Context: PCOS is a familial endocrine-metabolic dysfunction, increasingly recognized in adolescent girls with hyperandrogenism. However, it is difficult to establish if the metabolic abnormalities described in PCOS are present before the onset of hyperandrogenism. In children, a strong association of adiponectin levels with metabolic parameters of insulin resistance has been described.

Objective: To evaluate adiponectin serum concentrations and metabolic parameters in prepubertal and pubertal daughters of women with PCOS, in order to identify girls with increased metabolic risk.

Design: Fifty three prepubertal and 22 pubertal (Tanner II-V) daughters of PCOS women (PCOSd), and 32 prepubertal and 17 pubertal daughters of control women (Cd) were studied. In both groups, an oral glucose tolerance test was performed with measurement of glucose and insulin. Adiponectin, leptin, C-reactive protein, SHBG, sex steroids and lipids were determined in the fasting sample.

Results: Both groups had similar chronological ages, BMI SDS and Tanner stage distribution. In the prepubertal girls, 2 h insulin was higher (p= 0.023) and adiponectin levels were lower (p= 0.004) in the PCOSd group compared to the Cd group. In the pubertal girls, triglycerides (p= 0.03), 2 h insulin (p=0.01) and serum testosterone concentrations were higher (p=0.012) and SHBG lower (p=0.009) in PCOSd compared to Cd, but adiponectin levels were similar in both groups.

Conclusions: Some of the metabolic features of PCOS are present in daughters of PCOS women before the onset of hyperandrogenism. Adiponectin appears to be one of the early markers of metabolic derangement in these girls.