Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
J Adolesc Health. 2020 May;66(5):603-609. doi: 10.1016/j.jadohealth.2019.11.315. Epub 2020 Jan 25.
The aim of the study was to estimate the current incidence and the distribution of etiologies of primary ovarian insufficiency (POI) in a nationwide study. The prevalence of POI in young adult women has recently increased, but the data cited for adolescents are more than three decades old.
Data regarding females aged <21 years diagnosed with POI during the years 2000-2016 were collected from all the pediatric endocrinology units in Israel. POI was defined by at least 4 months of amenorrhea in association with menopausal levels of follicle-stimulating hormone. Iatrogenic cases were excluded.
For the 130 females aged <21 years included in the study, the distribution of POI etiologies was Turner syndrome/mosaicism in 56 (43%), idiopathic in 35 (27%), and other (developmental, genetic, metabolic, adrenal, and autoimmune) in 39 (30%) females. During the years 2009-2016, compared with 2000-2008, the incidence rate of new POI diagnoses per 100,000 person-years doubled (4.5 vs. 2.0; p value <.0001), and incidence rates of idiopathic and other etiologies increased by 2.6 (p value = .008) and 3.0 (p value = .002), respectively. In contrast, the incidence of Turner syndrome was constant (p value = .2). In the age group of 15-21 years, the current incidence of non-Turner POI in adolescents is one per 100,000 person-years.
In this nationwide study, the incidence rate of POI in youth aged <21 years was one tenth of the rate that is commonly cited. A significant increase in the rate of POI in non-Turner females was observed over the last decade. Contributions of environmental and epigenetic factors should be studied.
本研究旨在通过一项全国性研究来评估原发性卵巢功能不全（POI）的当前发病率和病因分布。最近，年轻成年女性的 POI 患病率有所增加，但引用的青少年数据已有三十多年的历史。
从以色列所有儿科内分泌科收集了 2000 年至 2016 年间诊断为 POI 的年龄<21 岁的女性的数据。POI 通过至少 4 个月的闭经和绝经后卵泡刺激素水平来定义。排除医源性病例。
在纳入研究的 130 名年龄<21 岁的女性中，POI 病因分布为特纳综合征/嵌合体 56 例（43%）、特发性 35 例（27%）和其他（发育、遗传、代谢、肾上腺和自身免疫性）39 例（30%）。与 2000-2008 年相比，2009-2016 年每 10 万人年新发 POI 诊断的发病率增加了一倍（4.5 比 2.0；p 值<0.0001），特发性和其他病因的发病率分别增加了 2.6（p 值=0.008）和 3.0（p 值=0.002）。相比之下，特纳综合征的发病率保持不变（p 值=0.2）。在 15-21 岁年龄组中，青少年非特纳 POI 的当前发病率为每 10 万人年 1 例。
在这项全国性研究中，年龄<21 岁的青年 POI 的发病率是通常引用的发病率的十分之一。在过去十年中，非特纳女性 POI 的发病率显著增加。应研究环境和表观遗传因素的作用。
