Research shows that Guangdong adolescent patients with normal body mass index but thick waist circumference, three years after menarche and still scanty menstruation, have a high probability of polycystic ovary syndrome Only “fat girls” get polycystic ovary syndrome? Not necessarily! The reporter learned from a recent symposium on polycystic ovary syndrome that research shows that Chinese patients are far less obese than Caucasians, and the average body mass index of patients in southern China is significantly lower than that in the north, which may be influenced by diet and geographical factors. The average body mass index of patients in southern China is significantly lower than that in northern China, which may be influenced by diet and geographical factors. As the most common female endocrine disorder, polycystic ovary syndrome can cause infertility and frequent miscarriages, and the best time to intervene is during puberty, not before planning to have a baby. If a girl still has scanty menstruation or amenorrhea two or three years after her menarche, she has a 50% or higher chance of having polycystic ovary syndrome and should be treated as soon as possible. The patient’s characteristics: normal weight, waist-to-hip ratio exceeds the standard Polycystic ovary syndrome is a common female gynecological disease, due to ovulatory dysfunction or loss of ovulation function, the body androgen excess, resulting in hyperandrogenemia, patients often appear irregular menstrual cycle, infertility, hirsutism, acne, obesity. The impression is that obesity is a typical characteristic of such patients, and past studies have shown that obese patients can even account for 60% of patients. ”The large sample study we conducted showed that the salient feature of adolescent patients in Guangdong is that they are not fat in appearance, with a body mass index of even less than 23, but have a thick waist circumference and an excessive waist-to-hip ratio.” This intermediate type of obesity is also called “male obesity” because of the high androgen in the patient’s body, resulting in the selective accumulation of fat in the waist and abdomen. When the waist-to-hip ratio is too high and the body mass index exceeds 23, the indicators of polycystic ovary syndrome are 10 times higher than those of the average patient, and the risk of developing metabolic syndromes such as diabetes is also steeply increased. About a quarter of patients with polycystic ovary syndrome end up heading for metabolic syndrome, with a higher incidence than in the general population. Adolescent patients are even more unusual in that 16 percent are already in prediabetes, manifested by the development of abnormal glucose tolerance, and “progress from prediabetes to type 2 diabetes in about six years.” She suggests that adolescent patients must start controlling their weight as early as possible and insist on regular waist circumference measurements, rather than focusing on “how many pounds of weight gain”. Three years after menarche, irregular menstruation is an alarm Polycystic ovary syndrome can occur throughout the patient’s adolescence and sexual maturity, but its manifestations during adolescence are more complex and easier to ignore. Patients in adolescence are highlighted by hirsutism, acne and irregular periods, and some develop islet resistance. “In fact, these symptoms can be easily confused with the normal manifestations of pubertal development.” Because the body is growing rapidly, normal adolescent girls will develop physiological islet resistance and will develop acne and hirsutism due to hormonal fluctuations in the body. However, one can simply identify if the disease is present by observing normal menstruation. Studies have shown that about 30% of adolescent girls have irregular menstruation at the beginning of menarche. But by two or three years after menarche, that percentage drops dramatically to only 8 to 9 percent, with nearly 50 percent of them diagnosed with polycystic ovary syndrome. ”By the time three years after menarche, only 6 percent still had irregular periods. And with the prevalence of polycystic ovary syndrome in adults at about 6 percent, the two numbers basically match.” If parents find that their daughters are still having scanty periods and amenorrhea two or three years after menarche, and are hairy on the upper lip, lower abdomen and inner thighs, they should be highly suspicious of the “alarm” of polycystic ovary syndrome and should go to the hospital for blood tests to see if the androgen content, insulin, blood sugar and other indicators are over the limit. Androgen testing can also cause “false alarms”. Testing for androgen levels is one of the diagnostic criteria for polycystic ovary syndrome. However, it is common to see “false alarms” from androgen tests in clinical practice. Some people have symptoms of polycystic ovary syndrome but have normal androgen tests, while others have high androgens but the condition is not severe. Some people have high androgen levels in one hospital, but then change hospitals and become “normal”, often leading to misunderstandings among patients. ”This is related to the current confusion of androgen testing reagents and testing standards.” The different kits used by different hospitals can lead to different test results. On the other hand, most hospitals in China only test one index, total testosterone, but most of the total testosterone will combine with sex hormone binding globulin in the body and lose its activity, therefore, a high level of total testosterone measured does not represent the level of free testosterone in the body. Currently, the mainstream international concept is to test the “free testosterone index”, i.e. both total testosterone and sex hormone binding globulin. Treatment should not be delayed until the childbearing years. Because the body is still developing and full of uncertainty, the treatment of adolescent patients is more difficult. “The symptoms that adolescent patients exhibit are likely to be different from year to year.” Some patients present primarily with hyperandrogenemia this year, and then come in for follow-up next year and islet resistance becomes the main problem again. Therefore, in long-term follow-up, the treatment plan needs to be adjusted according to the different conditions. Some patients have better control of their disease and do not need to stay on oral contraceptives, but still need to monitor their weight for a long time. Clinically, there are often female patients who delay treatment until their childbearing years, and there are also patients who have had multiple miscarriages and have difficulty conceiving when they come for infertility treatment, only to discover that their condition is rooted in polycystic ovary syndrome. Experts say that the benefits to patients are more obvious when intervention is made early and not delayed until the reproductive years. For more mildly affected patients, the effects of delayed treatment may manifest as recurrent miscarriages and infertility. Even if they do conceive, the risk of gestational diabetes and gestational hypertension is high. “If a patient with infertility has frequent irregular periods, it is best to rule out polycystic ovaries first.”