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lüll Clinical review: Identifying children at risk for polycystic ovary syndrome Rosenfield RLJ Clin Endocrinol Metab 2007[Mar]; 92 (3): 787-96CONTEXT: Polycystic ovary syndrome (PCOS) appears to arise as a complex trait with contributions from both heritable and nonheritable factors. Polygenic influences appear to account for about 70% of the variance in pathogenesis. In view of this evidence for congenital contributions to the syndrome, childhood manifestations may be expected. OBJECTIVE: The objective has been to review the evidence that risk factors for PCOS can be recognized in childhood. DESIGN: This study consisted of screening of the PCOS literature for articles pertaining to potential childhood and adolescent antecedents. RESULTS: Congenital virilizing disorders; above average or low birth weight for gestational age; premature adrenarche, particularly exaggerated adrenarche; atypical sexual precocity; or intractable obesity with acanthosis nigricans, metabolic syndrome, and pseudo-Cushing syndrome or pseudo-acromegaly in early childhood have been identified as independent prepubertal risk factors for the development of PCOS. During adolescence, PCOS may masquerade as physiological adolescent anovulation. Asymptomatic adolescents with a polycystic ovary occasionally (8%) have subclinical PCOS but often (42%) have a subclinical PCOS type of ovarian dysfunction, the prognosis for which is unclear. CONCLUSION: Identifying children at risk for PCOS offers the prospect of eventually preventing some of the long-term complications associated with this syndrome once our understanding of the basis of the disorder improves.|Adolescent[MESH]|Adrenarche/physiology[MESH]|Anovulation/etiology[MESH]|Child[MESH]|Female[MESH]|Humans[MESH]|Hypothalamus/physiopathology[MESH]|Models, Biological[MESH]|Obesity/etiology[MESH]|Ovary/physiopathology[MESH]|Pituitary Gland/physiopathology[MESH]|Polycystic Ovary Syndrome/congenital/*diagnosis/etiology/physiopathology[MESH]|Puberty, Precocious/etiology[MESH]|Risk Factors[MESH] |