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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

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Volume 29, Issue 5


Prevalence and clinical features of polycystic ovarian syndrome in adolescents with previous childhood growth hormone deficiency

Alessandro Ciresi
  • Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marco C. Amato
  • Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jessica Bianco
  • Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Carla Giordano
  • Corresponding author
  • Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Italy
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-03-08 | DOI: https://doi.org/10.1515/jpem-2015-0423


Background: Growth hormone (GH) plays a role in the regulation of ovarian function but there are limited data in women with GH deficiency (GHD). Our aim was to evaluate the features of polycystic ovarian syndrome (PCOS) in women with previous GHD.

Methods: Data of 22 adolescents previously GH-treated (group A) were compared with those of 22 women with classical PCOS (group B) and 20 controls (group C).

Results: Group A showed higher testosterone (p=0.048) and prevalence of menstrual irregularities (p<0.001) than group C. Compared to the group B, group A showed lower diastolic blood pressure (p=0.004), degree of hirsutism (p=0.005), testosterone (p=0.003) and prevalence of polycsytic ovaries (POC) morphology (p=0.024), with higher HDL-cholesterol (p=0.035) and 17-β-estradiol (p=0.009).

Conclusions: Adolescents with previous GHD show a higher prevalence of PCOS than controls, but with milder metabolic and hormonal features than adolescents with classical PCOS. A careful long-term follow-up is advisable in these patients.

Keywords: GH deficiency; growth hormone (GH); polycystic ovarian syndrome


  • 1.

    Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89:2745–9.Google Scholar

  • 2.

    Xu LZ, Li R, Sun ZJ, Han DW, Qiu DS. The relationship between leptin, insulin-like growth factor-1 (IGF-1) and hyperinsulinemia of patients with polycystic ovarian syndrome. Sichuan Da Xue Xue Bao Yi Xue Ban 2006;37:882–5.Google Scholar

  • 3.

    Holly JM, Eden JA, Alaghband-Zadeh J, Carter GD, Jemmott RC, et al. Insulin-like growth factor binding proteins in follicular fluid from normal dominant and cohort follicles, polycystic and multicystic ovaries. Clin Endocrinol (Oxf) 1990;33:53–64.Google Scholar

  • 4.

    Poretsky L, Grigorescu F, Seibel M, Moses AC, Flier JS. Distribution and characterization of insulin and insulin-like growth factor I receptors in normal human ovary. J Clin Endocrinol Metab 1985;61:728–34.Google Scholar

  • 5.

    Hull KL, Harvey S. Growth hormone and reproduction: a review of endocrine and autocrine/paracrine interactions. Int J Endocrinol 2014;2014:234014.Web of ScienceGoogle Scholar

  • 6.

    Hull KL, Harvey S. Growth hormone: roles in female reproduction. J Endocrinol 2001;168:1–23.Google Scholar

  • 7.

    Kaltsas GA, Androulakis II, Tziveriotis K, Papadogias D, Tsikini A, et al. Polycystic ovaries and the polycystic ovary syndrome phenotype in women with active acromegaly. Clin Endocrinol (Oxf) 2007;67:917–22.Google Scholar

  • 8.

    Hara M, Ichikawa K, Minemura K, Kobayashi H, Suzuki N, et al. Acromegaly associated with Chiari-I malformation and polycystic ovary syndrome. Intern Med 1996;35:803–7.Google Scholar

  • 9.

    Goto J, Otsuka F, Inagaki K, Tsukamoto N, Suzuki J, et al. Effects of growth hormone reduction in a patient with polycystic ovary syndrome complicated with acromegaly. Endocr J 2009;56:157–60.Web of ScienceGoogle Scholar

  • 10.

    Growth Hormone Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society. J Clin Endocrinol Metab 2000;85:3990–3.Google Scholar

  • 11.

    Hecht Baldauff N, Arslanian S. Optimal management of polycystic ovary syndrome in adolescence. Arch Dis Child 2015;100:1076–83.Web of ScienceGoogle Scholar

  • 12.

    Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Hum Reprod 2004;19:41–7.Google Scholar

  • 13.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.Google Scholar

  • 14.

    Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999;22:1462–70.Google Scholar

  • 15.

    Utzschneider KM, Prigeon RL, Faulenbach MV, Tong J, Carr DB, et al. Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels. Diabetes Care 2009;32:335–41.Web of ScienceGoogle Scholar

  • 16.

    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). J Am Med Assoc 2001;285:2486–97.Google Scholar

  • 17.

    Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010;33:920–2.Google Scholar

  • 18.

    Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961;21:1440–7.Google Scholar

  • 19.

    Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, et al. The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr 2015;83:376–89.Google Scholar

  • 20.

    Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, et al. Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society. Hum Reprod Update 2014;20:334–52.Web of ScienceGoogle Scholar

  • 21.

    Nicandri KF, Hoeger K. Diagnosis and treatment of polycystic ovarian syndrome in adolescents. Curr Opin Endocrinol Diabetes Obes 2012;19:497–504.Google Scholar

  • 22.

