Polycystic ovary syndrome in adolescents — controversial diagnostic criteria and potential new biomarkers

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting reproductive age women. The etiology and pathogenesis of the syndrome are still not fully understood, but insulin resistance and hyperinsulinemia, neuroendocrine dysfunction leading to elevated luteinizing hormone (LH) levels, imbalance between ovarian and adrenal androgens, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), genetic and epigenetic factors are thought to be involved. Polycystic ovary syndrome may start in adolescence and evolve into adulthood, leading to metabolic, cardiovascular, obstetric, and psychological complications. This makes early diagnosis and treatment very important. The main characteristics of PCOS, and main diagnostic criteria, are menstrual irregularities, clinical or biochemical hyperandrogenism and polycystic ovarian morphology (PCOM). In adolescents these characteristics overlap with physiological pubertal changes, which may lead to late diagnosis or overdiagnosis with adverse late consequences in terms of quality of life in adulthood. That is why there is ongoing research focusing on new biomarkers with high sensitivity and specificity for diagnosing the disease and monitoring the therapy. Some of these potential biomarkers, namely AMH, insulin-like peptide 3 (INSL-3), preptin, nesfatin-1, irisin, and microRNAs (miRNAs) are covered in this review.