Newly Discovered Hormone May Aid Accurate Diagnosis of PCOS in Teenagers

Highlights

• Polycystic ovary syndrome (PCOS), a common endocrine disorder affecting up to 12% of women.
• Symptoms include irregular periods, acne, obesity and excess hair growth.
• Diagnosis of PCOS in teenage girls may pose a problem since symptoms resemble normal pubertal changes.
• Measurement of blood irisin levels may help correctly diagnose PCOS, thereby avoiding unnecessary treatment in normal pubertal girls.

Irisin Levels in PCOS Diagnosis of polycystic ovarian syndrome (PCOS) in teenage girls is difficult since many of the symptoms could be seen as a part of the normal changes occurring in pubertal girls. It is essential to have a tool that would help in making an accurate diagnosis of PCOS, especially in teenagers. This would avoid unnecessary treatment being given to normal girls at a critical phase in their lives.

Scientists have found that measuring blood levels of irisin, a newly discovered hormone involved in brown adipose tissue activity may allow in making an accurate diagnosis of PCOS.

In their study, Greek researchers at Aghia Sophia Children's Hospital in Athens compared the hormones of 23 teenagers suspected to be having PCOS with 17 healthy teenagers of the same age and body mass index (BMI). They discovered that teenage girls with PCOS had significantly higher levels of irisin compared to the control group. Studies have also shown that circulating irisin is a primary predictor of hyperandrogenism (androgen excess), a key finding in PCOS.

"Teenagers who get an early diagnosis of PCOS can sooner start to deal with the physical and psychological symptoms caused by this lifelong condition," said lead researcher Dr. Flora Bacopoulou. "Whether it's through counseling or medication, girls can manage their symptoms and decrease the risk of further complications such as fertility problems, hirsutism (excessive hair growth) and type-2 diabetes".

These findings seem to suggest that irisin could be a marker in making a diagnosis of PCOS.

About PCOS

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Polycystic Ovary Syndrome (PCOS) is an endocrine disorder of unknown cause and affects women between the ages of 18 and 44. It is thought that a combination of genetic and hormonal factors may be responsible for the condition, and the prevalence varies between 4 to 12%. It is hypothesized that abnormal levels of the pituitary hormone luteinizing hormone (LH) and increased levels of male hormones (androgens) interfere with normal function of the ovaries.

The characteristic features of PCOS include

• Irregular periods
• Obesity
• Oily skin and acne
• Excess hair growth
• Pelvic pain
• Anxiety
• Depression.

Multiple ovarian cyst and ovulation is affected.

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PCOS is the most common cause of infertility among women. These women also have an increased risk of developing type 2 diabetes.

Presently there is no known cure for the condition.

Irisin and Its Physiological Role

In January 2012, Boström and colleagues discovered a new peptide hormone secreted by skeletal muscle and carried to other parts of the body, which they named irisin.

Irisin is named after Iris, the Greek goddess who acted as courier among the Gods.

The secretion of irisin is increased with exercise. Irisin hormone is believed to play a key role in the conversion of white adipose tissue (WAT) to brown adipose tissue, which is associated with weight loss. The circulating irisin levels are found to be markedly lower in persons with type 2 diabetes compared with non-diabetic control subjects. Its mechanism of action remains unknown.

The expression of irisin, and its role in brown adipose tissue formation and activity is positively associated with body mass index (BMI) and muscle mass. It has been postulated that dyslipidemia (high levels of lipids) plays a major role in the pathogenesis of PCOS, and that aberrant regulation of irisin metabolism may also contribute to the development of PCOS.

Future Research Plans

The researchers plan on confirming their results and to further investigate the biological role of irisin in PCOS. "If high irisin levels in teenagers with PCOS is established, this could lead to the development of treatments for PCOS. Lifestyle changes and different exercise-related signals that regulate the secretion of irisin could provide a potential option for the management of PCOS. The potential of irisin as a meaningful drug target in PCOS is very promising," said Dr. Bacopoulou.

Tips for Living with PCOS

• Healthy Eating: Diet low in carbohydrates and sugars can help reverse the imbalances of glucose and insulin in the body.
• Exercising everyday (30 – 60 minutes of mild to moderate activity) has been shown to lower insulin resistance.
• Avoid Caffeine: Coffee and other stimulants boost the insulin levels which have a negative impact on women with PCOS
• Weight loss - Loss of excess weight can cut the severity of PCOS symptoms.
• Practice relaxation techniques to reduce symptoms of depression, stress and mood swings
• Get regular physical examinations

References:

1. PCOS - (http://www.mayoclinic.org/diseases-conditions/pcos/basics/definition/con-20028841)
2. PCOS Fact Sheet - (http://womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html#c)
3. Irisin Two Years Later - (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835481/)
4. Circulating Irisin and Glucose Dependent Insulinotropic Peptide are Associated with the Development of PCOS - (http://press.endocrine.org/doi/full/10.1210/jc.2014-1180)
5. PCOS Management and Treatment - (https://jeanhailes.org.au/health-a-z/pcos/management-treatment)
6. Living with PCOS - Things to Avoid - (http://www.keeperofthehome.org/2008/10/living-with-pcos-things-to-avoid.html)

Source-Medindia