Katulski Krzysztof, Czyzyk Adam, Podkowa Natalia, Podfigurna-Stopa Agnieszka, Ignaszak Natalia, Paczkowska Katarzyna, Slawek Sylwia, Szpurek Dariusz, Meczekalski Blazej
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
Students Scientific Society of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
Ann Agric Environ Med. 2017 Sep 21;24(3):522-526. doi: 10.5604/12321966.1227642. Epub 2017 May 11.
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies among women at reproductive age, but its pathology remains unknown. From epidemiological studies it is known that endogenous, mainly genetic and exogenous, environmental factors are of importance.
The aim of the study was to compare the phenotype of women diagnosed with PCOS from urban and rural areas of Poland. According to the knowledge of the authors, this is first such study.
The retrospective study included 3,877 PCOS patients: 2511 women living in cities and 1,366 village inhabitants, aged between 18 - 45 years. Clinical data, including medical history, body mass, height and hirsutism severity was obtained from each patient. Hormones were also tested in each patient: follicle stimulating hormone, luteinizing hormone, prolactin, estradiol [E2], testosterone, dehydroepiandrosterone sulphate [DHEAS], thyroid stimulating hormone, free thyroxin, insulin [INS], 17 hydroxyprogesterone, cortisol [CORT]) and metabolic (75g oral glucose tolerance test, Chol - total cholesterol, HDL-C - high density lipoprotein cholesterol, LDL-C low density lipoprotein cholesterol, and the TG (triglicerides) profile.
PCOS women from urban areas had a higher mean serum concentration of E2 in comparison to the inhabitants of rural areas. Women from cities had a lower mean level of DHEAS, CORT, and INS measured in the morning than rural residents. Insulin-resistance, using homeostasis model assessment, was more pronounced among women from villages. The prevalence of menstrual disorders, in general, was higher in PCOS women living in rural comparing to urban areas.
The clinical and biochemical indices differed significantly between women diagnosed with PCOS living in cities and villages. In general in Poland, the PCOS phenotype is more severe in women living in rural areas. This study shows that different living conditions significantly affect the PCOS phenotype.
多囊卵巢综合征（PCOS）是育龄女性中最常见的内分泌疾病之一，但其病理机制仍不明晰。从流行病学研究可知，内源性因素（主要是遗传因素）和外源性环境因素都很重要。
本研究旨在比较波兰城乡地区被诊断为PCOS的女性的表型。据作者所知，这是首次此类研究。
这项回顾性研究纳入了3877例PCOS患者：2511名城市女性和1366名乡村女性，年龄在18至45岁之间。收集了每位患者的临床数据，包括病史、体重、身高和多毛症严重程度。还对每位患者进行了激素检测：促卵泡激素、促黄体生成素、催乳素、雌二醇[E2]、睾酮、硫酸脱氢表雄酮[DHEAS]、促甲状腺激素、游离甲状腺素、胰岛素[INS]、17-羟孕酮、皮质醇[CORT]）以及代谢指标（75克口服葡萄糖耐量试验、总胆固醇、高密度脂蛋白胆固醇[HDL-C]、低密度脂蛋白胆固醇[LDL-C]和甘油三酯[TG]水平）。
与农村居民相比，城市地区的PCOS女性血清E2平均浓度更高。城市女性早晨测得的DHEAS、CORT和INS平均水平低于农村居民。采用稳态模型评估，农村女性的胰岛素抵抗更为明显。总体而言，农村地区PCOS女性月经紊乱的患病率高于城市地区。
城市和农村被诊断为PCOS的女性在临床和生化指标上存在显著差异。在波兰总体上，农村地区女性的PCOS表型更为严重。本研究表明，不同的生活条件会显著影响PCOS表型。
