Characterizing the Adolescent Premature Ovarian Insufficiency Phenotype: A Case Control Study

Published:October 06, 2022DOI:


      Study Objectives

      To characterize the skeletal, cardiometabolic, cognitive, and mental health phenotype of adolescents with idiopathic premature ovarian insufficiency (POI)


      Case control


      Pediatric tertiary referral center in Cincinnati, Ohio


      Nine adolescents (ages 11-18.99 years) with newly diagnosed POI and 9 normally menstruating controls, matched by age and body mass index

      Main Outcome Measures

      Between-group comparisons of bone characteristics assessed by dual energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), psychosocial health (anxiety, depression, and quality of life), and cognition and memory by questionnaire


      Adolescents with POI had lower bone density Z-scores by DXA (lumbar spine −1.93 vs 0.80; whole body less head −2.05 vs 0.00; total hip −1.03 vs 0.83; and femoral neck −1.23 vs 0.91; all P < .001), as well as lower trabecular volumetric bone mineral density (tibia 3% site 226 vs 288 mg/mm3, P < .001; radius 3% site 200 vs 251, P = .001), smaller cortical area (tibia 66% site 251 vs 292 mm2, P = .028), and thickness (tibia 66% site 3.56 vs 4.30 mm, P = .001) than controls. No abnormalities in cardiometabolic biomarkers were detected in POI cases. Adolescents with POI were also more likely to report low energy (78% vs 22%, P = .02).


      Estrogen deficiency adversely affects bone health in adolescents with POI. However, we did not find associations with cardiometabolic, mental health, or cognitive outcomes in this small sample.

      Key Words


      BMD (bone mineral density), POI (premature ovarian insufficiency)
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