Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
J Pediatr Adolesc Gynecol. 2020 Dec;33(6):697-702. doi: 10.1016/j.jpag.2020.08.015. Epub 2020 Sep 1.
To analyze clinical, metabolic, hormonal, and ultrasound characteristics of adolescents with polycystic ovary syndrome phenotypes.
We performed a retrospective analysis of quality improvement data. We divided patients according to phenotype on the basis of clinical or biochemical diagnosis of hyperandrogenism (HA), irregular menstruation (IM), and presence or absence of polycystic ovarian morphology (PCOM) on pelvic ultrasound (PUS) images, if obtained. The 5 resulting groups were: (1) HA/IM/normal PUS, n = 28; (2) HA/PCOM, n = 10; (3) IM/PCOM, n = 18; (4) HA/IM/PCOM, n = 40; and (5) HA/IM/no PUS obtained, n = 80. We compared parameters between groups using the nonparametric Wilcoxon rank sum test.
Boston Children's Hospital, 2012-2016.
One hundred seventy-six girls and young women aged 11-25 years.
None.
(1) Clinical, metabolic, and hormonal characteristics; and (2) PUS measurements.
Groups with HA had significantly higher acne scores, Ferriman-Gallwey scores, and total and free testosterone concentrations than groups without HA. Significant differences in hemoglobin A1c were found between the IM/PCOM and HA/IM/PCOM groups (5.1% vs 5.3%; P = .01) and the IM/PCOM and HA/IM/no PUS groups (5.1% vs 5.3%; P < .01). In patients who had ultrasound performed, 49/94 (52.1%) met PCOM criteria on the basis of ovarian size, 37/94 (39.4%) on the basis of follicle number, and 27/94 (28.7%) on both; 10/94 (10.5)% had incidental findings on ultrasound, with 2 patients requiring further management.
Limited differences in clinical, metabolic, and hormonal characteristics exist between adolescents with different phenotypes of polycystic ovary syndrome, and are mostly related to the presence or absence of HA. Of patients with ultrasound examinations, only 2 had clinically actionable incidental findings.
分析多囊卵巢综合征表型青少年的临床、代谢、激素和超声特征。
我们对质量改进数据进行了回顾性分析。我们根据临床或生化诊断的高雄激素血症（HA）、不规则月经（IM）和盆腔超声（PUS）图像上是否存在多囊卵巢形态（PCOM），将患者分为表型。如果获得 PUS 图像，则将患者分为以下 5 组：（1）HA/IM/正常 PUS，n=28；（2）HA/PCOM，n=10；（3）IM/PCOM，n=18；（4）HA/IM/PCOM，n=40；（5）HA/IM/未获得 PUS，n=80。我们使用非参数 Wilcoxon 秩和检验比较组间参数。
波士顿儿童医院，2012-2016 年。
176 名 11-25 岁的女孩和年轻女性。
无。
（1）临床、代谢和激素特征；（2）PUS 测量。
HA 组的痤疮评分、Ferriman-Gallwey 评分、总睾酮和游离睾酮浓度明显高于无 HA 组。IM/PCOM 组和 HA/IM/PCOM 组（5.1%vs5.3%；P=0.01）以及 IM/PCOM 组和 HA/IM/no PUS 组（5.1%vs5.3%；P<.01）之间的血红蛋白 A1c 存在显著差异。在接受超声检查的患者中，94 例中有 49 例（52.1%）基于卵巢大小、37 例（39.4%）基于卵泡数、27 例（28.7%）基于两者均符合 PCOM 标准；94 例中有 10 例（10.5%）有超声意外发现，其中 2 例需要进一步处理。
不同多囊卵巢综合征表型青少年的临床、代谢和激素特征存在差异，主要与 HA 的存在与否有关。在接受超声检查的患者中，只有 2 例有临床可操作的意外发现。
