Original Study Serum Adiponectin Levels in High School Girls with Polycystic Ovary Syndrome and Hyperandrogenism L. Yasar 1 , M. Ekin 1 , * , A. Gedikbasi 2 , A.D. Erturk 1 , K. Savan 1 , A. Ozdemir 1 , M. Temur 1 1 Clinics of Gynecology Obstetrics, Bakirkoy Dr. Sadi Konuk Education and Training Hospital 2 Department of Biochemistry, Bakirkoy Dr. Sadi Konuk Education and Training Hospital, Istanbul, Turkey abstract Objective: To compare the serum adiponectin levels together with metabolic and hormonal parameters among teenage girls at the early onset of polycystic ovary syndrome (PCOS) and hyperandrogenism with controls. Design: Prospective study. Settings: Education and research hospital, outpatient gynecological endocrinology clinic. Participants: Four hundred seventy-nine teenage girls from a school of nursing were interviewed for the signs and symptoms of PCOS. Among them, 42 cases who had a definitive diagnosis of PCOS with hyperandrogenism based on Rotterdam diagnostic criteria were recruited for the study and other causes of hyperandrogenemia had been excluded. The controls were recruited from regularly cycling healthy teenage girls from the same high school of nursing; none of those who agreed to join the study met any of the diagnostic criteria for PCOS (n 5 44). Interventions: Cases were selected as group I: PCOS with body mass index (BMI) !25 kg/m 2 (n 5 20), group II: PCOS with BMI O25 kg/m 2 (n 5 22), group III: Controls with BMI !25 kg/m 2 (n 5 21) and group IV: Controls with BMI O25 kg/m 2 (n 5 23). Serum adiponectin, metabolic and hormonal parameters were compared in PCOS patients with BMI matched controls. Main Outcome Measures: Difference of serum adiponectin levels, metabolic and hormonal parameters between teenage girls with PCOS and controls. Results: Serum adiponectin levels were not significantly different in group I and group II. Serum adiponectin levels were significantly decreased in group I and group II compared with both control groups (III and IV). Conclusion: Serum adiponectin levels were lower in teenage girls with PCOS and this reduction was independent from BMI. Key Words: Adiponectin, Hyperandrogenism, PCOS, BMI Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic diseases affecting 6e10% of women of reproductive age. 1 Women with PCOS are at increased risk to develop endometrial cancer, diabetes mellitus, hypercholesterolemia, hypertension and probably heart disease. 2e4 PCOS has different etiologic factors and it has a clinical presentation which may include insulin resistance, hyperandrogenism, obesity and ovulatory dysfunction. PCOS is characterized by oligomenorrhea, hyperandrogenism, and/or polycystic ovaries on ultrasound. 2 Insulin resistance has the critical role in the development of PCOS. There are several reports that emphasize the impacts of adipose tissue inpathogenesis of PCOS. 5e9 Adipose tissue is not an inert reserve of triglycerides, but rather an active endocrine organ that plays an important role on insulin and other hormones which regulates the energy metabolism. Adiponectin is an adipocytokine regarded as a possible link between adiposity and insulin resistance. This seems to be accomplished among other means by the action of so-called adipo (cyto)-kines, biological molecules which are secreted and most likely contribute to peripheral insulin sensitivity. 6,7 In vitro, adiponectin has shown to have anti-atherogenic effects and has a potent insulin sensitizing action. 10,11 Paradoxically in humans, adiponectin levels were found to be decreased in obese, compared to normal, individuals, whereas high adiponectin levels are indepen- dently associated with increased insulin sensitivity. 12 Clinical manifestation of PCOS could be seen as early as adolescence. 1 It is not easy to confirm definitive diagnosis of PCOS, especially in adolescent girls, because of physiological menstrual irregularities and body changes depending on rapid growth. 1 The aim of the present study was to measure serum adiponectin levels in teenage girls with PCOS, related to body mass index (BMI); and to compare hormonal or metabolic parameters of the syndrome with BMI matched controls. Materials and Methods Symptoms of PCOS were researched among 479 teenage girls in a school of nursing with a questionnaire. Seventy-six of them who had described the symptoms of PCOS were interviewed for the signs and symptoms of PCOS. Out of these, eleven of them were not diagnosed as PCOS. Fourteen of them had oligomenorrhea and polycystic ovaries at * Address correspondence to: Murat Ekin, Bakirkoy Sadi Konuk Education and Research Hospital Obstetrics & Gynecology Tevfik Saglam Cad. No: 11 Zuhuratbaba 34147 istanbul Turkey E-mail address: muratekinmd@gmail.com (M. Ekin). 1083-3188/$ - see front matter Ó 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. doi:10.1016/j.jpag.2010.11.003