Third Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital, Athens, Greece.
J Endocrinol Invest. 2013 Jul-Aug;36(7):478-84. doi: 10.3275/8771. Epub 2012 Nov 27.
Recently, it has been debated whether the new polycystic ovary syndrome (PCOS) phenotypes, according to the Rotterdam criteria, share the same metabolic risk with the classic ones (National Institutes of Health 1990). Our study sought to compare the prevalence of metabolic syndrome (MS) and glucose homeostasis disorders in Greek women with classic and new PCOS phenotypes.
Two hundred and sixty-six Greek PCOS women were recruited and divided into groups according to two of the three Rotterdam criteria that they fulfilled. Two subgroups were formed; the first represented the classic phenotypes and the second the new phenotypes. The clinical, biochemical, and ultrasound characteristics of both groups were explored. All subjects were evaluated for MS and underwent a 2-h glucose tolerance test to assess insulin resistance (IR) as measured by the homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and MATSUDA indices.
62.4% of PCOS women were classified as classic NIH phenotypes of which 32 women had MS (prevalence 19.6%). Only 4 patients categorized in the newer phenotypic groups had MS (prevalence 4.1%). Among the subjects with classic phenotypes, 11.7% exhibited impaired glucose tolerance (3-fold higher percentage compared to patients with newer phenotypes). Regarding IR indices, HOMA-IR was significantly higher and QUICKI significantly lower for classic phenotypes.
Greek PCOS women with classic phenotypes are at increased risk for MS and impaired glucose homeostasis compared to women with newer phenotypes. A subclassification of PCOS permits the earlier recognition and closer surveillance of women whose metabolic profile indicates potential risks for adverse health outcomes.
最近，有人争论根据 Rotterdam 标准定义的新多囊卵巢综合征（PCOS）表型是否与经典表型（美国国立卫生研究院 1990 年）具有相同的代谢风险。本研究旨在比较符合 Rotterdam 标准的希腊女性中经典和新型 PCOS 表型的代谢综合征（MS）和糖稳态紊乱的患病率。
招募了 266 名希腊 PCOS 女性，并根据她们符合 Rotterdam 标准中的两项标准将其分为两组。形成了两个亚组；第一个代表经典表型，第二个代表新表型。研究了两组的临床、生化和超声特征。所有受试者均进行 MS 评估，并进行 2 小时葡萄糖耐量试验，以评估胰岛素抵抗（IR），采用稳态模型评估（HOMA-IR）、定量胰岛素敏感性检查指数（QUICKI）和 MATSUDA 指数进行测量。
62.4%的 PCOS 女性被归类为经典 NIH 表型，其中 32 名女性患有 MS（患病率为 19.6%）。只有 4 名归类于新型表型组的患者患有 MS（患病率为 4.1%）。在经典表型患者中，11.7%表现为糖耐量受损（与新型表型患者相比，高出 3 倍）。关于 IR 指数，经典表型的 HOMA-IR 显著升高，QUICKI 显著降低。
与新型表型女性相比，具有经典表型的希腊 PCOS 女性患 MS 和糖稳态受损的风险增加。PCOS 的亚分类允许对代谢特征表明存在不良健康结局潜在风险的女性进行更早的识别和更密切的监测。
