Adolescent menstrual disorders linked to hyperandrogenemia

By medwireNews Reporters

Menstrual disorders in adolescence are associated with an increased risk for hyperandrogenemia, research shows.

In addition, there was an observed correlation between body mass index (BMI) and hyperandrogenemia and various metabolic parameters.

"The girls with the highest BMI exhibited the greatest degree of hyperandrogenemia and the most unfavorable metabolic findings, and those with the highest FAI [free androgen index] had a more adverse lipid profile," state Laure Morin-Papunen (University Hospital of Oulu, Finland) and colleagues.

Published in Human Reproduction, the population-based, cross-sectional study included 2448 girls aged 15-16 years.

The participants were considered to have a menstrual disorder if the duration of one of their menstrual cycles exceeded 35 days on two or more occasions in 1 year. Of the entire cohort, 709 (29%) reported menstrual disorders and 1739 had regular periods.

Overall, BMI and the waist-to-hip ratio (WHR) correlated significantly, with hyperandrogenemia and metabolic measurements.

Adolescents with menstrual disorders had significantly higher serum concentrations of testosterone, lower levels of sex hormone-binding globulin, and higher FAI.

BMI, insulin sensitivity, and serum levels of glucose, insulin, and lipids were comparable between girls with menstrual disorders and those without.

There was a linear trend toward higher FAI values among girls with higher BMIs in both groups. The difference in FAI values between girls with menstrual disorders and those without was significant in the two highest BMI quartiles, at 0.5 in girls with a BMI of 20.5-22.5 kg/m² and 1.0 in girls with a BMI of 22.5-46.9 kg/m².

In the highest BMI quartile (mean >25.4 kg/m²), girls with menstrual disorders, compared with those without, had significantly higher FAI values and insulin levels, and lower hemostatic model assessment values and serum levels of sex hormone-binding globulin and HDL cholesterol.

After stratifying the participants into FAI quartiles, the researchers observed a significant linear trend toward lower serum HDL cholesterol levels among those in the higher FAI quartiles (from 1.48 to 1.41 mmol/L). Serum triglyceride levels were also significantly increased from the second (0.70-0.74 mmol/L) and third (0.70-0.75 mmol/L) FAI quartiles to the fourth FAI quartile (0.75-0.80 mmol/L).

According to Morin-Papunen and colleagues, the findings support "earlier data showing an association between obesity, hyperandrogenemia, and metabolic risks."

The data strengthen the support of documenting menstrual disorders at an early age, they say.

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