MON-181 Food Insecurity and Symptoms of Polycystic Ovary Syndrome among Hispanic Adolescents in South Texas

Abstract Disclosure: J. Sfeir: None. R. Castaneda: None. C. Yoro: None. E. Pena: None. R. Bloom: None. H. Vanden Brink: None. Purpose: Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy in reproductive-aged women, affecting approximately 7-10% of adolescents, with long-term psychological, metabolic, and reproductive health implications. PCOS severity and prevalence vary by ethnicity, however whether severity of PCOS is explained by social determinants of health such as food insecurity (FI), which disproportionately effects racial and ethnic minorities, is unknown. To that end, the objective of this study is to contrast the prevalence and severity of PCOS symptomology among Hispanic adolescents with or without risk of food insecurity. Methods: 47 post-menarcheal Hispanic adolescents (range: 12-18 years) were recruited into a cross-sectional study in South Texas. No participants had a previous diagnosis of PCOS. Participants underwent assessments of menstrual cycle history, hirsutism (modified Ferriman-Gallwey (mFG) scoring system), anthropometry, and dried blood spots to measure reproductive hormones, HbA1c, lipids, and fasting insulin. Risk of FI was assessed via the Hunger Vital SignTM. PCOS was defined as menstrual irregularity (>45 days) and hyperandrogenism (mFG ≥ 6 and/or Free Androgen Index > 3.6% and/or Total Testosterone > 45.2 ng/dL). Comparisons were conducted using independent sample t-test, Fishers Exact test, Kruskal-Wallis.Results: Overall, 17% met criteria for PCOS, 51% had one diagnostic feature (PCOS Risk), and 32% were eumenorrheic with no androgen excess (No PCOS). Waist hip ratio and cholesterol were higher in those with PCOS vs No PCOS (Dunn’s post hoc: 0.898 (0.879,0.945) vs 0.856 (0.807, 0.876), p=0.0215) and (208 (174,242) vs 151.5 (143, 174.75), p=0.03). Anti-Mullerian Hormone, body fat %, LDL, and VLDL cholesterol tended to be greater among those with PCOS (p=0.09, p=0.07, p=0.06, p=0.06) and SHBG tended to be lower in those with PCOS (p=0.05). Overall, the risk of FI occurred in 30% of participants by parent report and 19% by participant report. The distribution of all three PCOS phenotypes was similar across food secure households versus those at risk for FI (p = 0.68). However, adolescents from households at risk for FI by parent report had higher circulating concentrations of Total Testosterone versus food secure households (35 (25.5-51.5) ng/dl vs 26 (22-31) ng/dl, p = 0.028)). Conclusion: We report a substantially high risk of PCOS among undiagnosed Hispanic adolescents from a community in South Texas that is nearly two-fold of global estimates. Elevated lipids, central adiposity, and a trend towards greater AMH in those who met criteria for PCOS suggest early metabolic and reproductive dysfunction in Hispanic adolescents. Whereas risk of FI was prevalent regardless of PCOS phenotype, FI may be associated with biochemical hyperandrogenism, highlighting the potential relevance of social determinants of health and emergence of PCOS in adolescents. Presentation: Monday, July 14, 2025