Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Fertil Steril. 2017 Jan;107(1):261-268.e3. doi: 10.1016/j.fertnstert.2016.09.042. Epub 2016 Oct 27.
To compare the endocrine and cardiometabolic cord blood characteristics of offspring of mothers with polycystic ovary syndrome (PCOS) with those of healthy controls.
Cross-sectional case control study.
University medical centers.
PATIENT(S): Offspring from mothers with PCOS (n = 61) and healthy controls (n = 82).
INTERVENTION(S): Cord blood withdrawal from neonates.
MAIN OUTCOME MEASURE(S): Cord blood estradiol, androstenedione, dehydroepiandrosterone sulfate (DHEAS), testosterone, sex hormone-binding globulin, free androgen index (FAI), insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, c-reactive protein, adiponectin, and leptin.
RESULT(S): Androstenedione and leptin concentrations were increased in the offspring of women with PCOS compared with the controls: androstenedione median 2.9 (interquartile range [IQR] 2.3-3.9) nmol/L vs. 2.2 [IQR 1.6-2.7] nmol/L; and leptin median 13.6 [IQR 8.3-22.9] μg/L vs. 9.8 [IQR 6.0-16.5] μg/L. After adjusting for maternal and pregnancy-related confounders (such as maternal age, gestational age, birth weight), androstenedione appeared associated with PCOS in both male (relative change 1.36 [1.04; 1.78]) and female offspring (relative change 1.40 [1.08; 1.82]). Similarly, in male offspring the leptin concentrations appeared associated with PCOS after correction for confounders (relative change 1.55 [1.12; 2.14]). After correction for multiple testing, these associations attenuated.
CONCLUSION(S): Observed results suggest that androstenedione concentrations are increased in the cord blood of male and female offspring of women with PCOS, although this requires confirmation. This finding would support the hypothesis that a maternal hyperandrogenic environment during pregnancy in women with PCOS may predispose their offspring to fetal hyperandrogenism. The potential associations between fetal hyperandrogenism and long-term health effects remain to be elucidated.
NCT00821379.
比较多囊卵巢综合征（PCOS）母亲所生孩子与健康对照儿的脐带血内分泌和心血管代谢特征。
横断面病例对照研究。
大学医学中心。
PCOS 母亲所生孩子（n=61）和健康对照儿（n=82）。
新生儿脐带血采集。
脐带血雌二醇、雄烯二酮、硫酸脱氢表雄酮（DHEAS）、睾酮、性激素结合球蛋白、游离雄激素指数（FAI）、胰岛素、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、C 反应蛋白、脂联素和瘦素。
与对照组相比，PCOS 母亲所生孩子的雄烯二酮和瘦素浓度升高：雄烯二酮中位数 2.9（四分位距 [IQR]2.33.9）nmol/L 比 2.2（IQR1.62.7）nmol/L；瘦素中位数 13.6（IQR8.322.9）μg/L 比 9.8（IQR6.016.5）μg/L。在校正母亲和妊娠相关混杂因素（如母亲年龄、胎龄、出生体重）后，雄烯二酮与男性（相对变化 1.36[1.041.78]）和女性（相对变化 1.40[1.081.82]）后代的 PCOS 均相关。同样，在男性后代中，瘦素浓度在经混杂因素校正后与 PCOS 相关（相对变化 1.55[1.12~2.14]）。经多次检验校正后，这些关联减弱。
观察结果表明，PCOS 母亲的脐带血中雄烯二酮浓度在女性和男性后代中升高，尽管这需要进一步证实。这一发现支持这样一种假说，即 PCOS 母亲妊娠期间的高雄激素环境可能使后代易患胎儿高雄激素血症。胎儿高雄激素血症与长期健康影响之间的潜在关联仍有待阐明。
NCT00821379。
