*5.8.1 Endocrine*

Adipocytes secrete hormones which have paracrine and exocrine actions. The common abnormalities noted include increased production of steroid hormones, decreased progesterone secretion in females and decreased testosterone secretion in males. There is also a strong association between obesity and occurrence of polycystic ovarian syndrome. A study from Bombay looked at the prevalence of PCOS among 600 girls in the age group of 15–19 years from under privileged backgrounds. The prevalence of PCOS by Rotterdam criteria was 22.5%. PCOS was more common in obese than non-obese girls (p = 0.002) [101]. In comparison to Caucasians, Asian girls develop PCOS at an earlier age, are more symptomatic and have more fasting hyperinsulinemia and lower insulin sensitivity [102].
