Bedrick Bronwyn S, Eskew Ashley M, Chavarro Jorge E, Jungheim Emily S
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA.
Womens Health Rep (New Rochelle). 2020 Dec 16;1(1):566-573. doi: 10.1089/whr.2020.0073. eCollection 2020.
Polycystic ovary syndrome (PCOS) is a common yet underdiagnosed endocrinopathy with potentially serious sequelae. A screening questionnaire for PCOS can improve early identification and diagnosis. The purpose of this study was to test the utility of a self-administered questionnaire to help identify women at risk for PCOS. We recruited women ages 18-50 with and without PCOS as defined by modified Rotterdam criteria to complete a self-administered survey of common PCOS signs and symptoms. The survey included questions regarding menstrual cycle characteristics and hyperandrogenism as measured by images from the Ferriman-Gallwey (FG) scoring system, and by report of depilatory practices. Fifty-one women with PCOS and 50 women without PCOS participated in this study. Many study participants were current users of hormonal contraceptives making it difficult to discern menstrual cycle characteristics. Hirsutism, defined by a modification of the FG score of ≥3 from the upper lip and abdomen based on self-assessments, provided a sensitivity of 76% and specificity of 70%, whereas report of any depilatory practices provided a sensitivity of 71% and specificity of 74%. The combined sensitivity of these measures was 93% with a specificity of 52%. In multivariate logistic regression, women who used depilatory techniques had an adjusted odds ratio (aOR) of PCOS of 6.6 (95% confidence interval [CI] 2.5-17.3, = 0.0002). Those with obesity had similar aOR of PCOS (aOR 6.7, 95% CI 2.5-17.9, = 0.0001). Addition of other variables did not improve model fit and the net sensitivity and specificity of these two variables did not improve those of depilatory practices and hirsutism. Self-report of depilatory practices or hirsutism is sensitive for identifying women with PCOS. Given the prevalence of PCOS in reproductive-age women and the potentially serious health sequelae, it would be worthwhile to include questions about terminal hair growth and depilatory practices when providing general medical care to reproductive-age women to determine if further testing and screening for PCOS are indicated. This tool may also be helpful in populations where complete diagnostic evaluation may not be feasible.
多囊卵巢综合征（PCOS）是一种常见但诊断不足的内分泌病，可能会导致严重的后遗症。一份PCOS筛查问卷可以改善早期识别和诊断。本研究的目的是测试一份自我管理问卷在帮助识别PCOS风险女性方面的效用。我们招募了年龄在18至50岁之间、根据改良的鹿特丹标准诊断为患有和未患有PCOS的女性，让她们完成一份关于常见PCOS体征和症状的自我管理调查。该调查包括关于月经周期特征以及通过Ferriman-Gallwey（FG）评分系统的图像和脱毛习惯报告来衡量的高雄激素血症的问题。51名患有PCOS的女性和50名未患有PCOS的女性参与了本研究。许多研究参与者正在使用激素避孕药，这使得难以辨别月经周期特征。根据自我评估，将FG评分上唇和腹部≥3分进行修改后定义的多毛症，敏感性为76%，特异性为70%，而任何脱毛习惯的报告敏感性为71%，特异性为74%。这些措施的综合敏感性为93%，特异性为52%。在多因素逻辑回归中，使用脱毛技术的女性患PCOS的调整优势比（aOR）为6.6（95%置信区间[CI]2.5 - 17.3，P = 0.0002）。肥胖女性患PCOS的aOR相似（aOR 6.7，95% CI 2.5 - 17.9，P = 0.0001）。添加其他变量并没有改善模型拟合，这两个变量的净敏感性和特异性也没有优于脱毛习惯和多毛症。自我报告脱毛习惯或多毛症对于识别患有PCOS的女性很敏感。鉴于PCOS在育龄女性中的患病率以及潜在的严重健康后遗症，在为育龄女性提供常规医疗护理时，纳入关于终毛生长和脱毛习惯的问题以确定是否需要进一步进行PCOS检测和筛查是值得的。这个工具在无法进行完整诊断评估的人群中可能也会有帮助。
