Bronstein Jason, Tawdekar Sonali, Liu Yinghua, Pawelczak Melissa, David Raphael, Shah Bina
Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
J Pediatr Adolesc Gynecol. 2011 Feb;24(1):15-20. doi: 10.1016/j.jpag.2010.06.003.
To study the age at diagnosis of polycystic ovarian syndrome (PCOS) in a pediatric population. To compare risk factors involved in causing PCOS in preadolescent and adolescent girls. To review the current literature on the reported age of PCOS in girls.
A retrospective chart review and systematic review of the literature.
Patients included 58 girls (age ≤ 18 yrs) with a diagnosis of PCOS based on the Rotterdam criteria. Girls were grouped as preadolescents (<13 yrs) or adolescents (13-18 yrs). Clinical and biochemical data were reviewed from the time of diagnosis.
Age at diagnosis. Differences in risk factors for PCOS (Ethnicity, obesity, family history of PCOS, birth weight, age at pubarche, thelarche and menarche, evidence of hyperandrogenism and/or insulin resistance) were compared between the two groups.
There were 26% (15/58) preadolescent girls (9-12 yrs) vs 74% (43/58) adolescents (13-18 yrs). There was no significant difference between the two groups in ethnicity, BMI z-score, family history of maternal PCOS, birth weight, hyperandrogenism, or insulin resistance. Preadolescents with PCOS had significantly earlier onset of pubarche and thelarche than adolescents with PCOS, by 1.9 and 1.5 yrs, respectively (P = 0.018, 0.030). In addition to earlier puberty, PCOS developed 2.1 years sooner after thelarche in preadolescents than in adolescents. (P = 0.008) Preadolescents were significantly taller for age than adolescents (72nd % vs 43rd %) (P = 0.005). A review of the 28 studies published in the last 3 years that included PCOS patients with age <=18 yrs described only 6.4% (27/425) of pediatric subjects with age <13 yrs. Four were primarily pediatric studies that included patients under the age of 13 yrs, with 9.4% (12/127) of the patients <13 yrs.
Increased awareness of PCOS in young females is needed. PCOS may occur at a younger age in girls who develop early pubarche and thelarche. Therefore, the diagnosis and workup should be considered in young girls with risk factors suggestive of PCOS.
研究儿科人群中多囊卵巢综合征（PCOS）的诊断年龄。比较青春期前和青春期女孩患PCOS的相关危险因素。综述目前关于女孩PCOS报道年龄的文献。
回顾性病历审查和文献系统综述。
纳入58名诊断为PCOS的女孩（年龄≤18岁），诊断依据鹿特丹标准。女孩分为青春期前（<13岁）或青春期（13 - 18岁）。从诊断时起回顾临床和生化数据。
诊断年龄。比较两组PCOS危险因素（种族、肥胖、PCOS家族史、出生体重、阴毛初现年龄、乳房初现年龄和月经初潮年龄、高雄激素血症和/或胰岛素抵抗证据）的差异。
青春期前女孩占26%（15/58）（9 - 12岁），青春期女孩占74%（43/58）（13 - 18岁）。两组在种族、BMI z评分、母亲PCOS家族史、出生体重、高雄激素血症或胰岛素抵抗方面无显著差异。患有PCOS的青春期前女孩阴毛初现和乳房初现的起始时间分别比患有PCOS的青春期女孩早1.9年和1.5年（P = 0.018，0.030）。除青春期提前外，青春期前女孩在乳房初现后比青春期女孩早2.1年患PCOS（P = 0.008）。青春期前女孩的年龄别身高显著高于青春期女孩（第72百分位数 vs 第43百分位数）（P = 0.005）。对过去3年发表的28项研究进行综述，这些研究纳入了年龄≤18岁的PCOS患者，其中年龄<13岁的儿科受试者仅占6.4%（27/425）。四项主要是儿科研究纳入了13岁以下的患者，其中9.4%（12/127）的患者<13岁。
需要提高对年轻女性PCOS 的认识。PCOS可能在阴毛初现和乳房初现较早的女孩中发病年龄更小。因此，对于有提示PCOS危险因素的年轻女孩应考虑进行诊断和检查。
