Department of Pediatrics and Adolescence, Institute of Clinical Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland.
Horm Res Paediatr. 2010;74(5):372-5. doi: 10.1159/000320388. Epub 2010 Sep 22.
Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women. It may manifest as early as in the first decade of life. Most often it becomes clinically apparent during adolescence with maturation of the hypothalamic-pituitary-ovarian axis.
Typical features in adolescence include irregular menstrual cycles, acne, hirsutism, obesity and signs of insulin resistance such as acanthosis nigricans. Biochemical hyperandrogenism and polycystic ovaries are often present. However, some adolescents have no evidence of clinical and biochemical hyperandrogenism despite dysfunctional polycystic ovaries.
The pathogenesis of PCOS is uncertain, however, both genetic and environmental factors play a role, resulting in key features of the syndrome; disordered gonadotropin release, dysregulated steroidogenesis, ovarian and adrenal hyperandrogenism and hyperinsulinism. PCOS is often accompanied by metabolic syndrome, with abnormalities in lipid and glucose metabolism.
Treatment of PCOS is symptomatic. Lifestyle changes are a first-line intervention, however, increasing evidence suggests that metformin and estrogen-progestin combination pill may be beneficial.
PCOS is a lifelong condition that carries long-term health risks. Several risk factors for PCOS have been identified and clinicians should be alert for this condition already in childhood and adolescence. Early intervention and counseling might be the key for prevention of co-morbidities of PCOS.
多囊卵巢综合征（PCOS）是一种常见的女性内分泌疾病。它可能早在生命的第一个十年就出现。大多数情况下，它在青春期由于下丘脑-垂体-卵巢轴的成熟而变得明显。
青少年时期的典型特征包括月经周期不规律、痤疮、多毛症、肥胖和黑棘皮病等胰岛素抵抗的迹象。常伴有生化高雄激素血症和多囊卵巢。然而，尽管多囊卵巢功能障碍，一些青少年没有临床和生化高雄激素血症的证据。
PCOS 的发病机制尚不确定，但遗传和环境因素都起作用，导致该综合征的主要特征；促性腺激素释放紊乱、类固醇生成失调、卵巢和肾上腺高雄激素血症和高胰岛素血症。PCOS 常伴有代谢综合征，表现为脂类和葡萄糖代谢异常。
PCOS 的治疗是对症的。生活方式的改变是一线干预措施，但越来越多的证据表明二甲双胍和雌孕激素联合避孕药可能有益。
PCOS 是一种终身疾病，会带来长期的健康风险。已经确定了 PCOS 的几个危险因素，临床医生应该在儿童和青少年时期就注意到这种疾病。早期干预和咨询可能是预防 PCOS 合并症的关键。
