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青少年多囊卵巢形态的新诊断标准:对患病率和激素谱的影响。

New Diagnostic Criteria of Polycystic Ovarian Morphology for Adolescents: Impact on Prevalence and Hormonal Profile.

机构信息

Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.

Hospital Clínico San Borja Arriarán, Servicio de Salud Metropolitano Centro, Santiago, Chile.

出版信息

Horm Res Paediatr. 2017;88(6):401-407. doi: 10.1159/000481532. Epub 2017 Oct 19.

Abstract

BACKGROUND

The ultrasonographic criteria used to identify polycystic ovarian morphology (PCOM) during adolescence have changed over time. Recently, a Worldwide Pediatric Consensus (PedC) defined PCOM using stricter criteria than the previous recommendations of the Rotterdam Consensus (RC) and Androgen Excess-Polycystic Ovarian Syndrome Society (AES/PCOS) criteria. The aim of this study was to determine the prevalence of PCOM in healthy adolescents according to the 3 reported diagnostic criteria and compare the hormonal profile in females with and without PCOM based on the PedC criteria.

METHODS

Nonobese adolescents (n = 102) with regular menstrual cycles were studied. Transabdominal ultrasound and hormonal profiles were assessed during the follicular phase. PCOM was defined on the basis of the 3 published criteria.

RESULTS

On the basis of the PedC, RC, and AES/PCOS criteria, PCOM was diagnosed in 13, 34, and 24% of adolescents, respectively. Adolescents with and without PCOM according to the PedC criteria had similar androgen levels. Serum anti-Müllerian hormone (AMH) levels were elevated in adolescents with PCOM, irrespective of the criteria used.

CONCLUSIONS

Use of the new PedC diagnostic criteria for PCOM results in a lower prevalence of this ultrasonographic pattern in adolescents, but this condition is not associated with hyperandrogenism. Elevated AMH is associated with PCOM in adolescents regardless of the criteria used to determine the ultrasonographic pattern.

摘要

背景

在青春期,用于识别多囊卵巢形态(PCOM)的超声标准随着时间的推移而发生了变化。最近,一项全球性儿科共识(PedC)使用比以前的 Rotterdam 共识(RC)和雄激素过多-多囊卵巢综合征协会(AES/PCOS)标准更严格的标准来定义 PCOM。本研究的目的是根据 3 种报告的诊断标准确定健康青少年中 PCOM 的患病率,并根据 PedC 标准比较有和无 PCOM 的女性的激素特征。

方法

研究了 102 名非肥胖、月经周期规律的青少年。在卵泡期进行经腹超声和激素特征评估。根据 3 种已发表的标准诊断 PCOM。

结果

根据 PedC、RC 和 AES/PCOS 标准,分别有 13%、34%和 24%的青少年被诊断为 PCOM。根据 PedC 标准,有无 PCOM 的青少年雄激素水平相似。无论使用何种标准,患有 PCOM 的青少年血清抗苗勒管激素(AMH)水平均升高。

结论

使用新的 PCOM 诊断标准PedC 可降低青少年中这种超声模式的患病率,但这种情况与高雄激素血症无关。无论用于确定超声模式的标准如何,青春期的 AMH 升高均与 PCOM 相关。

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