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S19Poster Abstracts / 48 (2011) S18–S120

quent cigarette use (p � .003), and cigarette use before 13years of age (p � .04).Conclusions: This study demonstrated that asthmatic adoles-cents are more likely than non-asthmatic adolescents to en-gage in cigarette use behaviors and the presence of suicidalideation is an effect modifier of the relationship betweenasthma and cigarette use behaviors. Further research isneeded to elucidate the directionality of the relationships be-tween asthma and health risk behaviors such as cigarette useand suicidal behaviors and the interactions among these fac-tors. Particular attention should be paid to the awareness ofhealth risks of cigarette smoking and mental health problemsamong asthmatic adolescents.Sources of Support: Korea Centers for Disease Control andPrevention.

3.

A LONGITUDINAL COMPARISON OF CARDIOVASCULAR RISKFACTORS IN OVERWEIGHT AND NORMAL-WEIGHTADOLESCENTS WITH POLYCYSTIC OVARY SYNDROME (PCOS)Tamara Baer, MD, Amy DiVasta, MD, MMSc.Children’s Hospital Boston

Purpose: PCOS is associated with obesity, insulin resistance,hypertension, and dyslipidemia in adult women. Our studyaimed to determine the prevalence of cardiovascular risk fac-tors in adolescents with PCOS, to evaluate differences in car-diovascular risk factors between overweight (OW, defined asbody mass index (BMI) �85th percentile for age and gender)and normal-weight (NW, defined as BMI �85th percentile forage and gender) adolescents with PCOS, and to establishscreening patterns for cardiovascular risk factors in adoles-cents with PCOS.Methods: A systematic chart review was performed on a ran-dom sample of 180 female adolescent patients with PCOSevaluated at the Children’s Hospital Boston Adolescent Medi-cine Practice between 2006 and 2008. Eligible patients werebetween the ages of 12-22 years, had been diagnosed withPCOS based on 1990 NIH criteria, and had laboratory studiesperformedat their initial visit. Abstracteddata includeddemo-graphics, health history, family history, physical examinationfindings, and pre-treatment laboratory results. Data regardingweight changes, prescribed medications, and additional labo-ratory studies such as glucose tolerance tests and lipid panelswere collected during 1- and 2-year follow-up visits. Longitu-dinal data were analyzed using repeated measures ANOVA.Results: Seventy-three percent of patients were overweight(mean OW group BMI 32.4 � 6.6 kg/m2 vs. NW BMI 22.1 � 3.6g/m2;p� .0001). A family history of type II diabeteswasmorerevalent in OWas compared to NWpatients (48.8% vs. 17.1%;� .0001). Whereas acanthosis nigricans was identified morerequently in OW girls (48% vs. 9%; p � .0001), rates of hirsut-sm and acne were identical (61% and 44%, respectively). OWatients had higher free testosterone (p � .0003), lower sex-ormone binding globulin (p� .0001), higher fasting insulin (p.0003), and lower HDL cholesterol (p � .03) levels than NW

patients. The groups differed in the magnitude of BMI changeover time. While BMI went up in both groups over time, OWpatients demonstrated BMI increases of 0.5 kg/m2 more per

ear than NW patients (p � .03). Medications prescribed at

nitial visits, including estrogen/progestins, metformin, andpironolactone, did not affect BMI changes over time in eitherroup. Systolic blood pressure was higher in OW patients, buto significant changes occurred in either group over time (p �

76). OW patients reported greater concerns about weight andiabetes/insulin resistance at 1- and 2-year follow-up visits,nd were more likely to report nutritional changes than NWatients.onclusions: In this sample, the majority of adolescents withCOSwereOW. As compared toNWpatients, OWpatients hadigher prevalence of cardiovascular risk factors, including el-vated BMI, insulin resistance (elevated fasting insulin levelsnd acanthosis nigricans), and decreased HDL. OW patientseportedmore concerns about weight and risk of diabetes andore changes in nutritional patterns, and experienced more

apid increases in BMI over two years as compared to NWatients. Effective interventions and evidence-based recom-endations for optimal screening tests and intervals areeeded to address cardiovascular risk in adolescents withCOS.ources of Support: None.

