A Scoping Review of the Association Between Childhood Obesity and Early-Onset Polycystic Ovary Syndrome (PCOS)

Introduction Childhood obesity, defined as body mass index (BMI) _x۰۰۰۶_۶۹۵th percentile for age and sex, is a globally escalating public health concern and a major contributor to the early manifestation of polycystic ovary syndrome (PCOS) during adolescence. Recent evidence indicates a high prevalence of hyperandrogenemia (up to ۴۰%) among prepubertal obese girls, markedly elevating the risk of PCOS while accelerating metabolic complications_x۰۰۰۶_۴such as insulin resistance_x۰۰۰۶_۴and reproductive disturbances, including menstrual irregularities. Methods This scoping review was conducted according to the methodological framework proposed by Arksey and O ۰Malley (۲۰۰۵) and refined by Levac et al. (۲۰۱۰), with reporting aligned to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Inclusion criteria comprised original studies and reviews published in English or Persian between ۲۰۰۰ and ۲۰۲۵ that examined the relationship between childhood obesity (BMI or age at adiposity rebound) and early-onset PCOS (diagnosed using Rotterdam or NIH criteria before ۱۸ years of age). Animal studies and publications lacking relevant data were excluded. Comprehensive searches were performed in PubMed, Scopus, Web of Science, and Google Scholar using terms including _x۰۰۰۶_quot;childhood obesity,_x۰۰۰۶_quot; _x۰۰۰۶_quot;early onset PCOS,_x۰۰۰۶_quot; and their Persian equivalents (December ۲۰۲۵). Two independent reviewers screened records and extracted data using Covidence software, capturing author details, study design, population characteristics, and key findings. Data were synthesized descriptively and presented in tabular format, with emphasis on pathophysiological mechanisms, risk factors, and preventive interventions; quantitative meta-analysis was not performed. Results: Of ۶۱۲ identified records, ۱۲ studies (۳ cohort/longitudinal and ۹ reviews) met inclusion criteria. Key emerging themes were: (۱) ۲.۵ ۶۴.۹۹-fold higher prevalence of PCOS among obese girls (OR ۳.۸۰ for overweight, OR ۴.۹۹ for obesity); (۲) early adiposity rebound (_x۰۰۰۶_lt;۵ years) as a strong predictor of adult PCOS diagnosis (HR ۱.۸) and persistent obesity up to age ۴۶ years; (۳) core pathophysiological pathways involving hyperinsulinemia, adipokine-mediated inflammation, and reduced sex hormone-binding globulin (SHBG); (۴) early weight-loss interventions ۶including metformin ۶reducing risk by ۳۰ ۶۵۰%; and (۵) PCOS prevalence of approximately ۲۰ ۶۲۴% among girls with type ۲ diabetes, with notable ethnic variation. Limitations included heterogeneity in diagnostic criteria and scarcity of longitudinal data from low- and middle-income settings. Discussion and Conclusion Robust evidence confirms a strong causal link between childhood obesity and early-onset PCOS, underscoring the urgency of early screening (from ۸ ۶۱۲ years of age) and lifestyle-based interventions. Future research should prioritize multinational longitudinal cohorts and explore ethnic and genetic modifiers to refine prevention strategies

کلیدواژه ها:

Childhood obesity ، Early-onset PCOS ، Hyperandrogenism ، Scoping review