Joy Tisha R, Hegele Robert A
Robarts Research Institute and Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada.
Endocr Pract. 2008 Dec;14(9):1126-32. doi: 10.4158/EP.14.9.1126.
To compare the risk of having polycystic ovary syndrome (PCOS) or ovarian cysts among women with genetically confirmed familial partial lipodystrophy (FPLD) with that in the general population of healthy women.
Twenty-five women with FPLD who were 18 to 80 years old were interviewed regarding a history of PCOS or ovarian cysts (composite primary outcome) as well as for secondary outcomes of interest including menstrual irregularities, hirsutism, gynecologic surgical procedures, and fertility or obstetric complications. From the 2005 National Ambulatory Medical Care Survey, 3,326 women, aged 18 to 80 years (control subjects), were assessed for the presence of the primary outcome based on appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes.
Four of the 25 patients with FPLD (16%) had a history of PCOS or ovarian cysts, in comparison with 14 of the 3,326 control subjects (0.42%), resulting in an age- and body mass index-adjusted odds ratio of 40.6 (95% confidence interval, 12.1 to 136.7; P<.0001) among the patients with FPLD. Furthermore, 5 women with FPLD (20%) required at least 1 oophorectomy during their lifetime, and 6 (24%) had had hysterectomies at a young age (<or=55 years).
Women with genetically confirmed FPLD have an increased risk for PCOS and ovarian cysts, as well as early hysterectomies, in comparison with the general population. Therefore, timely involvement of gynecologists in the care of these patients is warranted.
比较经基因确诊的家族性部分脂肪营养不良(FPLD)女性患多囊卵巢综合征(PCOS)或卵巢囊肿的风险与健康女性总体人群的风险。
对25名年龄在18至80岁的FPLD女性进行访谈,了解她们的PCOS或卵巢囊肿病史(复合主要结局)以及包括月经不规律、多毛症、妇科手术、生育或产科并发症等感兴趣的次要结局。根据2005年全国门诊医疗调查,对3326名年龄在18至80岁的女性(对照对象),依据适当的《国际疾病分类》第九版临床修订本编码评估主要结局的存在情况。
25名FPLD患者中有4名(16%)有PCOS或卵巢囊肿病史,相比之下,3326名对照对象中有14名(0.42%)有该病史,FPLD患者经年龄和体重指数调整后的优势比为40.6(95%置信区间,12.1至136.7;P<0.0001)。此外,5名FPLD女性(20%)一生中至少需要进行1次卵巢切除术,6名(24%)在年轻时(≤55岁)进行了子宫切除术。
与总体人群相比,经基因确诊的FPLD女性患PCOS和卵巢囊肿以及早期子宫切除术的风险增加。因此,有必要让妇科医生及时参与这些患者的护理。