Insulin sensitivity and obstructive sleep apnea in adolescents with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) in adults is linked with insulin resistance (IR) and obstructive sleep apnea (OSA). However, less is known about these associations in adolescents. METHODS: We studied 3 groups of adolescents: 27 obese PCOS (OPCOS) (ages 13-21)11 normal-weight PCOS (NPCOS) (ages 13-21 years), and 8 healthy controls (ages 18-21 years). A hyperinsulinemic euglycemic clamp study was performed in all groups to determine IR by insulin sensitivity (M/I). Polysomnography was performed to assess for OSA in OPCOS and NPCOS groups. We compared indices of IR among all groups and OSA among OPCOS, and NPCOS. RESULTS: We noted that OPCOS and NPCOS and controls differed significantly in their IR. M/I was significantly lower in OPCOS vs. controls (p=0.0061), and also lower for NPCOS vs control but this approached but did not reach statistical significance (p=0.084). In addition, none of the NPCOS subjects had OSA compared to 42% of OPCOS (p=0.03). CONCLUSIONS: Our study suggests OPCOS adolescents have increased IR compared to controls and NPCOS subjects. Higher IR for NPCOS vs controls approached but did not reach statistical significance. Larger studies are needed. In addition, adolescents with OPCOS are at a high risk for OSA.

Lack of GNAS Remethylation During Oogenesis May Be a Cause of Sporadic Pseudohypoparathyroidism Type Ib.

CONTEXT: Pseudohypoparathyroidism type Ib (PHP1B) is characterized by hypocalcemia and hyperphosphatemia due to parathyroid hormone resistance in the proximal renal tubules. Maternal pathogenic STX16/GNAS variants leading to maternal epigenetic GNAS changes impair expression of the stimulatory G protein alpha-subunit (Gsα) thereby causing autosomal dominant PHP1B. In contrast, genetic defects responsible for sporadic PHP1B (sporPHP1B) remain mostly unknown. OBJECTIVE: Determine whether PHP1B encountered after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) causes GNAS remethylation defects similar to those in sporPHP1B. DESIGN: Retrospective analysis. RESULTS: Nine among 36 sporPHP1B patients investigated since 2000, all with loss of methylation (LOM) at the 3 maternal GNAS differentially methylated regions (DMRs) and gain of methylation at the paternal NESP DMR, had been conceived through IVF or ICSI. Besides abnormal GNAS methylation, IVF/ICSI PHP1B cases revealed no additional imprinting defects. Three of these PHP1B patients have dizygotic twins, and 4 have IVF/ICSI-conceived siblings, all with normal GNAS methylation; 2 unaffected younger siblings were conceived naturally. CONCLUSION: Sporadic and IVF/ICSI-conceived PHP1B patients revealed indistinguishable epigenetic changes at all 4 GNAS DMRs, thus suggesting a similar underlying disease mechanism. Given that remethylation at the 3 maternal DMRs occurs during oogenesis, male factors are unlikely to cause LOM postfertilization. Instead, at least some of the sporPHP1B variants could be caused by a defect or defects in an oocyte-expressed gene that is required for fertility and for re-establishing maternal GNAS methylation imprints. It remains uncertain, however, whether the lack of GNAS remethylation alone and the resulting reduction in Gsα expression is sufficient to impair oocyte maturation.

Segmented gamma-ray assay of large volume radioactive waste drums containing plutonium lumps.

Segmented gamma-ray scanning (SGS) is a traditional practice, globally, for the non-destructive assay of special nuclear materials (SNMs) in large volume radioactive waste drums. The conventional SGS is a relative two pass method and requires a standard drum of identical geometry. The present work is focused on identifying the limitations of traditional segmented gamma scanning methodology for the assay of waste drums containing plutonium lumps. It has been observed that, for drums containing Pu lumps, the conventional SGS methodology severely underestimates the assay results (~ 2-6 times depending on the gamma-ray energy) due to attenuation under-correction. An alternate single pass absolute efficiency approach following the principle of infinite energy extrapolation of apparent mass has been proposed for the assay of waste drums containing Pu lumps in various random and biased spatial distributions and has been found to agree within 1-10% with the actual value with a maximum uncertainty of 8%. The method has been further validated at higher collimator widths and it has been demonstrated that an increase in collimator width from 5.1 to 10.3 cm increases the throughput of the present system without much of losing the accuracy.

Using the 90-105 keV gamma-rays for isotopic composition determination of plutonium in dilute solutions.

