Insulin sensitivity and obstructive sleep apnea in adolescents with polycystic ovary syndrome

BACKGROUND: Polycystic ovary syndrome (PCOS) in adults is linked with insulin resistance (IR) and obstructive sleep apnea (OSA). However, less is known about these associations in adolescents. METHODS: We studied three groups of adolescents: 27 obese PCOS (OPCOS) (ages 13-21), 11 normal-weight PCOS (NPCOS) (ages 13-21 years), and eight healthy controls (ages 18-21 years). A hyperinsulinemic euglycemic clamp study was performed in all groups to determine IR by insulin sensitivity (M/I). Polysomnography was performed to assess for OSA in OPCOS and NPCOS groups. We compared indices of IR among all groups and OSA among OPCOS, and NPCOS. RESULTS: We noted that OPCOS and NPCOS and controls differed significantly in their IR. M/I was significantly lower in OPCOS vs. controls (P=0.0061), and also lower for NPCOS vs control but this approached but did not reach statistical significance (P=0.084). In addition, none of the NPCOS subjects had OSA compared to 42% of OPCOS (P=0.03). CONCLUSIONS: Our study suggests OPCOS adolescents have increased IR compared to controls and NPCOS subjects. Higher IR for NPCOS vs controls approached but did not reach statistical significance. Larger studies are needed. In addition, adolescents with OPCOS are at a high risk for OSA.