ECEESPE2025 Poster Presentations Reproductive and Developmental Endocrinology (93 abstracts)
Baseline obesity classifications influence the impact of pharmacotherapy on weight and BMI in adolescents with PCOS: findings from the clinical adolescent polycystic ovary (CALICO) database
Melanie Cree 1 , Aviva Sopher 2 , David Geller 3 , Rachana Shah 4 , Heidi Vanden Brink 5 , Michele Garant 5 , Amy DiVasta 6 , Rachel Massa 7 , Laura Torchen 8 , Christine Burt Solorzano 9 , Grayson Carey 1 , Janet Snell-Bergeon 1 , Tim Vigers 1 , Nazeen Morelli 1 , Shanlee Davis 1 , Lauryn Roth 1 , Manmohan Kamboj 10 , Jordi Friese 10 , Emily Paprocki 11 , Andrea Bonny 10 , Chase Branstetter 11 , Tania Burgert 11 , Sarah Pitts 6 , Hannah Lamar 5 , Jacqueline Reyes Diaz 12 , Erica Wee 12 , Christy Foster 13 , Anshu Gupta 9 , Bahareh Schweiger 14 , Jordin Frasch 14 , Amy Rydin 15 , Selma Witchel 16 , Akua Afriyie-Gray 15 , Vanessa Davis 17 & Angelina Bernier 18
1University of Colorado, Anschutz Campus, Aurora, United States; 2Columbia University Irving Medical Center, New York, United States; 3Keck School of Medicine, University of Southern California, Los Angeles, United States; 4Children’s Hospital of Philadelphia, Philadelphia, United States; 5Texas A&M University, College Station, United States; 6Boston Children’s Hospital, Boston, United States; 7Vanderbilt University Medical Center, Nashville, United States; 8Northwestern University Feinberg School of Medicine, Chicago, United States; 9School of Medicine, University of Virginia, Charlottesville, United States; 10The Ohio State University College of Medicine, Columbus, United States; 11Children’s Mercy Hospital of Kansas City, Kansas City, United States; 12Driscoll Children’s Hospital, Corpus Christi, United States; 13University of Alabama at Birmingham, Birmingham, United States; 14Cedars Sinai Guerin Childrens’, Los Angeles, United States; 15Dell Medical School at The University of Texas at Austin, Austin, United States; 16University of Pittsburgh Medical Center, Pittsburgh, United States; 17Cook County Health, Chicago, United States; 18University of Florida College of Medicine, Gainesville, United States
JOINT2820
Background: Estrogen-containing contraceptives (EC) and metformin are leading pharmacotherapies for polycystic ovary syndrome (PCOS), yet the impact of these medications on weight and body mass index (BMI) gains over time in adolescents are unclear. We sought to understand the effect of these treatments on the velocity of changes in weight and BMI over time in teens with PCOS, and if there was a differential effect based on preceding BMI category.
Methods: Participant (n = 899) information was extracted from the CALICO Database, a longitudinal chart review with data on adolescents with PCOS diagnosed using the 2018 international guidelines at 17 US sites. For this analysis, the primary outcomes were change in weight and BMI over time. As such, we excluded patients taking weight loss medications, atypical antipsychotics, and daily hormone therapies other than EC. Linear mixed effects models evaluated the differences in weight/BMI change trajectories over time between Ever EC Users (pill, patch, or ring, n = 458) vs Never EC Users (n = 441) and Ever Metformin Users (n = 503) vs Never Metformin Users (n = 396). All models were adjusted for age, race, and insurance status. Models were conducted by weight subgroup (BMI 5-84%, BMI 85-94%, BMI ≥95%). EC models were adjusted for metformin use, and vice versa. Analyses were performed using R version 4.4.2.
Results: For those with a BMI <85%ile, no group had an increase in weight trajectory over time. While taking medications, there was a decrease in both weight and BMI trajectories in those taking EC [-0.146(-0.257,-0.036)kg/mo, P = 0.010; -0.0627(-0.1055,-0.0198), kg/m2/mo, P = 0.005] or metformin [-0.211(-0.349,-0.074)kg/mo, P = 0.003; -0.2112(-0.3485,-0.0738)kg/m2/mo, P = 0.003]. For the overweight participants, no group demonstrated increases in weight velocities over time. Those taking metformin had a decrease in both weight [-0.382(-0.575,-0.189)kg/mo,P = 0.0002] and BMI [-0.113(-0.181,-0.0441)kg/m2/mo, P = 0.002] trajectories while taking the medications. For girls with obesity, BMI increased over time for EC [0.026(0.006,0.049)kg/m2/mo, P = 0.013] and metformin [0.0255(0.0008,0.0441) kg/m2/mo, P = 0.042] groups, but not the non-treatment groups [No EC 0.0256(-0.0086,0.0599) kg/m2/mo, P = 0.142; No metformin 0.0272(-0.0073,0.0617) kg/m2/mo, P = 0.122]. There was no change in the positive weight (P = 0.503) and BMI (P = 0.6840) trajectories while taking EC, whereas during metformin use, the weight [-0.1453(-0.2506,-0.0401) kg/mo, P = 0.007] and BMI [-0.0532(-0.0898,-0.0166)kg/m2/mo, P = 0.005] gain trajectories were significantly less positive.
Conclusion: The impact of EC and metformin on weight and BMI over time differ by baseline BMI category in adolescents with PCOS. Counseling of the weight effects of these medications should be guided by the patients’ pretreatment BMI category.
Volume 110
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Endocrine Abstracts
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