Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
Hum Reprod. 2012 May;27(5):1481-8. doi: 10.1093/humrep/des018. Epub 2012 Mar 7.
Polycystic ovary syndrome (PCOS) is a complex disorder with variable prevalence and clinical presentation in different populations, which may be mediated by geographical and ethnic background.
We performed a comparison of phenotypic characteristics between 547 Chinese and 427 Dutch women with PCOS and oligo/amenorrhoea attending University Reproductive Centers in China and the Netherlands.
Chinese women presenting with a clinical diagnosis of PCOS were observed to have a higher incidence of hyperandrogenism (HA) (P < 0.001) and amenorrhoea (P < 0.001) compared with Dutch women, but no difference was observed in the incidence of polycystic ovaries (PCOs). Using population-specific cut-off values, Chinese women with PCOS demonstrated a higher incidence of increased BMI (P < 0.001), waist circumference (WC) (P < 0.001) and waist-hip ratio (P < 0.001) than Dutch women. In both groups, HA was associated with increased age, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and serum LH while PCOs correlated with BMI, WC, HOMA-IR, fasting insulin and elevated total testosterone. Associations specific for ethnic background were found between LH and HA, and between both BMI and HOMA-IR, and PCOs.
Reproductive and metabolic characteristics differed between the two ethnic groups. Chinese women were found to present more frequently with a phenotype associated with increased risk of metabolic complications later in life, compared with Dutch Caucasian women. Ethnicity seems to determine part of the specific phenotypical presentation of PCOS.
多囊卵巢综合征(PCOS)是一种复杂的疾病,在不同人群中的患病率和临床表现存在差异,这种差异可能与地域和种族背景有关。
我们比较了在中国和荷兰的大学生殖中心就诊的 547 名中国女性和 427 名荷兰女性的表型特征,这些女性均患有 PCOS 和少/闭经。
与荷兰女性相比,中国女性临床诊断为 PCOS 的患者中高雄激素血症(HA)(P<0.001)和闭经(P<0.001)的发生率更高,但多囊卵巢(PCOs)的发生率没有差异。使用特定人群的截断值,中国 PCOS 患者的 BMI(P<0.001)、腰围(WC)(P<0.001)和腰臀比(P<0.001)的升高发生率高于荷兰女性。在两组中,HA 与年龄、空腹胰岛素、胰岛素抵抗稳态模型评估(HOMA-IR)和血清 LH 增加有关,而 PCOs 与 BMI、WC、HOMA-IR、空腹胰岛素和总睾酮升高有关。在两组中,LH 和 HA 之间、BMI 和 HOMA-IR 之间以及 PCOs 之间都存在与种族背景相关的特定关联。
两组人群的生殖和代谢特征存在差异。与荷兰白种女性相比,中国女性表现出更频繁的表型,这种表型与日后发生代谢并发症的风险增加有关。种族似乎决定了 PCOS 特定表型表现的一部分。