Using the 90-105 keV gamma-rays for determining Pu isotopic composition is studied for dilute Pu solutions (0.0001-0.05 µg/mm3) as well as Pu-U mixed solutions. It is shown that for concentrations higher than 0.001 µg/mm3 Pu, results match well with those of mass spectrometric results. However, in mixed solutions, beyond 0.005 mg/mm3 U concentration, the errors on isotopic compositions of Pu increased as U content increased.

Full energy peak efficiency calibration for the assay of large volume radioactive waste drums in a segmented gamma scanner.

Large volume radioactive waste drums with low/intermediate level of alpha activity, generated in radiochemical laboratories, are in general screened for special nuclear materials (SNM) in a segmented gamma scanner (SGS) before disposal. The assay methodology traditionally requires a standard drum of identical geometry and thereby making the procedure relying on the availability of a true standard, which is often difficult to organize. Here, we report a non-conventional absolute segmented gamma scanning (ASGS) methodology for the assay of 200 L waste drums, avoiding the use of a standard drum. The present analysis employ the full energy peak (FEP) efficiency, ingeniously determined using a standard 152Eu point source. From combined experiment and Monte Carlo simulation, it has been established that, the FEP efficiencies of the detector for a 200 L cylindrical sample can be well reproduced using a point source. While verifying the applicability of the point source FEP efficiencies for the assay of plutonium in 200 L drums, an energy dependent bias has been seen, which confirms the presence of lump attenuation in addition to the general matrix attenuation. An infinite energy extrapolation of apparent mass approach has been adopted for the assay of large volume waste drums which takes care of the gamma-ray attenuation from all sources that is otherwise difficult to correct for in a sample drum of unknown history.

Hybrid organic-inorganic anion-exchange pore-filled membranes for the recovery of nitric acid from highly acidic aqueous waste streams.

Recycling of acid from aqueous waste streams is highly important not only from the environmental point of view but also for developing the sustainable technology. One of the effective ways to recover acid from aqueous waste streams is the anion-exchange membrane based diffusion-dialysis. The work presents the synthesis and characterization of anion-exchange pore-filled membranes for the objective of recovery of high concentration of acid by diffusion dialysis. The membranes were prepared by anchoring the guest organic-inorganic anionic gel in the pores of the host poly(propylene) membrane by in situ UV-initiator induced polymerization of the appropriate monomers along with cross-linker. The removal of nitric acid in the presence of different representative monovalent, divalent and trivalent nitrates and the leakage of these ions through anion exchange membrane have been studied by DD technique for optimizing the chemical composition of the membrane. The nitric acid permeation rate of the membrane with the optimized composition has been found to be considerably faster than the commercial Selemion membrane without sacrificing salt leakage. The performance of the optimized pore-filled anion exchange membranes has been found to be independent of the acid concentration, nature of the anion and substrate and has been observed to be solely dependent on the guest inorganic-organic hybrid anionic gel component. The membranes have been found to be stable and reusable for the acid recovery. Removal of nitric acid as high as 90% from the simulated high level nuclear waste with the optimized grafted pore-filled membrane has been achieved with negligible salt transport.

Effect of Film Diffusion on the Ion-Exchange Kinetics of a Tracer Ion in Nafion-117 Membrane from a Mixture of Salt Solution.

The ion-exchange kinetics of a tracer ion (Cs+ and Ba2+) in presence of a bulk ion (Na+/H+) has been measured in Nafion-117 membrane for a range of concentrations of NaCl/HNO3 using the nonstationary radiotracer method. A systematic increase in the ion-exchange rate and decrease in the partition coefficients of the tracer ions between membrane and solution have been observed with the increase in bulk ion concentration. The sigmoidal nature of experimental profiles indicates film-diffusion-controlled kinetics even for well-stirred solutions. In the absence of an existing analytical or numerical solution, a simple empirical approach has been proposed to find the variable membrane surface concentration and has been used to solve the membrane diffusion equation by the finite difference method. The fitting of the experimental curves with a single diffusion coefficient for Cs+/Ba2+ has been achieved. The exchange rate has been found to be independent of the stirring speed beyond a limiting speed.

Isotopic composition analysis of dilute Pu solutions using 90-105keV region of gamma ray spectra.

Isotopic composition of dilute Pu solutions (1-3900µg/mL) has been determined by analysis of HPGe detector response function in the 90-105keV region of gamma ray spectra. Results are in excellent agreement with that obtained from mass spectrometric measurements. The present method has been successfully applied for samples of low Pu concentrations, which otherwise is not possible using the conventional 120-415keV region of plutonium γ ray spectra.

