towards higher FAI values in the higher BMI quartiles in both symptomatic and non–symptomatic girls.
- In the whole population, there was a statistically significant linear decrease in high–density lipoprotein concentrations (P < 0.001) and higher triglyceride concentrations (P =0.004) in the upper FAI quartile.