Zabuliene Lina, Tutkuviene Janina
Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, M. K. Ciurlionio 21/27, Vilnius, Lithuania.
Medicina (Kaunas). 2010;46(2):142-57.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine metabolic disorders of reproductive age women. The main signs of PCOS are as follows: androgen excess, menstrual dysfunction, infertility, obesity, and other numerous health problems. By different authors, the disorder affects 2-28% of reproductive age women. Polycystic ovary syndrome is characterized by presence of hyperandrogenism, anovulation, menstrual cycle disturbances, also by the other metabolic changes. The lack of well-defined and universally accepted diagnostic criteria makes identification of this syndrome confusing to many clinicians. There are only few studies concerning the correlations between phenotypic expression, body composition and PCOS, and relationship with the processes of growth and sexual maturation and various environmental factors (nutrition, physical activity, stress, and other factors). There is a lack of knowledge about further PCOS development and prognosis, considering the individual and environmental factors. Variation in human body composition and shape ranges considerably: many body size and shape indices (height, weight, body composition, and proportions) are the result of long evolution process and adaptation to environment. Obviously, the morphological body parameters, physiological and biochemical indices are complex and compound the interdependent system. By current literature, more than 50% of women are overweight or obese. If waist circumference and waist-to-hip ratio of women with PCOS increase, reproductive function and metabolic state of a woman is altered more than in cases when there are no changes in these parameters. The investigations of the strongest sexual dimorphism sign--the subcutaneous and visceral fat topography--showed that women with PCOS have greater adipose tissue mass in the areas of the abdomen, waist, and upper arms than control women. It is known that some indices of sexual dimorphism may be considered as the morphological signs of hyperandrogenism, for example handgrip, waist-to-hip ratio, hand and foot length, 2nd-to-4th digit (finger length) ratio (2D:4D), certain facial characteristics. Only 2D:4D ratio was investigated for the women with PCOS. The early changes of certain morphological and other indices of physical status could help to predict some metabolic characteristics, development of PCOS, and outcome of this syndrome.
多囊卵巢综合征(PCOS)是育龄期女性最常见的内分泌代谢紊乱疾病之一。PCOS的主要体征如下:雄激素过多、月经功能紊乱、不孕、肥胖以及其他众多健康问题。不同作者的研究表明,该疾病影响2%至28%的育龄期女性。多囊卵巢综合征的特征是存在高雄激素血症、无排卵、月经周期紊乱以及其他代谢变化。由于缺乏明确且被普遍接受的诊断标准,许多临床医生对该综合征的识别感到困惑。关于表型表达、身体成分与PCOS之间的相关性,以及与生长和性成熟过程及各种环境因素(营养、体育活动、压力等因素)之间的关系,仅有少数研究。考虑到个体和环境因素,对于PCOS的进一步发展和预后缺乏了解。人体成分和体型的变化范围相当大:许多身体大小和形状指标(身高、体重、身体成分和比例)是长期进化过程和对环境适应的结果。显然,身体形态参数、生理和生化指标是一个复杂且相互依存的系统。根据当前文献,超过50%的女性超重或肥胖。如果PCOS女性的腰围和腰臀比增加,其生殖功能和代谢状态的改变比这些参数无变化时更为明显。对最强性二态性标志——皮下和内脏脂肪分布——的研究表明,PCOS女性腹部、腰部和上臂的脂肪组织量比对照女性更多。已知一些性二态性指标可被视为高雄激素血症的形态学标志,例如握力、腰臀比、手和脚的长度、食指与无名指长度比(2D:4D)、某些面部特征。仅对PCOS女性的2D:4D比值进行了研究。某些身体状态的形态学和其他指标的早期变化有助于预测一些代谢特征、PCOS的发展以及该综合征的结局。