Naessén Sabine, Carlström Kjell, Garoff Leena, Glant Rolf, Hirschberg Angelica Lindén
Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
Gynecol Endocrinol. 2006 Jul;22(7):388-94. doi: 10.1080/09513590600847421.
An association between bulimia nervosa and polycystic ovary syndrome (PCOS) has been suggested but also questioned. Since there is still a controversy about this issue, we investigated clinical and biochemical symptoms of PCOS according to the new diagnostic criteria in a large group of bulimic women compared with controls. Seventy-seven women with bulimia and 59 matched healthy women were investigated with respect to menstrual status, polycystic ovaries, hirsutism, acne and sex hormone levels. We found increased occurrence of menstrual disturbances, hirsutism and PCOS in bulimic women, whereas ovarian variables and acne did not differ from controls. Hirsutism score and indices of biologically active testosterone were positively correlated in bulimics but not in controls, while there were no major differences in serum androgens. In conclusion, this study supports an increased frequency of PCOS in bulimic women and may also indicate increased androgen sensitivity in these women. PCOS may promote bulimic behavior since androgens have appetite-stimulating effects and could impair impulse control. Menstrual disturbances and clinical signs of hyperandrogenism should be evaluated in bulimics in order to provide adequate medical care and treatment.
神经性贪食症与多囊卵巢综合征(PCOS)之间的关联已被提出,但也受到质疑。由于关于这个问题仍存在争议,我们根据新的诊断标准,在一大群神经性贪食症女性中,与对照组相比,调查了PCOS的临床和生化症状。对77名神经性贪食症女性和59名匹配的健康女性进行了月经状况、多囊卵巢、多毛症、痤疮和性激素水平方面的调查。我们发现神经性贪食症女性中月经紊乱、多毛症和PCOS的发生率增加,而卵巢变量和痤疮与对照组没有差异。在神经性贪食症患者中,多毛症评分与生物活性睾酮指数呈正相关,而在对照组中则无此关联,血清雄激素水平无显著差异。总之,本研究支持神经性贪食症女性中PCOS发生率增加,也可能表明这些女性雄激素敏感性增加。由于雄激素具有刺激食欲的作用且可能损害冲动控制,PCOS可能会促进神经性贪食行为。应对神经性贪食症患者的月经紊乱和高雄激素血症的临床体征进行评估,以便提供适当的医疗护理和治疗。