To William W K, Wong Margaret W N
Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong SAR.
Gynecol Endocrinol. 2005 May;20(5):237-42. doi: 10.1080/09513590500097200.
We evaluated whether the presence of polycystic ovaries in adolescent girls as a cause of oligomenorrhoea and amenorrhoea would pose any protective effect against osteoporosis or low bone mineral density (BMD) compared with girls having similar menstrual dysfunction but normal ovaries. A cross-sectional observational study was done in consecutive girls, aged between 16 and 19 years, presenting to the adolescent gynaecology clinic with oligomenorrhoea or amenorrhoea. All patients underwent full hormonal profile assessment, pelvic ultrasound for ovarian morphology, bio-impedance estimation of body fat, and dual-energy X-ray absorptiometry and quantitative peripheral computed tomography scans to determine BMD in axial and appendicular skeletal sites. Polycystic ovaries were diagnosed according to ultrasound morphology. These were then compared with an age-matched eumenorrhoeic control group that had undergone the same evaluation. Of 45 patients with oligomenorrhoea or amenorrhoea, 14 (31%) were diagnosed to have polycystic ovaries, while the other 31 had normal ovaries. The control group consisted of 45 age-matched eumenorrhoeic girls. The group with normal ovaries had lower BMD at the lumbar spine and hip, as well as lower total tibial volumetric BMD, than the eumenorrhoeic controls, but there were no significant differences between the group with polycystic ovaries and eumenorrhoeic controls. We conclude that adolescents with oligomenorrhoea and amenorrhoea with normal ovaries had lower BMD than eumenorrhoeic ones, but those with polycystic ovaries had BMD values comparable to those of eumenorrhoeic controls despite their menstrual dysfunction.
我们评估了青春期女孩多囊卵巢的存在作为月经过少和闭经的一个原因，与有类似月经功能障碍但卵巢正常的女孩相比，是否会对骨质疏松症或低骨矿物质密度（BMD）产生任何保护作用。对连续就诊于青少年妇科门诊、年龄在16至19岁之间、患有月经过少或闭经的女孩进行了一项横断面观察性研究。所有患者均接受了全面的激素水平评估、盆腔超声检查卵巢形态、生物电阻抗法估算体脂，以及双能X线吸收法和定量外周计算机断层扫描，以确定轴向和附属骨骼部位的骨密度。根据超声形态诊断多囊卵巢。然后将这些患者与经过相同评估的年龄匹配的月经正常对照组进行比较。在45例月经过少或闭经的患者中，14例（31%）被诊断为多囊卵巢，而其他31例卵巢正常。对照组由45名年龄匹配的月经正常女孩组成。卵巢正常组的腰椎和髋部骨密度以及胫骨总体积骨密度均低于月经正常对照组，但多囊卵巢组与月经正常对照组之间无显著差异。我们得出结论，卵巢正常的月经过少和闭经青少年的骨密度低于月经正常者，但多囊卵巢者尽管有月经功能障碍，其骨密度值与月经正常对照组相当。
