Background: Problems with hormonal changes and the related
variations in bone turnover in adolescents with polycystic ovarian syndrome
(PCOS) have been of interest in terms of providing these patients with an
opportunity to receive a prophylactic and precision-based treatment aiming to
prevent early onset of osteoporosis. Materials and methods: Prospective comparative clinical trial—‘case-control’ type in Bulgarian
populace of 36 female patients with PCOS and 42 healthy controls aged 12 to 18.
The study protocol included a general section of anthropometric patient data,
clinical section–including general and Ob/Gyn Medical History, ultrasound exam
of the lesser pelvis and a lab section examining the serum levels of
Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), estradiol,
Anti-Müllerian hormone (AMH) and bone turnover markers–osteocalcin and
-CrossLaps (bCTX), as well as Vitamin D. Results: A
statistically significant high serum levels of the gonadotropic hormones were
observed (LH — p 0.001 и
FSH — p = 0.017), AMH (p 0.001) in patients with PCOS
compared to the controls, while the estradiol (p = 0.043) and
osteocalcin (p 0.001) levels displayed a statistically
significant lower values in patients with PCOS compared to the control group. AMH
can be utilized as a surrogate marker for diagnosing patients with PCOS where the
marker shows sensitivity — 94% and specificity — 69% with threshold value
(cut-off) at 5.95 ng/mL (area under the curve 0.854,
p 0.001). Significant variance in Vitamin D serum
levels between the two groups was not detected. Conclusion: Despite the
hormonal characteristic of normogonadotropic normogonadism in adolescent patients
with PCOS, the significantly lower values of osteocalcin demonstrated suppressed
bone metabolism–bone formation, in particular–compared to the healthy controls,
which can be interpreted as increased risk of insufficient bone accretion and
risk of early onset of osteoporosis later in life.