Kocaay Pınar, Siklar Zeynep, Buyukfirat Sema, Berberoglu Merih
Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey.
Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey.
J Pediatr Adolesc Gynecol. 2018 Aug;31(4):362-366. doi: 10.1016/j.jpag.2018.02.126. Epub 2018 Feb 17.
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism and chronic anovulation, which affects 5%-10% of reproductive-age women. Diagnosis of adult patients with PCOS is made easily with clinical and laboratory methods and the anti-Müllerian hormone (AMH) level are accepted as a good indicator. However, there is still no complete consensus on the diagnosis of PCOS in adolescents.
Prospective cohort study, December 2013 to November 2014.
The study was conducted on adolescent girls with oligomenorrhea, with at least 2 years since menarche. The study group consisted of adolescent girls with complete PCOS and incomplete PCOS. A control group was formed of healthy adolescent girls. Complete PCOS was diagnosed according to the Rotterdam criteria, as the presence of all the following characteristics: oligomenorrhea, hyperandrogenism, and polycystic ovarian morphology on ultrasound image. Incomplete PCOS was accepted as "oligomenorrhea and polycystic ovarian morphology," or "oligomenorrhea and hyperandrogenism."
All patients underwent a physical examination and the anthropometric assessments, insulin resistance, and acanthosis nigricans were recorded. It was also noted whether or not the patient had an acne score. The Ferriman-Gallwey score was applied to evaluate hirsutism.
The results of this study showed that no statistically significant difference was found between the PCOS and incomplete PCOS groups and the control group with respect to AMH levels.
The use of adult-specific diagnostic methods in adolescence might result in an incomplete diagnosis and inadequate treatment plan. Although the serum AMH level clearly facilitates the diagnosis of PCOS, the use of the AMH level in adolescence in PCOS diagnosis is still controversial and further studies are needed.
多囊卵巢综合征(PCOS)是一种常见的内分泌紊乱疾病,其特征为高雄激素血症和慢性无排卵,影响5%-10%的育龄妇女。成年PCOS患者通过临床和实验室方法易于诊断,抗苗勒管激素(AMH)水平被认为是一个良好指标。然而,对于青少年PCOS的诊断仍未达成完全共识。
前瞻性队列研究,2013年12月至2014年11月。
该研究针对初潮后至少2年的青春期少经女孩开展。研究组由完全型PCOS和不完全型PCOS的青春期女孩组成。对照组由健康青春期女孩组成。完全型PCOS根据鹿特丹标准诊断,即具备以下所有特征:少经、高雄激素血症以及超声图像显示多囊卵巢形态。不完全型PCOS被定义为“少经和多囊卵巢形态”或“少经和高雄激素血症”。
所有患者均接受体格检查,并记录人体测量评估、胰岛素抵抗和黑棘皮病情况。还记录患者是否有痤疮评分。采用费里曼-盖尔韦评分评估多毛症。
本研究结果显示,PCOS组、不完全PCOS组与对照组在AMH水平方面未发现统计学显著差异。
在青春期使用针对成人的诊断方法可能导致诊断不完整和治疗方案不充分。尽管血清AMH水平显然有助于PCOS的诊断,但在青春期PCOS诊断中使用AMH水平仍存在争议,需要进一步研究。