Pore-Filled Scintillating Membrane as Sensing Matrix for α-Emitting Actinides.

Pore-filled membranes with scintillating properties have been synthesized for sensing α-emitting radionuclides. The membranes have been prepared by in situ UV-initiator-induced polymerization of monomer bis[2-(methacryloxy)ethyl] phosphate in pores of the host membranes, poly(propylene) and poly(ethersulfone). The polymerization has been carried out in the presence of scintillating molecules, 2,5-diphenyloxazole. These scintillating molecules are physically trapped in the thus formed microgel in the membrane. Much higher α-scintillation efficiency has been obtained for the (241)Am-loaded poly(ethersulfone)-based grafted membrane compared to poly(propylene)-based membrane. This was attributed to the aromatic backbone of the poly(ethersulfone) membrane. The scintillation response of poly(ethersulfone)-based membranes has been found to be linear over the range of (241)Am activity studied. The pore-filled scintillating membranes have been found to be selective toward Pu(4+) ions at higher HNO3 concentration compared to Am(3+). The analytical performance of the pore-filled scintillating membranes has been evaluated. The membranes have been found to be stable and reusable. The scintillating membrane with optimized composition has been applied for quantification of Pu in a soil sample.

Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls.

OBJECTIVE: To evaluate ovarian morphology using three-dimensional magnetic resonance imaging (MRI) in adolescent girls with and without polycystic ovary syndrome (PCOS). Also compare the utility of MRI versus ultrasonography (US) for diagnosis of PCOS. DESIGN: Cross-sectional study. SETTING: Urban academic tertiary-care children's hospital. PATIENT(S): Thirty-nine adolescent girls with untreated PCOS and 22 age/body mass index (BMI)-matched controls. INTERVENTION(S): Magnetic resonance imaging and/or transvaginal/transabdominal US. MAIN OUTCOME MEASURE(S): Ovarian volume (OV); follicle number per section (FNPS); correlation between OV on MRI and US; proportion of subjects with features of polycystic ovaries (PCOs) on MRI and US. RESULT(S): Magnetic resonance imaging demonstrated larger OV and higher FNPS in subjects with PCOS compared with controls. Within the PCOS group, median OV was 11.9 (7.7) cm(3) by MRI compared with 8.8 (7.8) cm(3) by US. Correlation coefficient between OV by MRI and US was 0.701. Due to poor resolution, FNPS could not be determined by US or compared with MRI. The receiver operating characteristic curve analysis for MRI demonstrated that increasing volume cutoffs for PCOs from 10-14 cm(3) increased specificity from 77%-95%. For FNPS on MRI, specificity increased from 82%-98% by increasing cutoffs from ≥ 12 to ≥ 17. Using Rotterdam cutoffs, 91% of subjects with PCOS met PCO criteria on MRI, whereas only 52% met criteria by US. CONCLUSION(S): Ultrasonography measures smaller OV than MRI, cannot accurately detect follicle number, and is a poor imaging modality for characterizing PCOs in adolescents with suspected PCOS. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI should be considered as a diagnostic imaging modality.

Transport Properties of Multivalent Cations in Nafion-117 Membrane with Mixed Ionic Composition.

The transport characteristics of multivalent cations like Ba(2+) and Eu(3+) have been studied in bi-ionic form of the Nafion-117 membrane. The membranes have been prepared by loading different proportions of H(+)-Ba(2+)/Mg(2+)-Ba(2+)/Ba(2+)-Eu(3+)/H(+)-Eu(3+)/Na(+)-Eu(3+). The cationic compositions of the membranes have been determined from the measured ion exchange isotherms. Results show that the self-diffusion coefficient of Ba(2+) (D(Ba)) in H-Ba/Mg-Ba systems as well as the self-diffusion coefficient of Eu(3+) (D(Eu)) in H-Eu/Na-Eu systems are strongly dependent on the membrane ionic compositions and decreased continuously with increasing concentration of the highly hydrated ions (H(+)/Na(+)/Mg(2+)) in the membrane. Increase in the proportion of H(+)/Na(+)/Mg(2+) ions in the membrane increases the effective charge on the membrane matrix. This causes stronger electrostatic interaction of the less hydrated multivalent ions (Ba(2+)/Eu(3+)) with the membrane matrix charges, which ultimately results in their slower self-diffusion coefficients. The higher the valence, the stronger the electrostatic interaction is with the fixed ionic charges; hence, in general, D(Eu) is affected more as compared to D(Ba). On the basis of the free-volume theory for polymers, the effective interaction potential (Φ) of the Ba(2+) with the fixed ionic sites in the membrane has been calculated and found to be on the order of approximately millivolts. The higher the proportion of hydrated ion in the membrane, the higher the Φ is and the stronger the ion pair formation is with the fixed ionic sites in the membrane. However, in the Ba-Eu system, as the electrostatic interactions of the two ions with the membrane matrix are close, D(Ba) and D(Eu) are independent of the membrane ionic composition. The ionic composition dependence of D(Ba) in the H-Ba system is reflected in the transport rate of Ba(2+), showing the importance of such measurements in understanding the transport characteristics of the membrane.

