Carmina E, Koyama T, Chang L, Stanczyk F Z, Lobo R A
Cattedra di Endocrinologia, Universita di Palermo, Italy.
Am J Obstet Gynecol. 1992 Dec;167(6):1807-12. doi: 10.1016/0002-9378(92)91779-a.
Our purpose was to determine the prevalence of adrenal hyperandrogenism and insulin resistance in patients with hyperandrogenic chronic anovulation, also called polycystic ovary syndrome, living in the United States, Italy, and Japan.
Seventy-five women with polycystic ovary syndrome, 25 each from the United States, Italy, and Japan, and 10 ovulatory controls were studied. Hirsutism, obesity, and the presence of cystic ovaries were assessed, as were blood levels for estrogen, luteinizing hormone, testosterone, adrenal androgens, and insulin. All patients received an insulin tolerance test to assess insulin resistance.
Women from Japan were less obese (p < 0.05) and did not have hirsutism, although the percentage of cystic ovaries (68% to 80%) was comparable. Serum luteinizing hormone, testosterone, and estradiol were similar, but levels of 3 alpha-androstanediol glucuronide, which was elevated in women from the United States and Italy, was normal in women from Japan. The adrenal androgens, dehydroepiandrosterone sulfate and 11 beta-hydroxyandrostenedione were elevated in 48% to 64% of the patients and by a similar percentage in the three groups. Fasting insulin was elevated in all groups, but was significantly higher in women from the United States and Italy compared with women from Japan (p < 0.05). However, insulin resistance as assessed by dissociation constant of insulin tolerance test values was significantly elevated but similar in the three groups and occurred in 68% to 76% of patients.
In polycystic ovary syndrome, although obesity and hirsutism vary according to dietary, genetic, and environmental factors, the prevalence of adrenal androgen excess and insulin resistance appear to be fairly uniform. These results suggest that these factors may be involved in the pathophysiologic features of the disorder.
我们的目的是确定生活在美国、意大利和日本的患有高雄激素性慢性无排卵（也称为多囊卵巢综合征）的患者中肾上腺雄激素过多症和胰岛素抵抗的患病率。
对75名多囊卵巢综合征女性患者进行了研究，其中25名来自美国，25名来自意大利，25名来自日本，另有10名排卵正常的对照者。评估了多毛症、肥胖症以及卵巢囊肿的情况，还检测了雌激素、促黄体生成素、睾酮、肾上腺雄激素和胰岛素的血液水平。所有患者均接受胰岛素耐量试验以评估胰岛素抵抗。
来自日本的女性肥胖程度较低（p < 0.05）且没有多毛症，尽管卵巢囊肿的比例（68%至80%）相当。血清促黄体生成素、睾酮和雌二醇水平相似，但美国和意大利女性中升高的3α - 雄烷二醇葡萄糖醛酸水平在日本女性中正常。肾上腺雄激素硫酸脱氢表雄酮和11β - 羟基雄烯二酮在48%至64%的患者中升高，且在三组中的升高比例相似。所有组的空腹胰岛素水平均升高，但美国和意大利女性的空腹胰岛素水平显著高于日本女性（p < 0.05）。然而，通过胰岛素耐量试验值的解离常数评估的胰岛素抵抗在三组中均显著升高且相似，68%至76%的患者存在胰岛素抵抗。
在多囊卵巢综合征中，尽管肥胖和多毛症因饮食、遗传和环境因素而有所不同，但肾上腺雄激素过多症和胰岛素抵抗的患病率似乎相当一致。这些结果表明这些因素可能参与了该疾病的病理生理特征。
