McBreairty Laura E, Zello Gordon A, Gordon Julianne J, Serrao Shani B, Pierson Roger A, Chizen Donna R, Chilibeck Philip D
College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, SK S7N 5C9, Canada.
College of Kinesiology, Physical Activity Complex, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK S7N 5B2, Canada.
J Clin Densitom. 2018 Jan-Mar;21(1):54-60. doi: 10.1016/j.jocd.2016.10.007. Epub 2016 Dec 26.
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting women of reproductive age manifesting with polycystic ovaries, menstrual irregularities, hyperandrogenism, hirsutism, and insulin resistance. The oligomenorrhea and amenorrhea characteristic to PCOS are associated with low bone mineral density (BMD); conversely, the hyperandrogenism and hyperinsulinemia may elicit a protective effect on BMD. As bone geometric properties provide additional information about bone strength, the objective of this study was to compare measures of hip geometry in women with PCOS to a healthy female population. Using dual-energy X-ray absorptiometry, BMD and measures of hip geometry were determined in women with PCOS (n = 60) and healthy controls (n = 60) aged 18-35 years. Clinical biochemical measures were also determined in women with PCOS. Measures of hip geometry, including cross-sectional area, cross-sectional moment of inertia, subperiosteal width (SPW), and section modulus, were similar between groups following correction for body mass index (BMI) (all p > 0.05) with intertrochanter SPW significantly lower in women with PCOS (p < 0.05). BMI-corrected whole body BMD as well as the lumbar spine and regions of proximal femur were also comparable between groups. In women with PCOS, BMI-corrected correlations were found between insulin and femoral shaft SPW (r = 0.322, p < 0.05), glucose and femoral neck (r = 0.301, p < 0.05), and trochanter BMD (0.348, p < 0.05), as well as between testosterone and femoral neck BMD (0.376, p < 0.05) and narrow neck cross-sectional area (0.306, p < 0.05). This study demonstrates that women with PCOS may have compromised intertrochanter SPW while oligomenorrhea appears to have no detrimental effect on bone density or geometry in women with PCOS.
多囊卵巢综合征（PCOS）是一种影响育龄女性的内分泌紊乱疾病，表现为多囊卵巢、月经不规律、高雄激素血症、多毛症和胰岛素抵抗。PCOS特有的月经过少和闭经与低骨矿物质密度（BMD）有关；相反，高雄激素血症和高胰岛素血症可能对BMD产生保护作用。由于骨几何特性提供了有关骨强度的额外信息，本研究的目的是比较PCOS女性与健康女性群体的髋部几何测量值。使用双能X线吸收法，测定了60例18 - 35岁的PCOS女性和60例健康对照者的BMD和髋部几何测量值。还测定了PCOS女性的临床生化指标。在校正体重指数（BMI）后，两组之间的髋部几何测量值，包括横截面积、截面惯性矩、骨膜下宽度（SPW）和截面模量相似（所有p>0.05），PCOS女性的转子间SPW显著较低（p<0.05）。两组之间校正BMI后的全身BMD以及腰椎和股骨近端区域也具有可比性。在PCOS女性中，发现胰岛素与股骨干SPW之间（r = 0.322，p<0.05）、葡萄糖与股骨颈之间（r = 0.301，p<0.05）以及转子BMD之间（0.348，p<0.05）存在校正BMI后的相关性，睾酮与股骨颈BMD之间（0.376，p<0.05）以及窄颈横截面积之间（0.306，p<0.05）也存在相关性。本研究表明，PCOS女性可能存在转子间SPW受损的情况，而月经过少似乎对PCOS女性的骨密度或几何形状没有不利影响。
