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肥胖型多囊卵巢综合征青少年的睡眠多导图变量、血清雄激素和葡萄糖代谢参数的纵向分析。

Longitudinal analyses of polysomnographic variables, serum androgens, and parameters of glucose metabolism in obese adolescents with polycystic ovarian syndrome.

机构信息

Vestische Kinder- und Jugendklinik, University of Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Germany.

出版信息

Sleep Breath. 2012 Dec;16(4):1139-46. doi: 10.1007/s11325-011-0620-z. Epub 2011 Nov 20.

Abstract

PURPOSE

The prevalence of obstructive sleep apnea syndrome (OSAS) is clearly increased in adults with polycystic ovarian syndrome (PCOS), whereas OSAS does not seem to be frequent in adolescents with PCOS, pointing towards the fact that some patients with PCOS develop OSAS in the further course of the disease. We therefore aimed to analyze the changes of polysomnographic variables in obese adolescents with PCOS in a longitudinal analysis.

METHODS

Fifteen adolescents with PCOS (age 15.3 years ± 1.2, BMI 32.9 kg/m(2) ± 6.4, SDS-BMI 2.5 ± 0.8) underwent overnight 12-channel polysomnography at baseline and after a mean duration of 28 ± 6 months (age 17.8 years ± 1.1, BMI 32.7 kg/m(2) ± 7.0, SDS-BMI 2.1 ± 0.9). After performing the initial polysomnography, we treated hyperandrogenemia and insulin resistance in the study group. We determined parameters of body weight/body composition, parameters of glucose metabolism, and serum androgens in all patients at baseline and follow-up. At follow-up, we compared the polysomnographic variables of the study group to those of healthy female adults.

RESULTS

The polysomnographic variables, the parameters of body weight/body composition, and the parameters of glucose metabolism in the study group did not change significantly during the observation period. The serum levels of total testosterone and sex hormone binding globulin increased significantly, whereas free androgen index decreased significantly. At follow-up, the polysomnographic variables of the study group did not differ from those of healthy female adults.

CONCLUSIONS

OSAS does not seem to develop in adolescents with PCOS being treated for hyperandrogenism and insulin resistance. The pathogenesis of OSAS in PCOS needs to be examined in larger controlled studies.

摘要

目的

多囊卵巢综合征(PCOS)患者中阻塞性睡眠呼吸暂停综合征(OSAS)的患病率明显增加,而青少年 PCOS 患者中 OSAS 似乎并不常见,这表明一些 PCOS 患者在疾病的进一步发展过程中会出现 OSAS。因此,我们旨在通过纵向分析来分析肥胖青少年 PCOS 患者的多导睡眠图变量的变化。

方法

15 名患有 PCOS 的青少年(年龄 15.3±1.2 岁,BMI 32.9kg/m²±6.4,SDS-BMI 2.5±0.8)在基线时和平均 28±6 个月后(年龄 17.8±1.1 岁,BMI 32.7kg/m²±7.0,SDS-BMI 2.1±0.9)接受了 12 通道过夜多导睡眠图检查。在研究组中,我们对高雄激素血症和胰岛素抵抗进行了初始多导睡眠图检查后进行了治疗。我们在基线和随访时确定了所有患者的体重/身体成分参数、葡萄糖代谢参数和血清雄激素。在随访时,我们将研究组的多导睡眠图变量与健康女性成年人的多导睡眠图变量进行了比较。

结果

在观察期间,研究组的多导睡眠图变量、体重/身体成分参数和葡萄糖代谢参数均无明显变化。总睾酮和性激素结合球蛋白的血清水平显著增加,而游离雄激素指数显著降低。在随访时,研究组的多导睡眠图变量与健康女性成年人的多导睡眠图变量无差异。

结论

接受高雄激素血症和胰岛素抵抗治疗的青少年 PCOS 似乎不会发生 OSAS。需要在更大的对照研究中检查 PCOS 中 OSAS 的发病机制。

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