Attenuation correction for the collimated gamma ray assay of cylindrical samples.

The Hybrid Monte Carlo (HMC) method developed earlier for attenuation correction of non-collimated samples [Agarwal et al., 2008, Nucl. Instrum. Methods A 597, 198], has been extended to the segmented gamma ray assay of cylindrical samples. The method has been validated both experimentally and theoretically. For experimental validation, the results of HMC calculation have been compared with the experimentally obtained attenuation correction factors. The HMC attenuation correction factors have also been compared with the results obtained from literature available near-field and far-field formulae at two sample-to-detector distances (10.3cm and 20.4cm). The method has been found to be valid at all sample-to-detector distances over a wide range of transmittance. On the other hand, the literature available near-field and far-field formulae have been found to work over a limited range of sample-to detector distances and transmittances. The HMC method has been further extended to circular collimated geometries where analytical formula for attenuation correction does not exist.

A de novo 10.79 Mb interstitial deletion at 2q13q14.2 involving PAX8 causing hypothyroidism and mullerian agenesis: a novel case report and literature review.

Reports of interstitial deletions involving proximal long arm of chromosome 2 are limited. Based on early chromosomal analysis studies, the phenotypic consequence of deletions at the ancestral chromosome fusion site at chromosome 2q13q14.1 remains unclear. A recurrent 1.71 Mb deletion at 2q13 has recently been proposed as a new genomic disorder, associated with an increased risk of intellectual disability and craniofacial dysmorphism. Herein, we report the case of a 12 year-old girl with unique clinical features including global developmental delay, mullerian agenesis, and hypothyroidism associated with a normal size and position of the thyroid gland, as well as negative thyroid antibodies. Microarray-based comparative genomic hybridization study revealed a de novo 10.79 Mb deletion at 2q13q14.2 (111,548,932-122,336,492), which involves more than 88 UCSC genes, 38 of which are OMIM genes, 7 of which are disease-causing and 3 of which (including GLI2, IL1B and PAX8) show a dominant inheritance pattern.. Interestingly, PAX8 (chr2:113,973,574-114,036,498), a member of the paired-box gene family, is essential for the formation of thyroxine-producing follicular cells. Autosomal dominant transmission of congenital thyroid hypoplasia due to loss-of-function mutation of PAX8 suggests a possible haploinsufficiency effect. Additionally, PAX8 is also expressed in the tissue primordia that form both the mullerian duct derivatives and the upper urinary tracts. A recent study has associated a novel PAX8 mutation with a severe form of hypothyroidism and abnormalities in the urogenital tract. Taken together, the unique clinical manifestation seen in this patient could be attributed to the heterozygous deletion of PAX8 gene. A prospective investigation is merited to fully evaluate the pathogenic effect of the interstitial deletion of 2q13q14.2.

Obesity, hyperglycemia and endothelial function in inner city Bronx adolescents: a cross-sectional study.

