Amato Marco Calogero, Galluzzo Aldo, Finocchiaro Sara, Criscimanna Angela, Giordano Carla
Section of Endocrinology, DOSAC, Università degli Studi di Palermo, Palermo, Italy.
Clin Endocrinol (Oxf). 2008 Jul;69(1):52-60. doi: 10.1111/j.1365-2265.2007.03145.x. Epub 2008 Jul 1.
Polycystic ovary syndrome (PCOS) is considered predominantly as a hyperandrogenetic syndrome and the evaluation of metabolic parameters and insulin sensitivity is not mandatory.
PCOS diagnostic criteria [National Institute of Health (NIH), Rotterdam Consensus (ROT), Androgen Excess Society (AES)] are unanimous recognized. We aimed to assess in women with suspected PCOS whether the application of the three diagnostic criteria differently characterizes the metabolic profile and insulin sensitivity.
Retrospective study in a cohort of women admitted to our Outpatient Clinic for suspected PCOS.
Two hundred and four women with suspected PCOS in comparison to a group of normal, age-matched Sicilian women (N = 34) without signs of metabolic syndrome.
We evaluated hyperandrogenaemia and clinical hyperandrogenism, ovarian morphology, hypothalamo-hypophyseal axis and metabolic syndrome parameters. An oral glucose tolerance test (OGTT; 75 g glucose) measured areas under the curve (AUC) for insulin, C peptide and homeostasis model assessment of insulin-resistance (HOMA-IR) were performed.
The prevalence of PCOS was 51% according to NIH, 83% to ROT and 70.6% to AES, and only 100 patients were qualified simultaneously under these three criteria. The prevalence of the metabolic syndrome in PCOS women was 26.92% (NIH), 21.77% (ROT) and 23.61% (AES), respectively. In comparison to healthy women, PCOS women showed increased fasting insulinaemia (PCOS/ROT: P = 0.028; PCOS/NIH: P = 0.007; PCOS/EAS: P = 0.023), 120 min insulin after OGTT insulinaemia (for the three criteria: P < 0.001), AUC(2h) insulin (for the three criteria: P < 0.001) and AUC(2h) C peptide (for the three criteria: P < 0.001).
Our study highlights the fact that regardless of the diagnostic criteria used, evaluation of the metabolic parameters and insulin sensitivity is important for a correct diagnosis of PCOS and a therapeutic approach.
多囊卵巢综合征（PCOS）主要被视为一种高雄激素血症综合征，代谢参数和胰岛素敏感性的评估并非必需。
PCOS诊断标准[美国国立卫生研究院（NIH）、鹿特丹共识（ROT）、雄激素过多协会（AES）]已得到一致认可。我们旨在评估疑似PCOS的女性中，这三种诊断标准的应用是否会对代谢特征和胰岛素敏感性产生不同的表征。
对我院门诊疑似PCOS的女性队列进行回顾性研究。
204名疑似PCOS的女性，并与一组年龄匹配、无代谢综合征迹象的正常西西里女性（N = 34）进行比较。
我们评估了高雄激素血症和临床高雄激素表现、卵巢形态、下丘脑 - 垂体轴以及代谢综合征参数。进行了口服葡萄糖耐量试验（OGTT；75g葡萄糖），测量胰岛素、C肽的曲线下面积（AUC）以及胰岛素抵抗的稳态模型评估（HOMA - IR）。
根据NIH标准，PCOS的患病率为51%，ROT标准为83%，AES标准为70.6%，且只有100名患者同时符合这三个标准。PCOS女性中代谢综合征的患病率分别为26.92%（NIH）、21.77%（ROT）和23.61%（AES）。与健康女性相比，PCOS女性空腹胰岛素血症升高（PCOS/ROT：P = 0.028；PCOS/NIH：P = 0.007；PCOS/EAS：P = 0.023），OGTT后120分钟胰岛素血症（三种标准下：P < 0.001）、AUC（2小时）胰岛素（三种标准下：P < 0.001）和AUC（2小时）C肽（三种标准下：P < 0.001）。
我们的研究突出了这样一个事实，即无论使用何种诊断标准，代谢参数和胰岛素敏感性的评估对于PCOS的正确诊断和治疗方法都很重要。
