Javed Asma, Lteif Aida N, Kumar Seema, Simmons Patricia S, Chang Alice Y
Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
J Pediatr Adolesc Gynecol. 2015 Dec;28(6):451-6. doi: 10.1016/j.jpag.2015.01.001. Epub 2015 Jan 7.
To compare changes in fasting glucose among adolescents with polycystic ovary syndrome (PCOS) with those in obese adolescents without PCOS.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 310 adolescents with PCOS and 250 obese adolescents (age range 13 to 18 years) seen at Mayo Clinic, Rochester, MN, from 1996 to 2012.
Included for analysis were 98 adolescents with PCOS and 150 obese adolescents who had 2 or more fasting glucose measurements separated by at least 6 months. Adolescents with impaired fasting glucose (IFG) or diabetes were excluded. Multivariate models were used to assess predictors of change in fasting glucose.
At diagnosis, adolescents with PCOS had lower body mass index (BMI) (kg/m(2)) and older age than obese adolescents (P < .001). Adolescents with PCOS had shorter follow-up (P = .02). Baseline fasting glucose was not different between groups. Mean change in fasting glucose was 2.4 ± 9.4 mg/dL per year for PCOS and 2.2 ± 6.2 mg/dL per year for obese adolescents (P = .83). Significant predictors for change in fasting glucose were BMI and fasting glucose at diagnosis (P < .01). Within the PCOS cohort, BMI was a significant predictor for development of IFG (P = .003). Prevalence of hypertension increased in the PCOS cohort from baseline to follow-up (P = .02). PCOS and BMI were significantly associated with development of HTN in the entire cohort.
Adolescent girls with PCOS do not show a significant change in fasting glucose or an increased risk for the development of IFG compared with obese adolescents. BMI, not PCOS status, was the strongest predictor for changes in fasting glucose and development of IFG over time.
比较多囊卵巢综合征(PCOS)青少年与无PCOS的肥胖青少年空腹血糖的变化。
设计、地点和参与者:对1996年至2012年在明尼苏达州罗切斯特市梅奥诊所就诊的310例PCOS青少年和250例肥胖青少年(年龄范围13至18岁)进行回顾性队列研究。
纳入分析的是98例PCOS青少年和150例肥胖青少年,他们有至少间隔6个月的2次或更多次空腹血糖测量值。排除空腹血糖受损(IFG)或糖尿病青少年。使用多变量模型评估空腹血糖变化的预测因素。
诊断时,PCOS青少年的体重指数(BMI)(kg/m²)低于肥胖青少年,年龄大于肥胖青少年(P<.001)。PCOS青少年的随访时间较短(P=.02)。两组的基线空腹血糖无差异。PCOS青少年空腹血糖的平均变化为每年2.4±9.4mg/dL,肥胖青少年为每年2.2±6.2mg/dL(P=.83)。空腹血糖变化的显著预测因素是BMI和诊断时的空腹血糖(P<.01)。在PCOS队列中,BMI是IFG发生的显著预测因素(P=.003)。从基线到随访,PCOS队列中高血压患病率增加(P=.02)。PCOS和BMI与整个队列中高血压的发生显著相关。
与肥胖青少年相比,患有PCOS的青春期女孩空腹血糖无显著变化,IFG发生风险也未增加。随着时间推移,BMI而非PCOS状态是空腹血糖变化和IFG发生的最强预测因素。