Division of Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
J Clin Endocrinol Metab. 2019 Aug 1;104(8):3355-3361. doi: 10.1210/jc.2018-02313.
Increased testosterone (T) levels are a cardinal feature of polycystic ovary syndrome (PCOS). Female relatives of affected women, including premenarchal daughters, have elevated T levels supporting a genetic susceptibility to this phenotype. Girls with obesity (OB-g) also have increased T levels throughout puberty, which may indicate risk for PCOS.
We tested the hypothesis that premenarchal daughters of women affected with PCOS (PCOS-d) have distinctive phenotypic features compared with OB-g.
DESIGN, SETTING, AND PARTICIPANTS: Forty-eight PCOS-d, 30 OB-g, and 22 normal weight (NW-g) premenarchal girls were studied. Mothers of OB-g and NW-g had no evidence for PCOS.
Reproductive hormones were measured.
Body mass index differed by design, was highest in OB-g, followed by PCOS-d (P > 0.001). PCOS-d and OB-g had similar increases in free T levels compared with NW-g (PCOS-d vs NW-g, P = 0.01; OB-g vs NW-g, P = 0.0001). Sex hormone binding globulin levels were lowest in OB-g and lower in PCOS-d than in NW-g (PCOS-d vs NW-g, P = 0.005; OB-g vs NW-g, P < 0.0001; PCOS-d vs OB-g, P < 0.0001). Anti-Müllerian hormone (AMH) levels in PCOS-d were significantly increased compared with OB-g, who tended to have lower AMH levels than NW-g (PCOS-d vs OB-g, P < 0.0001; PCOS-d vs NW-g, P = 0.10).
Despite similarly elevated free T levels, PCOS-d had increased AMH levels compared with OB-g. This finding suggests that OB-g lack alterations in ovarian folliculogenesis, a key reproductive feature of PCOS. Causal mechanisms may differ in PCOS-d or OB-g, or elevated T in OB-g may not be an early marker for PCOS.
睾酮（T）水平升高是多囊卵巢综合征（PCOS）的一个主要特征。受影响女性的女性亲属，包括初潮前的女儿，T 水平升高，支持这种表型存在遗传易感性。肥胖（OB-g）的女孩在整个青春期也有 T 水平升高，这可能表明存在 PCOS 的风险。
我们检验了这样一个假设，即患有 PCOS 的女性的初潮前女儿（PCOS-d）与肥胖的女孩相比，具有独特的表型特征。
设计、环境和参与者：研究了 48 名 PCOS-d、30 名 OB-g 和 22 名正常体重（NW-g）的初潮前女孩。OB-g 和 NW-g 的母亲均无 PCOS 证据。
测量生殖激素。
体重指数因设计而异，OB-g 最高，其次是 PCOS-d（P > 0.001）。与 NW-g 相比，PCOS-d 和 OB-g 的游离 T 水平相似增加（PCOS-d 与 NW-g，P = 0.01；OB-g 与 NW-g，P = 0.0001）。OB-g 中的性激素结合球蛋白水平最低，PCOS-d 中的水平低于 NW-g（PCOS-d 与 NW-g，P = 0.005；OB-g 与 NW-g，P < 0.0001；PCOS-d 与 OB-g，P < 0.0001）。与 OB-g 相比，PCOS-d 的抗苗勒管激素（AMH）水平显著升高，而 OB-g 的 AMH 水平倾向于低于 NW-g（PCOS-d 与 OB-g，P < 0.0001；PCOS-d 与 NW-g，P = 0.10）。
尽管游离 T 水平相似升高，但 PCOS-d 的 AMH 水平与 OB-g 相比仍有所升高。这一发现表明，OB-g 缺乏卵巢卵泡发生的改变，而卵巢卵泡发生是 PCOS 的一个关键生殖特征。PCOS-d 或 OB-g 中的因果机制可能不同，或者 OB-g 中的 T 升高可能不是 PCOS 的早期标志物。
