Kauffman Robert P, Baker Teresa E, Baker Vicki M, DiMarino Pamela, Castracane V Daniel
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX 79106, USA.
Am J Obstet Gynecol. 2008 Jun;198(6):670.e1-7; discussion 670.e7-10. doi: 10.1016/j.ajog.2008.01.037. Epub 2008 Mar 20.
The Rotterdam criteria extend the phenotypic spectrum of polycystic ovary syndrome (PCOS). We characterized endocrine and metabolic differences among women meeting the National Institutes of Health (NIH) definition for PCOS vs two novel phenotypes established by the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine definition.
Endocrine and metabolic data from a retrospective analysis of 160 age- and weight-matched women with PCOS and 23 controls were compared. Insulin sensitivity indices were correlated with androgens, gonadotropins, and lipids within each phenotype.
Ovarian and adrenal androgens were highest in the NIH-defined PCOS group, lowest in the nonhyperandrogenic PCOS group, and intermediate in the hyperandrogenic ovulatory PCOS population. Insulin sensitivity indices, gonadotropins, and lipids were similar across all PCOS phenotypes. The magnitude of insulin resistance correlated with free testosterone only in the NIH-defined group.
Androgen levels are the major distinguishing endocrine feature differentiating phenotypic expressions of PCOS. Hyperinsulinemia correlates with free testosterone levels only in traditional NIH-defined women with PCOS.
鹿特丹标准扩展了多囊卵巢综合征（PCOS）的表型谱。我们对符合美国国立卫生研究院（NIH）PCOS定义的女性与由欧洲人类生殖与胚胎学会/美国生殖医学学会定义的两种新表型的女性之间的内分泌和代谢差异进行了特征描述。
对160名年龄和体重匹配的PCOS女性及23名对照进行回顾性分析，比较其内分泌和代谢数据。在每种表型中，胰岛素敏感性指标与雄激素、促性腺激素和脂质进行相关性分析。
卵巢和肾上腺雄激素在NIH定义的PCOS组中最高，在非高雄激素性PCOS组中最低，在高雄激素性排卵型PCOS人群中处于中间水平。所有PCOS表型的胰岛素敏感性指标、促性腺激素和脂质相似。仅在NIH定义的组中，胰岛素抵抗程度与游离睾酮相关。
雄激素水平是区分PCOS表型表达的主要内分泌特征。高胰岛素血症仅在传统NIH定义的PCOS女性中与游离睾酮水平相关。
