Pawelczak Melissa, Rosenthal Jamie, Milla Sarah, Liu Ying-Hua, Shah Bina
Division of Pediatric Endocrinology, Department of Pediatrics, New York University School of Medicine, New York, New York.
Department of Radiology, New York University School of Medicine, New York, New York.
J Pediatr Adolesc Gynecol. 2014 Dec;27(6):356-9. doi: 10.1016/j.jpag.2014.01.104. Epub 2014 Sep 23.
Patients with polycystic ovary syndrome (PCOS) often suffer from comorbidities associated with chronic inflammation characterized by elevations in pro-inflammatory cytokines. There is limited data on markers of chronic inflammation, in particular Tumor Necrosis Factor-alpha (TNF-α), in adolescents with PCOS.
To compare serum levels of TNF-α in overweight or obese adolescents with PCOS and obese controls. In the PCOS group, to correlate serum TNF-α levels with body mass index (BMI) z-score, severity of hyperandrogenism, degree of insulin resistance, and ovarian ultrasonographic characteristics.
We performed a cross-sectional retrospective analysis of clinical and biochemical findings in 23 overweight or obese adolescent females with PCOS (mean BMI z-score 2, mean age 15.2 yrs) and 12 obese age- and sex-matched controls (mean BMI z-score 2, mean age 14.1 y). All subjects were post-menarchal. Serum TNF-α levels were compared between groups. In the PCOS group, cytokine levels were correlated with BMI z-score, androgen levels, fasting insulin and glucose levels as well as ovarian ultrasonographic features.
Both groups were comparable in age, BMI z-score, fasting glucose, and fasting insulin. Mean free testosterone was 9.76 ± 5.13 pg/mL in the PCOS group versus 5 ± 2.02 pg/mL in the control group (P = .0092). Serum TNF-α was 7.4 ± 4 pg/mL in the PCOS group versus 4.8 ± 3.16 pg/mL in the control group (P = .0468). There was no significant correlation between serum TNF-α and BMI z-score, free testosterone, fasting insulin, or fasting glucose. No correlation existed between serum TNF-α and ovarian follicle number, distribution, or volume.
Serum TNF-α is elevated in overweight/obese adolescents with PCOS. Chronic inflammation in adolescents with PCOS render them at a potential increased risk for the development of atherosclerosis, type 2 diabetes, cancer, infertility, and other comorbidities. Every effort should be made to identify adolescents with PCOS early and initiate aggressive therapy to prevent future complications.
多囊卵巢综合征（PCOS）患者常伴有与慢性炎症相关的合并症，其特征为促炎细胞因子升高。关于PCOS青少年慢性炎症标志物的数据有限，尤其是肿瘤坏死因子-α（TNF-α）。
比较超重或肥胖的PCOS青少年与肥胖对照组的血清TNF-α水平。在PCOS组中，将血清TNF-α水平与体重指数（BMI）z评分、高雄激素血症严重程度、胰岛素抵抗程度及卵巢超声特征进行关联分析。
我们对23名超重或肥胖的PCOS青少年女性（平均BMI z评分为2，平均年龄15.2岁）和12名年龄及性别匹配的肥胖对照者（平均BMI z评分为2，平均年龄14.1岁）的临床和生化检查结果进行了横断面回顾性分析。所有受试者均已月经初潮。比较两组之间的血清TNF-α水平。在PCOS组中，将细胞因子水平与BMI z评分、雄激素水平、空腹胰岛素和血糖水平以及卵巢超声特征进行关联分析。
两组在年龄、BMI z评分、空腹血糖和空腹胰岛素方面具有可比性。PCOS组的平均游离睾酮为9.76±5.13 pg/mL，而对照组为5±2.02 pg/mL（P = 0.0092）。PCOS组的血清TNF-α为7.4±4 pg/mL，而对照组为4.8±3.16 pg/mL（P = 0.0468）。血清TNF-α与BMI z评分、游离睾酮、空腹胰岛素或空腹血糖之间无显著相关性。血清TNF-α与卵巢卵泡数量、分布或体积之间也无相关性。
超重/肥胖的PCOS青少年血清TNF-α升高。PCOS青少年的慢性炎症使他们患动脉粥样硬化、2型糖尿病、癌症、不孕症和其他合并症的潜在风险增加。应尽一切努力尽早识别PCOS青少年并启动积极治疗以预防未来并发症。