4.

PREVALENCE OF SUBSTANCE USE IN YOUTHWITH TYPE 1DIABETES: QUESTIONNAIRE VS. FACE-TO-FACE INTERVIEWChristina Grant, MD, FRCP3, Zubin Punthakee,MD, MSc1, Sherry Van Blyderveen, PhD2.1Department of Medicine and Pediatrics,McMaster University 2Department of Pediatrics,McMaster University 3Division of AdolescentMedicine, Department of Pediatrics, McMasterUniversity

Purpose: The validity of self-reports of youth regarding riskbehaviors, such as substance use, has been called into ques-tion. One study compared substance use data collected byface-to-face interviews to data from self-administered ques-tionnaires and found that youth tended to report greater fre-quency of substance use during face-to-face interviews com-pared to self-administered questionnaires. Increasingly,substance use has been linked to premature deaths in youngadults with TIDM. To date, in this population, the data onsubstance use has been only collected by self-report question-naires. The objectives of this study were to: 1) provide anestimate of lifetime and current substance use among youthwith type 1 Diabetes (T1DM); and 2) to examine the concor-dance between youths self reports of substance use duringclinical interviews and questionnaires.Methods: Youth with type 1 diabetes referred to a DiabetesTransition Clinic at a large Canadian academic teaching hospi-tal were consecutively enrolled into this cross-sectional study.Data was prospectively collected using structured interviewsand self-report questionnaires regarding lifetime and currentsubstance use.Results: The mean age of the 51 participants included in thisstudy was 17.5 years (range 15.67 to 19.17, SD � 0.64). Ap-proximately 31%, 65%, 39%, and 10% of youth with T1DM re-ported ever havingused tobacco, alcohol,marijuana, andothersubstances, respectively, although much fewer reported re-

cent use. In general, the self reports of youth with T1DM

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S20 Poster Abstracts / 48 (2011) S18–S120

regarding their use of substances to their physician during aninterviewwere consistent with their self-reports on question-naires. However, youth were less likely to report ever usingtobacco or marijuana to their physician than on self-reports,but they were equally likely to report recently (within the last1 or 6 months) using these substances to their physician andon questionnaires.Conclusions: Results suggest that youth with T1DM are lesslikely to inform their physician of ever using tobacco or mari-juana, if they have used but are not presently using, thesesubstances. However, youth with T1DM do report current useof substances similarly whether by face-to-face structuredinterview or questionnaire.Sources of Support: New Investigator Fund, Hamilton Healthciences, Hamilton, Ontario, Canada.

5.

RETT SYNDROME AND MENSTRUATIONAmy Hamilton, BA3, Pamela Murray, MD, MHP1,ichael Marshal, PhD2. 1Department ofediatrics, West Virginia University 2Divison of

Adolescent Medicine, Children’s Hospital ofPittsburgh of UPMC 3University of PittsburghSchool of Medicine

