Alvarez-Blasco Francisco, Botella-Carretero José I, San Millán José L, Escobar-Morreale Héctor F
Departments of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Arch Intern Med. 2006 Oct 23;166(19):2081-6. doi: 10.1001/archinte.166.19.2081.
Surprisingly, the prevalence of polycystic ovary syndrome (PCOS) in otherwise unselected overweight or obese women is unknown, despite obesity being frequent in patients with PCOS. We conducted the present study to obtain an unbiased estimate of the prevalence of PCOS in unselected overweight and obese premenopausal women from Spain.
All premenopausal women reporting to the Department of Endocrinology, Hospital Universitario Ramón y Cajal, for dietary treatment of overweight or obesity from May 2002 to December 2005 were prospectively recruited. Women referred for any other reason were automatically excluded to avoid selection bias. Diagnosis of PCOS relied on the presence of clinical and/or biochemical hyperandrogenism, oligo-ovulation, and exclusion of secondary causes. Anthropometric measurements, hirsutism scores, and androgen, gonadotropin, metabolic, and lipid profiles were obtained.
Of a total of 113 consecutive women recruited, 32 (28.3%) were diagnosed as having PCOS (95% confidence interval, 20.0%-36.6%). The prevalence of PCOS was not different when considering the degree of obesity. Another 3 women presented with hyperandrogenemia without oligo-ovulation, 2 had idiopathic hirsutism, 2 had chronic oligomenorrhea without clinical or biochemical hyperandrogenism, and 2 had oligomenorrhea with hyperprolactinemia, precluding the diagnosis of PCOS. The remaining 72 women (63.7%) had no evidence of hyperandrogenism or reproductive abnormalities.
Our results demonstrate a 28.3% prevalence of PCOS in overweight and obese women from Spain, which is markedly increased compared with the 5.5% prevalence of PCOS in lean women of our country. Therefore, PCOS must be routinely ruled out in overweight and obese premenopausal women seeking advice for weight loss.
令人惊讶的是，尽管多囊卵巢综合征（PCOS）患者中肥胖很常见，但在未经过挑选的超重或肥胖女性中PCOS的患病率尚不清楚。我们开展本研究以获得西班牙未经过挑选的超重和肥胖绝经前女性中PCOS患病率的无偏估计。
前瞻性招募了2002年5月至2005年12月期间因超重或肥胖到拉蒙·卡哈尔大学医院内分泌科接受饮食治疗的所有绝经前女性。因任何其他原因转诊的女性被自动排除以避免选择偏倚。PCOS的诊断依赖于临床和/或生化高雄激素血症、稀发排卵的存在以及继发性病因的排除。获取了人体测量数据、多毛症评分以及雄激素、促性腺激素、代谢和血脂谱。
在总共连续招募的113名女性中，32名（28.3%）被诊断为患有PCOS（95%置信区间，20.0% - 36.6%）。考虑肥胖程度时，PCOS的患病率无差异。另外3名女性表现为高雄激素血症但无稀发排卵，2名有特发性多毛症，2名有慢性月经过少但无临床或生化高雄激素血症，2名有月经过少伴高催乳素血症，排除了PCOS的诊断。其余72名女性（63.7%）没有高雄激素血症或生殖异常的证据。
我们的结果表明，西班牙超重和肥胖女性中PCOS的患病率为28.3%，与我国瘦女性中5.5%的PCOS患病率相比显著增加。因此，在寻求减肥建议的超重和肥胖绝经前女性中必须常规排除PCOS。
