Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
Ultrasound Obstet Gynecol. 2012 Aug;40(2):223-9. doi: 10.1002/uog.11202.
It is not known whether polycystic ovaries (PCO) are an ovarian appearance without pathological meaning or whether they share with polycystic ovary syndrome (PCOS) the same ovarian follicle abnormality. There are few studies including strictly selected women with PCO but without other criteria of PCOS. In order to address these issues, we compared hormonal, metabolic and ultrasound parameters obtained from patients with PCO only, patients with PCOS and controls.
This was a comparative analysis including three age-matched groups of 95 patients, who were included consecutively in a database: controls, patients with sonographic PCO but no symptoms (PCO group) and patients with PCOS. A clinical examination, fasting serum sampling and pelvic ultrasound examination were performed between cycle days 2 and 5 and results were compared between groups.
The median serum anti-Mullerian hormone (AMH) level in the PCO group was intermediate between that in controls and that in the PCOS group (33.6 pmol/L, 19.8 pmol/L and 63.3 pmol/L, respectively), the differences being significant after adjustment for follicle number (P < 0.05), while the mean androgen serum level in the PCO group was similar to that in the control group and significantly lower than that in the PCOS group (P < 0.05) (median serum testosterone levels: 0.90 nmol/L, 0.79 nmol/L and 1.39 nmol/L; median androstenedione levels: 5.25 nmol/L, 4.37 nmol/L and 6.09 nmol/L, respectively). Body mass index, waist circumference and insulin levels had no effect on these differences.
PCO is an abnormal condition, affected women showing no evidence of hyperandrogenism but having higher AMH serum levels compared with controls, suggesting a granulosa cell abnormality in PCO similar to that observed in PCOS. The absence of hyperandrogenism in PCO does not seem linked to the metabolic status.
目前尚不清楚多囊卵巢（PCO）是否为一种无病理意义的卵巢外观，还是与多囊卵巢综合征（PCOS）具有相同的卵巢卵泡异常。很少有研究包括严格选择的 PCO 但无其他 PCOS 标准的女性。为了解决这些问题，我们比较了仅患有 PCO、患有 PCOS 和对照组的患者的激素、代谢和超声参数。
这是一项包括三个年龄匹配组共 95 例患者的对比分析，这些患者是从数据库中连续入选的：对照组、有超声 PCO 但无症状的患者（PCO 组）和患有 PCOS 的患者。在月经周期第 2-5 天进行临床检查、空腹血清采样和盆腔超声检查，并对各组结果进行比较。
PCO 组的血清抗苗勒管激素（AMH）水平中位数在对照组和 PCOS 组之间处于中间水平（分别为 33.6 pmol/L、19.8 pmol/L 和 63.3 pmol/L），在调整卵泡数后差异有统计学意义（P < 0.05），而 PCO 组的血清雄激素水平与对照组相似，明显低于 PCOS 组（P < 0.05）（血清睾酮水平中位数：0.90 nmol/L、0.79 nmol/L 和 1.39 nmol/L；血清雄烯二酮水平中位数：5.25 nmol/L、4.37 nmol/L 和 6.09 nmol/L）。体重指数、腰围和胰岛素水平对这些差异没有影响。
PCO 是一种异常情况，受影响的女性没有表现出高雄激素血症的证据，但与对照组相比，其血清 AMH 水平较高，提示 PCO 中存在类似于 PCOS 中观察到的颗粒细胞异常。PCO 中不存在高雄激素血症似乎与代谢状态无关。