Purpose: This study describes the experience of adolescentgirls with Rett Syndrome with menstruation as reported bytheir caregivers. We address frequency, severity, and func-tional morbidity of menstrual hygiene concerns, dysmenor-rhea, and premenstrual syndrome (PMS) and treatment at-tempts.Methods: Anonymous web-based survey of the caregivers ofoung women (10-25 years) with Rett Syndrome was devel-ped. An established patient panel list serve from the Interna-ional Rett Syndrome Association was used for recruitment.nalyses were conducted using SPSS (v. 17). The University ofittsburgh IRB approved the study.esults: Twenty-one caregivers completed the survey. Meange of their female dependants was 17.1 years. Mean age ofenarchewas 11.7 years (SD 2.0). Periodswith duration of 3-7ays were reported by 62% and 38% reported 10 or moreeriods a year. Almost half (48%) reported current use of hor-onal contraception. Longer periods (t test p � .018) were aredictor of hormonal contraception use. Of those currentlysing hormonal contraception, 50% were using it to eliminateeriods and 30% to treat dysmenorrhea. Oral contraceptiveills were used by 70%, and 20% used medroxyprogesteronenjections; 80% reported that their hormonal contraceptionas very effective for their concern. All of the young womenequired substantial assistance with menstrual hygiene.hree-quarters of respondents reported at least one symptomf dysmenorrhea with 57% reporting at least one moderate toevere symptom, and 67% of reported symptoms occurringften or almost always. Despite frequent and severemenstrualymptoms, 62% reported that these symptoms never or rarelyept their female dependant from school or other scheduledctivities and 52% reported dysmenorrhea never or rarelyaused a problem at home. At least one symptom of PMS inheir female dependant was reported by 71%. Almost half

eported moderate to severe symptoms and 62% reported fre-

uent symptoms. Premenstrual symptoms rarely or never in-erfered with school or other scheduled activates or caused aroblem at home, reported 38% and 38% respectively. At leastne autism-specific premenstrual symptom such as increasedbsessive behaviors or repetitivemovementswas endorsed by3%, and 9.5% reported increased premenstrual seizure activ-ty in response to an open-ended question. The average num-er of non-hormonal treatments tried for dysmenorrhea was.4 and for PMS 1.9. Ibuprofen and acetaminophen were theost commonly tried non-hormonal treatments.onclusions: Symptoms of dysmenorrhea and premenstrualyndrome are frequent and severe in young women with Rettyndrome. These symptoms cause less functional morbidityhan might be expected. These young women are entirelyependent on their caregivers for hygiene. Hormonal contra-eption is predominately and effectively used for menstrualanagement. The significant neurodevelopmental issues that

hese young women with Rett Syndrome face can complicateenstrual symptom recognition. Management of these issuesay improve the quality of life for these young women and

heir caregiver.ources of Support: Dean’s Summer Scholarship, Universityf Pittsburgh School of Medicine and the Division of Adoles-ent Medicine, Children’s Hospital of Pittsburgh of UPMC.

6.

MOOD SYMPTOMS AND DISORDERED EATING BEHAVIORS INADOLESCENTS WITH TYPE 1 DIABETESCarrie Bernstein, MD2, Karen Soren, MD2,elissa Stockwell, MD, MPH1, Susan Rosenthal,

PhD2, Mary Pat Gallagher, MD3. 1Columbianiversity Medical Center 2Columbia University

Medical Center 3Columbia University MedicalCenter, Naomi Berrie Diabetes Center

Purpose: The coexistence of mental health disorders and type1 diabetes is well known in adults and has been shown toadversely affect disease control; however, few studies haveexamined this association in adolescents. In this study, wesought to determine the prevalence of and demographic riskfactors formood and eating disorders in adolescentswith type1 diabetes.Methods: A cross-sectional study of 150 adolescents 11 to 25years of age with type 1 diabetes was conducted. The patientswere selected in a waiting room at an urban, academic diabe-tes center serving a diverse patient population with varieddisease severity. All participants were asked to complete aself-report questionnaire, which included demographic infor-mation, date of diagnosis of diabetes, and three validated in-struments, the Beck’s Depression Inventory, the SCARED-41Screen for anxiety, and the Eating Disorder Screen for PrimaryCare. They were also asked “Do you take less insulin than youshould?”; intentional insulin manipulation has been report-edly used by some diabetic patients to facilitate weight loss.Prevalence of a positive screen for each of the four outcomemeasures was determined. A variable, called “any disorder”was created, which reflected if participants screened positiveon at least one of the four measures. Chi-square analysis wasperformed to determine the association between having “any

disorder” and factors including gender, age, race, maternal