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多囊卵巢综合征的表型与代谢紊乱

Phenotype and metabolic disorders in polycystic ovary syndrome.

作者信息

Głuszak Olgierd, Stopińska-Głuszak Urszula, Glinicki Piotr, Kapuścińska Renata, Snochowska Hanna, Zgliczyński Wojciech, Dębski Romuald

机构信息

The Medical Centre of Postgraduate Education, ul. Marymoncka 99/103, 01-813 Warsaw, Poland.

出版信息

ISRN Endocrinol. 2012;2012:569862. doi: 10.5402/2012/569862. Epub 2012 Feb 29.

Abstract

The polycystic ovary syndrome (PCOS) is one of the most frequent endocrinopathies in women. Its incidence is assessed at 6-8% of the female population in the reproductive age. It is characterised by oligomenorrhea (Oligo), hyperandrogenism (HA), and the presence of polycystic ovaries (PCOs). Carbohydrate and lipid metabolism is being disturbed in many women with PCOS. The pathogenesis of PCOS is still unexplained. Following the main criteria of diagnosis (Rotterdam Consensus 2003), Dewailly, Welt and Pehlivanov divided the patients with PCOS into 4 phenotype groups: A, B, C, and D. In our studies of 93 patients with PCOS, we found (1) the most frequent appearance (60,2%) of the phenotype A [Oligo + HA + PCO]; (2) an increased androstenedione concentration in a group with HA (A, B, C); (3) an increased HOMA-β and insulin concentration after 30 min an oral 75 g glucose tolerance test (OGTT) in a group of obese women with BMI > 30 kg/m(2); (4) high levels of total testosterone, total cholesterol, and LDL cholesterol concentrations in a group A with classic phenotype of PCOS: Oligo + HA + PCO-increasing the risk of development of cardiovascular diseases, type 2 diabetes, or metabolic syndrome. The average androstenedione concentrations could be a good diagnostic and prognostic parameter.

摘要

多囊卵巢综合征(PCOS)是女性中最常见的内分泌疾病之一。据评估,其在育龄女性中的发病率为6%-8%。其特征为月经稀发(Oligo)、高雄激素血症(HA)以及多囊卵巢(PCOs)的存在。许多PCOS女性存在碳水化合物和脂质代谢紊乱。PCOS的发病机制仍未明确。根据主要诊断标准(2003年鹿特丹共识),德瓦伊、韦尔特和佩利瓦诺夫将PCOS患者分为4个表型组:A、B、C和D。在我们对93例PCOS患者的研究中,我们发现:(1)表型A[Oligo + HA + PCO]出现频率最高(60.2%);(2)HA组(A、B、C)的雄烯二酮浓度升高;(3)在体重指数(BMI)>30 kg/m²的肥胖女性组中,口服75 g葡萄糖耐量试验(OGTT)30分钟后,HOMA-β和胰岛素浓度升高;(4)具有PCOS经典表型Oligo + HA + PCO的A组中,总睾酮、总胆固醇和低密度脂蛋白胆固醇浓度较高,增加了患心血管疾病、2型糖尿病或代谢综合征的风险。平均雄烯二酮浓度可能是一个良好的诊断和预后参数。

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