Poster Abstracts / J Pediatr Adolesc Gynecol 30 (2017) 275e298 279

served as evidence of the SRY gene. The AMH levels are consistent with her
imaging ndings of absent Mu llerian structures. An HCG stimulation test
can help distinguish between abnormal androgen synthesis and abnormal
androgen sensitivity. An abnormal testosterone response to HCG suggests
an error in androgen synthesis as is seen in cases of enzyme deciencies or
LH receptor defects with subsequent Leydig cell hypoplasia. In the setting
of an abnormal response to HCG stimulation, an ACTH stimulation test is
indicated to assess for possible adrenal insufciency. If a normal testos-
terone response to HCG is seen, a form of androgen insensitivity should be
investigated. This latter scenario is less likely in our case given the low
testosterone levels in the setting of elevated LH and FSH levels. Our case
underscores the complex etiologies of DSD. Failure of the patient to keep
follow up appointments highlights the difculty patients may have in
comprehending and accepting their diagnosis.

10. Anthropometric Markers Are Poor Predictors of

Androgen Levels in Obese Adolescent Girls With PCOS

Lauren A. Kanner MD, Jennifer L. Rehm MD, M. Tracy Bekx MD,

Jens Eickhoff PhD, David B. Allen MD, Ellen L. Connor MD*

University of Wisconsin School of Medicine and Public Health, Madison, WI

Background: Hyperandrogenism in PCOS has been directly associated

with abdominal fat accumulation. Waist circumference (WC), in contrast to
BMI, preferentially assesses visceral adiposity by measuring visceral,
intraperitoneal and abdominal subcutaneous fat to give an estimate of
global adiposity distribution. Since women with PCOS are distinguished by
a higher abdominal fat deposition, increased WC might be associated.
Therefore, in addition to its correlation with insulin resistance (IR), a strong
correlation between WC and androgen levels is plausible. While excess
abdominal adiposity has been positively correlated with total and free
testosterone levels in women with and without PCOS, WC has not been
11. Reduced Fertility Potential in Young Females
evaluated as an independent and clinically feasible predictor of
Following Hematopoietic Stem Cell Transplantation
hyperandrogenism.
Despite Reduced Intensity Conditioning
We hypothesize that targeted testing of obese adolescent females
based upon WC facilitates detection of hyperandrogenism and IR. This
study compares the correlation of BMI, WC and WC to BMI ratio with Helen Oquendo-del Toro 1, Jonathan C. Howell MD, PhD 2,
androgen levels in adolescents with known hyperandrogenism. Janie Benoit MD 1, Stella Davies MBBS, PhD, MRCP 3, Michael Grimley MD 3,
Methods: Retrospective cross-sectional chart review of adolescent girls Sonata Jodele MD 3, Pooja Khandelwal MD 3, Javier El-Bietar MD 3,
ages 13-20 years (median age 16 years) meeting Androgen Excess-PCOS Rebecca Marsh MD 3, Adam Nelson MD 3, Gregory Wallace MD 3,
Society diagnostic criteria for PCOS presenting to a multidisciplinary clinic Christopher Dandoy MD 3, Pauline Daniels MD 3, Abigail Pate 3,
between 2011-2016. Those using oral contraceptives or metformin at Lesley Breech MD 1, Holly Hoefgen MD 1, Susan R. Rose MD 2,
initial visit were excluded. BMI, WC, WC/BMI and weight for age z-scores Kasiani C. Myers MD*3
were analyzed compared to free (FT) and total testosterone (TT), fasting 1

insulin (FI), and fasting glucose (FG) levels. Division of Pediatric and Adolescent Gynecology, Cincinnati Childrens
Results: Forty-six subjects met inclusion criteria (Table 1). Multivariate Hospital Medical Center, Cincinnati, OH
2

analysis (Table 2) conrmed that weight-for-age is an independent pre- Division of Endocrinology, Cincinnati Childrens Hospital Medical Center,
dictor for FG.BMI z-score is moderately positively correlated with fasting Cincinnati, OH
3

glucose and fasting insulin. Waist Circumference is moderately positively
correlated with FI. Weight-for-age z-score is strongly positively correlated
with FG. There was no signicant association between BMI z-score,
weight-for-age or WC with total or free testosterone.
Conclusions: Multiple studies in adult women report an association
between abdominal adiposity and hyperandrogenism. This study of ado-
lescents with PCOS does not support these previous studies as both BMI
and WC were non-signicant predictors of testosterone levels. These re-
sults could be secondary to WC being an inaccurate indicator of abdominal
adiposity in this group, but this seems unlikely given extensive prior
experience demonstrating validity of WC and to an the expected correla-
tions of these measures with markers of insulin resistance. Perhaps like the
evolution of hirsutism as hyperandrogenism continues, the relationship
between abdominal adiposity and hyperandrogenism is an evolving one
and may not be apparent in an adolescent population. Further study of this
data will include a case-control study comparing these data to matched
control obese adolescent females to for correlations of androgens and
anthropometric measures in those with and without known
hyperandrogenemia.
Acknowledgements: Research supported by NIH Grant T32 DK077586.
Bone Marrow Transplantation and Immune Deciency, Childrens Hospital
Medical Center, Cincinnati, OH
Background: Hematopoietic stem cell transplantation (HSCT) is an
increasingly common treatment for childhood malignancies and other
genetic and immune disorders. More recently, reduced intensity condi-
tioning (RIC) in preparation for HSCT has been used to mitigate compli-
cations of HSCT. The goal of RIC is to maintain therapeutic efcacy while
limiting toxic side effects. Risk of infertility and primary ovarian insuf-
ciency in females after more intense, myeloablative HSCT is high, but little
is known of late endocrine and fertility effects with the use of RIC HSCT.
Objectives: Longitudinally evaluate gonadal function and fertility po-
tential in young females after RIC HSCT as compared to myeloablative
HSCT.
Methods: A retrospective cohort study of female patients, presenting  1
year after a single HSCT was performed. Preliminary results from 33 female
subjects enrolled in our ongoing study were obtained, 16 of whom were in
puberty and had laboratory data available for review. Of these, 11 received
myeloablative HSCT and 5 received RIC HSCT. Median age at time of HSCT
was 12.2 years (range 9.1 e 23.1 years) for the myeloablative group and