    Brewer M, Pawelczak M, Kessler M, Shah B. A review of polycystic ovarian syndrome in adolescents. Minerva Pediatr 2010;62:459–73.Google Scholar

  • 23.

    de Boer JA, Schoemaker J, van der Veen EA. Impaired reproductive function in women treated for growth hormone deficiency during childhood. Clin Endocrinol (Oxf) 1997;46:681–9.Google Scholar

  • 24.

    Lee M. Growth hormone deficiency as the only identifiable cause for primary amenorrhea. J Pediatr Adolesc Gynecol 2000;13:93.Google Scholar

  • 25.

    Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010;203:201.e1-5.Google Scholar

  • 26.

    Legro R, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565–92.Google Scholar

  • 27.

    Drosdzol-Cop A, Sidło-Stawowy A, Sajdak D, Skrzypulec-Plinta V. Diagnosing polycystic ovary syndrome in adolescent girls. Ginekol Pol 2014;85:145–8.Google Scholar

  • 28.

    Agapova SE, Cameo T, Sopher AB, Oberfield SE. Diagnosis and challenges of polycystic ovary syndrome in adolescence. Semin Reprod Med 2014;32:194–201.Web of ScienceGoogle Scholar

  • 29.

    Gambineri A, Fanelli F, Prontera O, Repaci A, Di Dalmazi G, et al. Prevalence of hyperandrogenic states in late adolescent and young women: epidemiological survey on italian high-school students. J Clin Endocrinol Metab 2013;98:1641–50.Web of ScienceGoogle Scholar

  • 30.

    Hull KL, Harvey S. GH as a co-gonadotropin: the relevance of correlative changes in GH secretion and reproductive state. J Endocrinol 2002;172:1–9.Google Scholar

  • 31.

    Genazzani AD, Petraglia F, Volpogni C, Gastaldi M, Pianazzi F, et al. Modulatory role of estrogens and progestins on growth hormone episodic release in women with hypothalamic amenorrhea. Fertil Steril 1993;60:465–70.Google Scholar

  • 32.

    Ovesen P, Møller J, Møller N, Christiansen JS, Orskov H, et al. Growth hormone secretory capacity and serum insulin-like growth factor I levels in primary infertile, anovulatory women with regular menses. Fertil Steril 1992;57:97–101.Google Scholar

  • 33.

    Piaditis GP, Kounadi TG, Rangou DB, Trovas GP, Kaklas NA, et al. Dysfunction of the growth hormone/insulin-like growth factor-I axis in women with polycystic ovarian syndrome. Clin Endocrinol (Oxf) 1995;42:635–40.Google Scholar

  • 34.

    Lanzone A, Villa P, Fulghesu AM, Pavone V, Caruso A, et al. The growth hormone response to growth hormone-releasing hormone is blunted in polycystic ovary syndrome: relationship with obesity and hyperinsulinaemia. Hum Reprod 1995;10:1653–7.Google Scholar

  • 35.

    Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015;149:R219–227.Web of ScienceGoogle Scholar

  • 36.

    Vélez LM, Motta AB. Association between polycystic ovary syndrome and metabolic syndrome. Curr Med Chem 2014;21:3999–4012.Google Scholar

  • 37.

    Conway G, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Franks S, et al. The polycystic ovary syndrome: a position statement from the European society of endocrinology. Eur J Endocrinol 2014;171:P1–29.Google Scholar

  • 38.

    Chandrashekar V, Zaczek D, Bartke A. The consequences of altered somatotropic system on reproduction. Biol Reprod 2004;71:17–27.Google Scholar

  • 39.

    Bachelot A, Monget P, Imbert-Bolloré P, Coshigano K, Kopchick JJ, et al. Growth hormone is required for ovarian follicular growth. Endocrinology 2002;143:4104–12.Google Scholar

  • 40.

    Ahumada-Solórzano SM, Carranza ME, Pedernera E, Rodríguez-Méndez AJ, Luna M, et al. Local expression and distribution of growth hormone and growth hormone receptor in the chicken ovary: effects of GH on steroidogenesis in cultured follicular granulosa cells. Gen Comp Endocrinol 2012;175:297–310.Web of ScienceGoogle Scholar

  • 41.

    Apa R, Caruso A, Andreani CL, Miceli F, Lazzarin N, et al. Growth hormone stimulates androsterone synthesis by rat theca-interstitial cells. Mol Cell Endocrinol 1996; 118:95–101.Google Scholar

  • 42.

    Cara JF, Rosenfield RL. Insulin-like growth factor I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian thecal-interstitial cells. Endocrinology 1988;123:733–9.Google Scholar

  • 43.

    Tapanainen J, Martikainen H, Voutilainen R, Orava M, Ruokonen A, et al. Effect of growth hormone administration on human ovarian function and steroidogenic gene expression in granulosa-luteal cells. Fertil Steril 1992;58:726–32.Google Scholar

About the article

Corresponding author: Carla Giordano, Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Italy, Phone: +39.091.6552109, Fax: +39.091.6552123, E-mail:

Received: 2015-10-27

Accepted: 2015-12-30

Published Online: 2016-03-08

Published in Print: 2016-05-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 5, Pages 571–578, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0423.

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