Ates Seda, Aydın Serdar, Ozcan Pinar, Soyman Zeynep, Gokmen Karasu Ayse Filiz, Sevket Osman
a Faculty of Medicine, Department of Obstetrics and Gynecology , Bezmialem Vakif University , Istanbul , Turkey.
b Department of Obstetrics and Gynecology , Istanbul Education and Research Hospital , Istanbul , Turkey.
J Obstet Gynaecol. 2018 Feb;38(2):236-240. doi: 10.1080/01443615.2017.1345875. Epub 2017 Sep 18.
The aim of this study was to investigate the clinical, endocrine, metabolic features and prevalence of metabolic syndrome (MBS) in Turkish adolescents with polycystic ovary syndrome (PCOS) and the differences in metabolic parameters between adolescent PCOS with or without the presence of polycystic ovaries (PCO) on ultrasound. Subjects (n = 77) were classified into two groups: oligomenorrhea (O) and clinical and/or biochemical hyperandrogenism (HA) (n = 38), without PCO and O + HA with PCO (n = 39). The control group consisted of 33 age-matched adolescents. Adolescents with PCOS had a significantly higher body mass index (BMI), waist circumference and levels of LH, LH/FSH ratio, triglyceride, insulin, HOMA-IR, free androgen index and lower levels of SHBG and FSH. After adjustment for BMI, LH, LH: FSH ratio remained significantly higher. Adolescents with PCOS had a higher prevalence of MBS. No significant differences in lipid profiles, insulin levels and insulin sensitivity in both the PCOS groups were seen. HDL-C levels were lower in the O + HA + PCO group compared to the controls. BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS. Impact statement Many studies have investigated the effect of PCOS on metabolic and cardiovascular risks. It is thought that PCOS increases metabolic and cardiovascular risks. Increase in metabolic and cardiovascular risks associated with PCOS may be handled with early diagnosis and early intervention of PCOS in adolescents, although the diagnosis of PCOS in adolescents could be hard because of the features of PCOS overlapping normal pubertal physiological events. However, early identification of adolescent girls with PCOS may provide opportunities for prevention of well-known health risks associated with this syndrome and reduction of long-term health consequences of PCOS by reducing androgen levels and improving metabolic profile. Our results also support that BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS.
本研究旨在调查患有多囊卵巢综合征(PCOS)的土耳其青少年的临床、内分泌、代谢特征及代谢综合征(MBS)患病率,以及超声检查显示有或无多囊卵巢(PCO)的青少年PCOS患者代谢参数的差异。研究对象(n = 77)分为两组:无PCO的月经稀发(O)及临床和/或生化高雄激素血症(HA)组(n = 38),以及有PCO的O + HA组(n = 39)。对照组由33名年龄匹配的青少年组成。患有PCOS的青少年体重指数(BMI)、腰围、促黄体生成素(LH)水平、LH/FSH比值、甘油三酯、胰岛素、稳态模型胰岛素抵抗指数(HOMA-IR)、游离雄激素指数显著更高,而性激素结合球蛋白(SHBG)和促卵泡生成素(FSH)水平更低。校正BMI、LH后,LH:FSH比值仍显著更高。患有PCOS的青少年MBS患病率更高。两组PCOS患者的血脂谱、胰岛素水平及胰岛素敏感性无显著差异。与对照组相比,O + HA + PCO组的高密度脂蛋白胆固醇(HDL-C)水平更低。BMI可能是青少年PCOS患者代谢异常发生的主要影响因素。影响声明许多研究调查了PCOS对代谢和心血管风险的影响。人们认为PCOS会增加代谢和心血管风险。尽管由于PCOS的特征与正常青春期生理事件重叠,青少年PCOS的诊断可能较困难,但通过对青少年PCOS进行早期诊断和早期干预,或许可以应对与PCOS相关的代谢和心血管风险增加问题。然而,早期识别患有PCOS的青春期女孩可能为预防与该综合征相关的知名健康风险以及通过降低雄激素水平和改善代谢状况来减少PCOS的长期健康后果提供机会。我们的研究结果还支持BMI可能是青少年PCOS患者代谢异常发生的主要影响因素。