Broekmans F J, Knauff E A H, Valkenburg O, Laven J S, Eijkemans M J, Fauser B C J M
Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, The Netherlands.
BJOG. 2006 Oct;113(10):1210-7. doi: 10.1111/j.1471-0528.2006.01008.x.
The current report aims to compare the prevalence of polycystic ovary syndrome (PCOS) diagnosed according to the new Rotterdam criteria (Rott-PCOS) versus the previous criteria as formulated by the National Institutes of Health (NIH) (NIH-PCOS) in women with normogonadotropic (WHO-II) anovulation and assess the frequency of obesity and related factors determined in these women.
Cohort study based on large anovulation screening database.
Two large tertiary referral centres for reproductive medicine.
WHO-II normogonadotropic, anovulatory, infertility cases.
WHO-II cases were extracted from the screening database and classified according to both the Rotterdam and NIH criteria for PCOS. Within these two classes, the prevalence of obesity, hyperglycaemia and insulin resistance was assessed and compared and their relation to the difference in diagnostic criteria applied was analysed.
Prevalence of diagnosis PCOS in the WHO-II anovulation group. Prevalence of obesity, hyperglycaemia and insulin resistance in the two diagnostic classes.
The Rott-PCOS group appeared to be more than 1.5 times larger than the group classified as NIH-PCOS (91 versus 55% of the WHO-II cohort). Especially, women with ovarian dysfunction and polycystic ovaries at ultrasound scan, but without hyperandrogenism, were added to the PCOS diagnostic group. The Rott-PCOS exhibited a lower frequency of obesity, hyperglycaemia and insulin resistance compared with the NIH-PCOS group. Obese women in the Rott-PCOS group without androgen excess had a different metabolic profile compared with obese women in the NIH-PCOS group, with lower rates of hyperglycaemia and hyperinsulinism, despite comparable distributions of body weight.
The present findings indicate that with the new Rotterdam consensus criteria, oligo/anovulatory women with less severe metabolic derangement will be added to the heterogeneous group of women with PCOS.
本报告旨在比较根据新的鹿特丹标准（Rotterdam-PCOS）与美国国立卫生研究院（NIH）制定的先前标准（NIH-PCOS）诊断的多囊卵巢综合征（PCOS）在正常促性腺激素水平（WHO-II型）无排卵女性中的患病率，并评估这些女性中肥胖及相关因素的发生频率。
基于大型无排卵筛查数据库的队列研究。
两个大型生殖医学三级转诊中心。
WHO-II型正常促性腺激素水平、无排卵的不孕病例。
从筛查数据库中提取WHO-II型病例，并根据鹿特丹和NIH的PCOS标准进行分类。在这两类病例中，评估并比较肥胖、高血糖和胰岛素抵抗的患病率，并分析它们与所应用诊断标准差异之间的关系。
WHO-II型无排卵组中PCOS的诊断患病率。两个诊断类别中肥胖、高血糖和胰岛素抵抗的患病率。
Rotterdam-PCOS组的规模似乎比分类为NIH-PCOS组的规模大1.5倍以上（分别占WHO-II队列的91%和55%）。特别是，超声检查显示卵巢功能障碍和多囊卵巢但无高雄激素血症的女性被纳入PCOS诊断组。与NIH-PCOS组相比，Rotterdam-PCOS组肥胖、高血糖和胰岛素抵抗的发生率较低。Rotterdam-PCOS组中无雄激素过多的肥胖女性与NIH-PCOS组中的肥胖女性具有不同的代谢特征，尽管体重分布相当，但高血糖和高胰岛素血症的发生率较低。
目前的研究结果表明，采用新的鹿特丹共识标准，代谢紊乱较轻的少排卵/无排卵女性将被纳入异质性的PCOS女性群体。
