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与多囊卵巢综合征患者相比,有性早熟和阴毛早现病史的成年女性存在不良的激素和心理状况。

Unfavorable Hormonal and Psychologic Profile in Adult Women with a History of Premature Adrenarche and Pubarche, Compared to Women with Polycystic Ovary Syndrome.

机构信息

Endocrine Hospital, Unit, Metropolitan Greece, Athens, Greece.

Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

出版信息

Horm Metab Res. 2020 Mar;52(3):179-185. doi: 10.1055/a-1109-2630. Epub 2020 Feb 19.

Abstract

If circulating adrenal androgens levels rise before the age of 8 years in girls, this phenomenon is termed premature adrenarche (PA), while the concomitant appearance of pubic hair is called premature pubarche (PP). Girls with PA-PP display an unfavorable hormonal profile compared to their normal peers and have an increased risk of developing polycystic ovary syndrome (PCOS) features peripubertally. However, the sequelae of premature adrenarche remains unclear. We assessed metabolic, hormonal, psychologic profiles, and ovarian morphology in 21 women of mean age (±SD) 21.3±3.3 years, BMI: 23.6±4.4 kg/m with PA-PP, 45 women with PCOS and 26 controls, matched for age and BMI. PA-PP women displayed a favorable lipid profile compared to PCOS and controls. Insulin resistance index (HOMA-IR), however, were similar in PA-PP and PCOS women (2.09±1.42, 2.08±0.83) and higher than controls (1.13±0.49, p <0.05). Circulating androstenedione levels did not differ between PA-PP and PCOS women (0.11±0.05 vs. 0.12±0.03), but was higher than that of controls (0.02±0.0 nmol/l, p <0,05). Ovarian volume was increased in PA-PP and PCOS (11.14±3.3 vs. 10.99±4.61) compared to controls (6.74±1.83 cm). PA-PP women had a higher score of state/trait anxiety and depressive and eating disorder symptoms than controls, with a pattern that matched that of PCOS women. Only 14% of the PA-PP group fulfilled the Rotterdam PCOS criteria. Some women with a history of PA-PP displayed hormonal and psychologic profile similar to PCOS, and accordingly a regular monitoring of these girls during adulthood is advised.

摘要

如果女孩在 8 岁之前出现循环肾上腺雄激素水平升高,这种现象被称为性早熟(PA),而同时出现阴毛则称为性早熟阴毛(PP)。与正常同龄人相比,患有 PA-PP 的女孩表现出不利的激素谱,并且在青春期期间患多囊卵巢综合征(PCOS)特征的风险增加。然而,性早熟的后遗症仍不清楚。我们评估了 21 名平均年龄(±SD)为 21.3±3.3 岁、BMI:23.6±4.4kg/m 的患有 PA-PP 的女性、45 名患有 PCOS 的女性和 26 名年龄和 BMI 匹配的对照组的代谢、激素、心理和卵巢形态。与 PCOS 和对照组相比,PA-PP 女性的血脂谱良好。然而,胰岛素抵抗指数(HOMA-IR)在 PA-PP 和 PCOS 女性之间相似(2.09±1.42、2.08±0.83),高于对照组(1.13±0.49,p<0.05)。PA-PP 和 PCOS 女性的循环雄烯二酮水平无差异(0.11±0.05 与 0.12±0.03),但高于对照组(0.02±0.0nmol/l,p<0.05)。与对照组(6.74±1.83cm)相比,PA-PP 和 PCOS 的卵巢体积增加(11.14±3.3 与 10.99±4.61)。PA-PP 女性的状态/特质焦虑、抑郁和饮食障碍症状评分高于对照组,与 PCOS 女性的模式相匹配。只有 14%的 PA-PP 组符合鹿特丹 PCOS 标准。一些有 PA-PP 病史的女性表现出与 PCOS 相似的激素和心理特征,因此建议在成年期对这些女孩进行定期监测。

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