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口服避孕药对排卵障碍性多囊卵巢综合征患者人体测量学、内分泌和代谢特征的影响。

Influence of oral contraceptives on anthropomorphometric, endocrine, and metabolic profiles of anovulatory polycystic ovary syndrome patients.

机构信息

Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

出版信息

Fertil Steril. 2014 Jun;101(6):1757-65.e1. doi: 10.1016/j.fertnstert.2014.02.039. Epub 2014 Mar 26.

Abstract

OBJECTIVE

To evaluate the influence of oral contraceptive pills (OCPs) on anthromorphometric, endocrine, and metabolic parameters in women with polycystic ovary syndrome (PCOS).

DESIGN

Retrospective cross-sectional cohort study for the period 1993-2011.

SETTING

Tertiary university hospital.

PATIENT(S): PCOS patients, who never, ever, or at time of screening were using OCPs were included. A total of 1,297 patients, of whom 827 were white, were included. All PCOS patients diagnosed according to the Rotterdam 2003 consensus criteria were divided into three groups: current users, (n = 76; 6% of total), ever users (n = 1,018; 78%), and never users (n = 203; 16%). Ever users were subdivided based on the OCP-free interval.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Anthromorphometric (blood pressure, cycle duration) and ultrasound (follicle count, mean ovarian volume) parameters, endocrine (SHBG, testosterone, free androgen index, antimüllerian hormone [AMH]) and lipid profiles.

RESULT(S): Current users and ever users were compared with never users. In current users, SHBG was increased and androgen levels decreased. Patients with an OCP-free interval of <1 year had a higher mean follicle count, higher AMH level, and increased serum androgen level compared with never users. SHBG levels remained increased until 5-10 years after cessation of OCP use.

CONCLUSION(S): OCP use causes a milder phenotypic presentation of PCOS regarding hyperandrogenism. However, it does not alter parameters associated with increased health risks.

摘要

目的

评估口服避孕药(OCPs)对多囊卵巢综合征(PCOS)女性的人体测量学、内分泌和代谢参数的影响。

设计

1993 年至 2011 年的回顾性横断面队列研究。

地点

三级大学医院。

患者

包括从未、曾经或筛查时使用过 OCP 的 PCOS 患者。共纳入 1297 例患者,其中 827 例为白人。所有根据 2003 年鹿特丹共识标准诊断为 PCOS 的患者分为三组:当前使用者(n=76;占总人数的 6%)、曾经使用者(n=1018;78%)和从未使用者(n=203;16%)。曾经使用者根据 OCP 停药间隔进一步分为亚组。

干预

无。

主要观察指标

人体测量学(血压、周期持续时间)和超声(卵泡计数、平均卵巢体积)参数、内分泌(SHBG、睾酮、游离雄激素指数、抗缪勒管激素 [AMH])和血脂谱。

结果

将当前使用者和曾经使用者与从未使用者进行比较。在当前使用者中,SHBG 增加,雄激素水平降低。OCP 停药间隔<1 年的患者的平均卵泡计数、AMH 水平较高,血清雄激素水平较从未使用者升高。SHBG 水平在停止使用 OCP 后 5-10 年内仍保持升高。

结论

OCP 使用导致 PCOS 的表型表现为轻度高雄激素血症,但不会改变与增加健康风险相关的参数。

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