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自我报告有月经过少和/或多毛症状的女性中多囊卵巢的患病率:芬兰北部1966年出生队列研究

Prevalence of polycystic ovaries in women with self-reported symptoms of oligomenorrhoea and/or hirsutism: Northern Finland Birth Cohort 1966 Study.

作者信息

Taponen S, Ahonkallio S, Martikainen H, Koivunen R, Ruokonen A, Sovio U, Hartikainen A-L, Pouta A, Laitinen J, King V, Franks S, McCarthy M I, Järvelin M-R

机构信息

Department of Clinical Chemistry, University of Oulu and Oulu University Hospital, Finland.

出版信息

Hum Reprod. 2004 May;19(5):1083-8. doi: 10.1093/humrep/deh214. Epub 2004 Mar 25.

Abstract

BACKGROUND

The aim of this study was to investigate the prevalence of polycystic ovaries (PCO) among women with self-reported oligomenorrhoea and/or hirsutism and to see whether women with symptoms and PCO have less favourable levels of biochemical markers than controls or women with symptoms and normal ovaries.

METHODS

The ultrasonographic ovarian morphology and the hormonal and metabolic profile of female cases with self-reported symptoms typical of polycystic ovary syndrome (PCOS) (n = 196) and asymptomatic controls (n = 67) at the age of 31 years were examined in a general population-based Northern Finland Birth Cohort 1966.

RESULTS

The prevalence of PCO (37.3 versus 18.2%; P = 0.004) was significantly higher in the cases (oligomenorrhoea and/or hirsutism) than in the controls. PCO morphology was detected in 18.4% of those who reported only hirsutism, in 47.9% of those reporting only oligomenorrhoea, and in 70.4% of those reporting both symptoms. In the cases with PCO compared to (i) the controls and (ii) the cases without PCO, body mass index (P = 0.026 and P = 0.011), ovarian volume [right P = 0.001, left P = 0.208 (non-significant) and right P < 0.001, left P = 0.022], mean follicle number (P < 0.001 and P < 0.001), testosterone (P = 0.063 and P = 0.029), free androgen index (P = 0.007 and P = 0.013) and insulin (P = 0.033 and P = 0.040) were higher, and sex hormone-binding globulin (P = 0.039 and P = 0.068) and glucose:insulin ratio (P = 0.060 and P = 0.054) lower. Cases with PCO also had higher waist:hip ratio (P = 0.011), infertility rate (P = 0.005) and glucose (P = 0.045) and lower insulin-like growth factor-binding protein-1 (P = 0.012) than controls. The clinical, hormonal and metabolic characteristics did not differ significantly between cases without PCO and controls with the exception of infertility rate, which was significantly higher in the cases without PCO (26.4 vs. 10.0%; P = 0.009).

CONCLUSIONS

In a general population, women with symptoms of oligomenorrhoea and/or hirsutism more often have PCO than asymptomatic women. Levels of biochemical and clinical markers in symptomatic women with PCO differed from and were less favourable than those in symptomatic women without PCO or asymptomatic women, implying an increased risk for health.

摘要

背景

本研究旨在调查自我报告有月经过少和/或多毛症状的女性中多囊卵巢(PCO)的患病率,并观察有症状且患有PCO的女性与对照组或有症状但卵巢正常的女性相比,其生化指标水平是否更不理想。

方法

在基于芬兰北部普通人群的1966年出生队列中,对196名自我报告有典型多囊卵巢综合征(PCOS)症状的女性病例和67名无症状对照者在31岁时的超声卵巢形态、激素和代谢情况进行了检查。

结果

病例组(月经过少和/或多毛)中PCO的患病率(37.3%对18.2%;P = 0.004)显著高于对照组。仅报告有多毛症状的女性中,18.4%检测出PCO形态;仅报告有月经过少症状的女性中,47.9%检测出;同时报告两种症状的女性中,70.4%检测出。与(i)对照组和(ii)无PCO的病例相比,患有PCO的病例组体重指数(P = 0.026和P = 0.011)、卵巢体积[右侧P = 0.001,左侧P = 0.208(无显著差异),右侧P < 0.001,左侧P = 0.022]、平均卵泡数(P < 0.001和P < 0.001)、睾酮(P = 0.063和P = 0.029)、游离雄激素指数(P = 0.007和P = 0.013)和胰岛素(P = 0.033和P = 0.040)更高,而性激素结合球蛋白(P = 0.039和P = 0.068)和葡萄糖:胰岛素比值(P = 0.060和P = 0.054)更低。与对照组相比,患有PCO的病例组腰臀比也更高(P = 0.011)、不孕率更高(P = 0.005)、血糖更高(P = 0.045),胰岛素样生长因子结合蛋白-1更低(P = 0.012)。除不孕率外,无PCO的病例组和对照组的临床、激素和代谢特征无显著差异,无PCO的病例组不孕率显著更高(26.4%对10.0%;P = 0.009)。

结论

在普通人群中,有月经过少和/或多毛症状的女性比无症状女性更常患有PCO。有症状且患有PCO的女性的生化和临床指标与无PCO的有症状女性或无症状女性不同且更不理想,这意味着健康风险增加。

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