BACKGROUND: Along with the rise in obesity, cardiovascular disease (CVD) has become the major cause of death in developed countries. Although overt coronary heart disease rarely manifests during childhood, atherosclerosis can begin by the second decade of life. Therefore, identifying reliable risk markers of early vascular disease in childhood could be important. Alteration in endothelial function (EF) is an early preclinical marker of the atherosclerotic process and can be assessed non-invasively using reactive hyperemia peripheral arterial tonometry (RH-PAT). The purpose of this study was to investigate if obesity in children is associated with lower EF as measured with RH-PAT, and if obese children with impaired glucose regulation have further impairment in RH-PAT measured EF compared to obese children with normal glucose tolerance. METHODS: Cardiovascular risk factors, adipocytokines and EF using RH-PAT were evaluated in lean (n = 14) and obese (n = 37) adolescents (age 12-18 years). Based on an oral glucose tolerance test, the obese group was subdivided into: obese with normal (NGT, n = 22) and obese with impaired glucose regulation (IGR, n = 15). RESULTS: RH-PAT score was lower in obese subjects compared to lean controls (1.70 ± 0.02 vs. 1.98 ± 0.09, P = 0.02), indicating worse EF. This difference remained significant when adjusted for age, sex and ethnicity (P = 0.02). We observed a pattern of worsening EF with increasing metabolic burden, with RH-PAT scores of 1.98 ± 0.09,1.73 ± 0.08 and 1.65 ± 0.12 in the lean, obese-NGT and obese-IGR groups, respectively, ptrend = 0.03. Obese subjects were more insulin resistant [higher HOMA] (p = 0.03), and had higher levels of leptin (p = 0.004), hsCRP (p = 0.0004), and TNF-α (p = 0.03) compared to lean subjects. Adjusting for insulin resistance and adipocytokines substantially attenuated the obesity association with RH-PAT, suggesting that insulin resistance and inflammation may mediate the association of EF with obesity. CONCLUSIONS: Risk factors for adult cardiovascular disease, including impaired EF, insulin resistance and inflammation, are evident in obese adolescents. Whether early detection of these cardiovascular risk factors will be useful for informing interventions to prevent disease progression needs further study. TRIAL REGISTRATION: Clinical Trials Identifier: NCT01879033.

Isotopic ratio correlation for the isotopic composition analysis of plutonium in Am-Pu mixed samples having high americium content.

Interference of high amount of americium in the plutonium isotopic composition analysis has been studied by simulating gamma-ray spectra for Am-Pu samples over a wide composition range (5-97% (241)Am) for both power and research reactor grade plutonium. An alternate way for isotopic composition analysis has been proposed by correlating the isotopic ratios available in our old database with the experimentally obtained (241)Pu/(239)Pu isotopic ratio. The proposed method has been validated using simulated spectra of known isotopic compositions.

Attenuation correction for the assay of uranium(VI) solutions in large cylindrical containers by gamma ray spectrometry.

The Hybrid Monte Carlo method developed for attenuation correction has been extended for 500 ml cylindrical geometry. The method has been experimentally validated. Absolute efficiency studies for 500 ml aqueous, air and point source has been carried out using Monte Carlo simulation. It has been observed that point source efficiency is a good estimate of 500 ml source beyond sample-to-detector distance of 15 cm. It has been found that while HMC method for attenuation correction is valid at all sample-to-detector distances and over all transmittance range, the far-field and near-field formulae available in literature are valid only over a very narrow range of sample-to-detector distance.

Sleep and cardiometabolic function in obese adolescent girls with polycystic ovary syndrome.

OBJECTIVE: To compare the polysomnography findings and cardiometabolic function among adolescent girls with polycystic ovary syndrome (PCOS) and matched female and male controls. METHOD: Retrospective chart review of electronic medical records of 28 girls with PCOS (age: 16.8±1.9 years, body mass index (BMI) Z-score 2.4±0.4), 28 control females (age: 17.1±1.8, BMI Z-score 2.4±0.3) and 28 control males (age: 16.6±1.6, BMI Z-score 2.5±0.5) in a tertiary care centre. RESULTS: The prevalence of obstructive sleep apnoea (OSA) was higher in girls with PCOS compared to control females (16/28 (57%) vs. 4/28(14.3%), p<0.01); however, it was comparable to that of the control males (16/28(57%) vs. 21/28(75%), p=0.4). Girls with PCOS had a significantly higher prevalence of insulin resistance compared to control females and control males (20/28 (71.4%) vs. 9/22 (41.0%) (p=0.04) vs. 8/23 (34.8%) (p=0.01). Among girls with PCOS, those with OSA had significantly higher proportions of metabolic syndrome (MetS) (9/16 (56.3%) vs. 1/12 (8.3%) p=0.03), higher insulin resistance (14/16 (87.5%) vs. 6/12 (50%), p=0.04), elevated daytime systolic blood pressure (128.4±12.8 vs. 115.6±11.4, p<0.01), lower high-density lipoprotein (HDL) (38.6±8.7 vs. 49±10.9, p=0.01) and elevated triglycerides (TG) (149.7±87.7 vs. 93.3±25.8, p=0.03) compared to those without OSA. CONCLUSIONS: We report a higher prevalence of OSA and metabolic dysfunction in a selected group of obese girls with PCOS referred with sleep-related complaints compared to BMI-matched control girls without PCOS. We also report higher prevalence of cardiometabolic dysfunction in girls with PCOS and OSA compared to girls with PCOS without OSA.

