Shi Yuhua, Gao Xuan, Sun Xuedong, Zhang Peng, Chen Zijiang
Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Jinan, China.
Fertil Steril. 2008 Oct;90(4):1139-43. doi: 10.1016/j.fertnstert.2007.07.1375. Epub 2007 Sep 24.
To demonstrate clinical features of a patient subgroup presenting with polycystic ovary syndrome (PCOS) without polycystic ovary morphology.
Retrospective study.
Hospital-based IVF center.
PATIENT(S): In the present study, 876 PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital, Shandong University, between September 2004 and October 2006. Women with PCOS were divided into two groups based on ultrasound image: group A, PCOS patients with classic polycystic ovary (n = 800); group B, PCOS patients without polycystic ovary morphology (n = 76). The following available data were analyzed in the large cohort of women: body height, weight, waistline, hip circumference, hirsutism scores, family history, serum sex hormone levels, blood glucose levels, insulin levels, and blood lipid levels.
INTERVENTION(S): An oral glucose tolerance test and insulin release test were performed for each woman. After overnight fasting, blood samples were collected to determine fasting blood glucose, LH, FSH, T, PRL, E(2), and blood lipid levels.
MAIN OUTCOME MEASURE(S): Height, weight, waistline, hip circumference, Ferriman-Gallwey grade for hirsutism, gonadal hormone results, blood lipid level, blood glucose tolerance, each-moment insulin level, and family history were determined for the two groups.
RESULT(S): No statistical difference was observed between groups in age, body height and weight, waistline, hip circumference, FSH, LH, PRL, E(2), each-moment blood glucose, and each-moment insulin. There were significantly higher hirsutism scores (6.31 +/- 6.44 vs. 4.18 +/- 4.96) and serum T levels (80.71 +/- 17.89 vs. 66.35 +/- 33.31) in group B than in group A. Cholesterol (4.99 +/- 1.01 vs. 4.70 +/- 0.91) and low-density lipoprotein (3.59 +/- 1.17 vs. 3.03 +/- 1.10) were both significantly higher in group B than in group A. In addition, significantly higher rates of diabetes mellitus and hypertension were observed in patients' first-grade relatives in group B than in group A.
CONCLUSION(S): Patients with PCOS without polycystic ovaries had higher cholesterol and low-density lipoprotein and possibly had a higher incidence of developing long-term complications.
阐述无多囊卵巢形态的多囊卵巢综合征(PCOS)患者亚组的临床特征。
回顾性研究。
医院附属体外受精中心。
在本研究中,从2004年9月至2006年10月期间就诊于山东大学山东省立医院生殖医学中心的女性中选取876例PCOS患者。根据超声图像将PCOS患者分为两组:A组,经典多囊卵巢的PCOS患者(n = 800);B组,无多囊卵巢形态的PCOS患者(n = 76)。对该大样本女性队列中的以下可用数据进行分析:身高、体重、腰围、臀围、多毛症评分、家族史、血清性激素水平、血糖水平、胰岛素水平和血脂水平。
对每位女性进行口服葡萄糖耐量试验和胰岛素释放试验。过夜禁食后,采集血样以测定空腹血糖、促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)、泌乳素(PRL)、雌二醇(E₂)和血脂水平。
测定两组患者的身高、体重、腰围、臀围、多毛症的Ferriman-Gallwey分级、性腺激素结果、血脂水平、血糖耐量、即时胰岛素水平和家族史。
两组在年龄、身高、体重、腰围、臀围、FSH、LH、PRL、E₂、即时血糖和即时胰岛素方面未观察到统计学差异。B组的多毛症评分(6.31±6.44 vs. 4.18±4.96)和血清T水平(80.71±17.89 vs. 66.35±33.31)均显著高于A组。B组的胆固醇(4.99±1.01 vs. 4.70±0.91)和低密度脂蛋白(3.59±1.17 vs. 3.03±1.10)均显著高于A组。此外,B组患者一级亲属中糖尿病和高血压的发生率显著高于A组。
无多囊卵巢的PCOS患者胆固醇和低密度脂蛋白水平较高,可能发生长期并发症的发生率也较高。