Siklar Zeynep, Oçal Gönül, Adiyaman Pelin, Ergur Ayça, Berberoğlu Merih
Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2007 Apr;20(4):475-81. doi: 10.1515/jpem.2007.20.4.475.
Functional ovarian hyperandrogenism (FOH) is considered to be a form of polycystic ovary syndrome (PCOS) at adolescence. There are almost no data in the prepubertal period, although one of the earliest manifestations of PCOS is premature pubarche. Prepubertal girls with obesity or insulin resistance are also at risk to develop the full PCOS phenotype after puberty. The aim of this study was to evaluate prepubertal girls with premature pubarche and/or obesity for PCOS or FOH.
Twenty-seven prepubertal girls with premature pubarche and/or obesity aged >6 years were evaluated. FOH was defined as abnormal ovarian 17OHP response to challenge with GnRH analog of >2 ng/ml after exclusion of adrenal dysfunction. All patients underwent a pelvic ultrasound examination.
Sixteen patients had premature pubarche, seven were obese, and four had both premature pubarche and obesity. Eleven of 27 patients (40.7%) showed high (>2 ng/ml) 17OHP response to GnRH challenge. Three patients (11%) with FOH also showed PCO morphology on pelvic ultrasound examination.
In prepubertal girls who carry risk factors, including genetic polymorphisms and/or particular environmental factors, FOH/PCOS could develop at a high rate.
功能性卵巢高雄激素血症（FOH）被认为是青春期多囊卵巢综合征（PCOS）的一种形式。尽管PCOS最早的表现之一是青春期提前，但青春期前几乎没有相关数据。青春期前肥胖或有胰岛素抵抗的女孩在青春期后也有发展为完全PCOS表型的风险。本研究的目的是评估青春期前有青春期提前和/或肥胖的女孩是否患有PCOS或FOH。
对27名年龄大于6岁、有青春期提前和/或肥胖的青春期前女孩进行评估。FOH的定义为在排除肾上腺功能障碍后，卵巢对GnRH类似物刺激的17OHP反应异常，大于2 ng/ml。所有患者均接受盆腔超声检查。
16例患者有青春期提前，7例肥胖，4例既有青春期提前又有肥胖。27例患者中有11例（40.7%）对GnRH刺激的17OHP反应较高（>2 ng/ml）。3例（11%）患有FOH的患者在盆腔超声检查中也显示有多囊卵巢形态。
在携带包括基因多态性和/或特定环境因素等危险因素的青春期前女孩中，FOH/PCOS可能有较高的发病率。
