Ashrafi Mahnaz, Sheikhan Fatemeh, Arabipoor Arezoo, Rouhana Nicole, Hosseini Roya, Zolfaghari Zahra
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Acadmic Center for Education, Culture, and Research, Tehran, Iran.
Director of Graduate Programs, Decker School of Nursing, Binghamton, USA.
Oman Med J. 2017 May;32(3):214-220. doi: 10.5001/omj.2017.40.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder related to several metabolic consequences. However, there remains uncertainty regarding the metabolic features of various phenotypes. The aim of this study was to explore the relationship between the prevalence of gestational diabetes mellitus (GDM) and metabolic disorders among the four different phenotypes of PCOS.
A cross-sectional study was performed in Royan Institute including 208 pregnant women with a history of infertility and PCOS. Using the diagnostic criteria of the American Diabetes Association (ADA), pregnant women with a documented diagnoses of PCOS were further categorized into four different phenotypes (A, B, C, and D) as defined by the Rotterdam criteria.
The prevalence of GDM failed to demonstrate a significant relationship among the four phenotypes of PCOS. The mean levels of fasting blood sugar, plasma glucose concentrations at three hours (following the 100 g oral glucose tolerance test) and triglyceride levels were significantly higher in phenotype B compared to the remaining phenotypes ( < 0.050). There was a statistically significant difference between the mean free testosterone level and phenotypes A and C groups (1.8±1.6 vs. 1.1±1.0, 0.003).
Women with a known diagnosis of PCOS who exhibited oligo/anovulation and hyperandrogenism demonstrated an increase of metabolic disorders. These results suggest that metabolic screening, before conception or in the early stages of pregnancy, can be beneficial particularly in women with PCOS phenotypes A and B. Early screening and identification may justify enhanced maternal fetal surveillance to improve maternal and fetal morbidity among women affected with PCOS.
多囊卵巢综合征（PCOS）是一种常见的内分泌紊乱疾病，与多种代谢后果相关。然而，关于各种表型的代谢特征仍存在不确定性。本研究的目的是探讨妊娠期糖尿病（GDM）患病率与PCOS四种不同表型的代谢紊乱之间的关系。
在罗扬研究所进行了一项横断面研究，纳入了208名有不孕史和PCOS的孕妇。根据美国糖尿病协会（ADA）的诊断标准，已确诊PCOS的孕妇进一步按照鹿特丹标准分为四种不同表型（A、B、C和D）。
PCOS的四种表型中，GDM患病率未显示出显著关系。与其他表型相比，表型B的空腹血糖、三小时血浆葡萄糖浓度（口服100克葡萄糖耐量试验后）和甘油三酯水平的均值显著更高（<0.050）。游离睾酮水平均值在表型A和C组之间存在统计学显著差异（1.8±1.6 vs. 1.1±1.0，P=0.003）。
已知诊断为PCOS且表现为少排卵/无排卵和高雄激素血症的女性，代谢紊乱有所增加。这些结果表明，在受孕前或妊娠早期进行代谢筛查可能有益，特别是对于PCOS表型A和B的女性。早期筛查和识别可能有助于加强母胎监测，以改善PCOS女性的母婴发病率。