Self-diffusion of ions in Nafion-117 membrane having mixed ionic composition.

The self-diffusion coefficients (SDCs) of Na(+), Cs(+), and Ba(2+) have been determined in Nafion-117 membrane having mixed cationic compositions. Membranes with different proportions of Na(+)-Cs(+), Cs(+)-Ba(2+), Na(+)-Ba(2+), and Ag(+)-Ba(2+) cations have been prepared by equilibrating with solutions containing different ratios of these cations. The SDCs of the cations (D(Na), D(Cs), D(Ba)) and the ionic compositions of the membrane have been determined using a radiotracer method. For the Na-Cs and Cs-Ba systems, the SDCs of the cations have been found to be independent of the ionic compositions of the membrane. In the case of the Na-Ba system, D(Na) does not change with ionic composition, while D(Ba) has been found to be strongly dependent on the ionic composition of the membrane and decreases continuously with increasing Na(+) content in the membrane. Similar results have also been obtained for D(Ba) in the case of the Ag-Ba system. The specific conductivities (κ(imp)) of the membrane in mixed cationic forms have also been obtained from ac impedance measurement and compared with that (κ(cal)) calculated from the SDC data. For the Na-Ba system, the increment of κ(imp) with increase in the Na(+) content of the membrane has been found to be parabolic, whereas for the Na-Cs system the increment is linear. The reason behind the different behaviors for different types of ionic systems has been qualitatively explained based on different transport pathways of the cations in the membrane.

Temperature dependence of ion and water diffusion in crown ether loaded Nafion matrix.

Temperature dependence study of the self-diffusion coefficient of Cs(+) ion in dibenzo-18-crown-6 (DB18C6) modified Nafion-117 (Cs-Naf-CR) was carried out in the temperature range of 50-65 °C. Temperature dependence of water diffusion in Cs-Naf-CR was also studied to understand the mechanism of cation and water transport in the membrane. Because of the very slow kinetics of isotopic exchange, self-diffusion measurement of Na(+) in Na-Naf-CR was carried out only at 60 °C. The result indicates that self-diffusion behavior is governed by the nature of the cation in which the crown ether was loaded in the membrane matrix. The activation energy of diffusion for Cs(+) ion and water in Cs-Naf-CR was found to be much higher than that in the pure Cs(+) form of Nafion (Cs-Naf). Water uptake of the membrane was also found to have reduced compared to Cs/Na-Naf. The results point to the binding of the ions by DB18C6 and the destruction of the water channels in the crown ether loaded membrane. The differential scanning calorimetry (DSC) data supports these observations.

Screening for sleep-disordered breathing and excessive daytime sleepiness in adolescent girls with polycystic ovarian syndrome.

OBJECTIVE: To determine the prevalence and clinical and metabolic correlates of sleep-disordered breathing (SDB) and excessive daytime sleepiness (EDS) in adolescent girls with polycystic ovarian syndrome (PCOS). STUDY DESIGN: Standardized questionnaires were administered to participants with PCOS and age-, sex-, ethnicity-, and body mass index (BMI) z score-matched controls. Medical records were reviewed for anthropometric and metabolic data. RESULTS: We studied 103 participants with PCOS (16.9 ± 1.5 years) and 90 controls (16.8 ± 1.7 years). Compared with controls, girls with PCOS had a higher prevalence of SDB (45.6% vs 27.8%; P = .01) and EDS (54.4% vs 35.6%; P < .01). Within PCOS, those with SDB had higher BMI z score (2.1 ± 0.5 vs 1.7 ± 0.6; P < .01), higher homeostatic model assessment index (5.1 ± 2.3 vs 4.1 ± 3.5; P < .01), and higher prevalence of the metabolic syndrome (MetS) (42.6% vs 16.1%; P = .003) compared with those without SDB. Similarly, participants with PCOS and EDS had a higher BMI z score (2.0 ± 0.6 vs 1.7 ± 0.6; P = .03), higher homeostatic model assessment index (5.1 ± 2.9 vs 3.8 ± 3.1; P = .01), and higher rate of MetS (39.3% vs. 14.9%; P < .01) compared with those without EDS. MetS was independently associated with SDB (OR, 3.2; 95% CI, 1.0-10.1) and EDS (OR, 4.5; 95% CI, 1.2-16). CONCLUSIONS: SDB and EDS are highly prevalent in adolescent girls with PCOS compared with matched controls. The MetS is independently associated with SDB and EDS in this group.