Clinical and Hormonal Profile of Adolescents with PCOS and 'At Risk of PCOS': A Cross-Sectional Study.

Authors

Gamidi Meghana, Anju Seth, Preeti Singh, Pratip Jana, Ritu Singh, Kiran Aggarwal, Vibhu Mendiratta

Published in

Indian journal of pediatrics. Jul 28, 2026. Epub Jul 28, 2026.

Abstract

To determine the frequency of polycystic ovary syndrome (PCOS) among symptomatic adolescents and to evaluate their clinical and hormonal profiles.
Hundred post-menarcheal adolescents with menstrual irregularities, acne, and/or hirsutism were evaluated. Assessment included anthropometry, blood pressure, Ferriman-Gallwey (FG) scoring, acne grading and serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, sex hormone-binding globulin (SHBG), prolactin, and thyroid function tests. Free androgen index (FAI) was calculated. Participants were categorized as "PCOS" , "at risk of PCOS" , "others" , or "normal" per 2018 International Guidelines. Fifty age-matched healthy adolescents served as controls.
Among participants, 32% met criteria for PCOS, and 59% for 'at risk of PCOS'. Compared to 'at-risk' adolescents, those with PCOS had significantly higher BMI z-scores, serum LH, LH: FSH ratio, testosterone, and FAI. Over half of the affected adolescents were lean (17/32). Hyperandrogenemia markers (testosterone ≥2.1 nmol/L, FAI ≥97th percentile) and LH: FSH ≥3 were significantly more prevalent in the PCOS group. On multivariable logistic regression, FAI (AOR 1.18, 95% CI 1.06-1.33) and SHBG (AOR 1.08, 95% CI 1.04-1.14) were independently associated with PCOS/'at risk of PCOS' compared with controls. Among symptomatic adolescents, high FAI (AOR 1.26, 95% CI 1.07-1.56), and LH: FSH ratio (AOR 2.32, 95% CI 1.34-4.42) independently differentiated PCOS from the "at risk of PCOS" group.
Adolescents with PCOS and those 'at risk' represent a spectrum with escalating hormonal abnormalities. Early identification of symptomatic adolescents, including lean individuals, are essential for targeted intervention and reduction of long-term risks.

PMID:
42518087
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

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