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中国青少年多囊卵巢综合征的临床和代谢特征

Clinical and metabolic features of polycystic ovary syndrome among Chinese adolescents.

作者信息

Li Lin, Chen Xiaoli, He Zuanyu, Zhao Xiaomiao, Huang Lili, Yang Dongzi

机构信息

Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

J Pediatr Adolesc Gynecol. 2012 Dec;25(6):390-5. doi: 10.1016/j.jpag.2012.07.006. Epub 2012 Oct 22.

Abstract

OBJECTIVES

To explore the clinical and metabolic features exhibited by Chinese adolescents with polycystic ovary syndrome (PCOS) and to determine the differences between nonobese and obese adolescent patients with PCOS.

DESIGN

Clinical cross-sectional study.

SETTING

Department of Gynecology and Reproductive Center.

PARTICIPANTS

25 obese and 66 nonobese adolescents with PCOS and 26 age-matched controls.

INTERVENTIONS

Fasting venous blood samples and an oral glucose tolerance test using 75 g of glucose were obtained from PCOS patients and controls.

MAIN OUTCOME MEASURES

Clinical features were summarized. Serum levels of FSH, LH, E(2), TT, SHBG, fasting insulin, and fasting glucose were measured.

RESULTS

The prevalence of obesity in adolescents with PCOS was 27% (25/91). 99% of these patients presented with menstrual disorders, 84% presented with clinical and/or biochemical hyperandrogenism, and 90% exhibited an ultrasonographic appearance of polycystic ovaries. The prevalence of hirsutism and acanthosis nigricans were higher in the obese PCOS group than in the nonobese PCOS group (72% vs 41% and 44% vs 5%, respectively). A total of 5 of 20 obese (25%) and 5 of 36 nonobese patients (14%) demonstrated impaired glucose tolerance levels.

CONCLUSIONS

Chinese adolescents with PCOS manifest clinical and metabolic features similar to those of adult Chinese women with PCOS except for the increased prevalence of hyperandrogenism and insulin resistance. Adolescents with high risk factors, especially those with menstrual disorders and hyperandrogenism, may need careful clinical screening.

摘要

目的

探讨中国青少年多囊卵巢综合征(PCOS)患者的临床和代谢特征,并确定非肥胖和肥胖青少年PCOS患者之间的差异。

设计

临床横断面研究。

地点

妇科和生殖中心。

参与者

25名肥胖和66名非肥胖青少年PCOS患者以及26名年龄匹配的对照者。

干预措施

从PCOS患者和对照者中采集空腹静脉血样本,并进行口服75 g葡萄糖的葡萄糖耐量试验。

主要观察指标

总结临床特征。测量血清促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E₂)、睾酮(TT)、性激素结合球蛋白(SHBG)、空腹胰岛素和空腹血糖水平。

结果

青少年PCOS患者的肥胖患病率为27%(25/91)。这些患者中99%出现月经紊乱,84%出现临床和/或生化高雄激素血症,90%表现为多囊卵巢的超声图像。肥胖PCOS组的多毛症和黑棘皮病患病率高于非肥胖PCOS组(分别为72%对41%和44%对5%)。20名肥胖患者中有5名(25%)和36名非肥胖患者中有5名(14%)表现出糖耐量受损。

结论

中国青少年PCOS患者表现出与成年中国PCOS女性相似的临床和代谢特征,但高雄激素血症和胰岛素抵抗的患病率有所增加。具有高风险因素的青少年,尤其是那些有月经紊乱和高雄激素血症的青少年,可能需要仔细的临床筛查。

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