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多囊卵巢综合征中年女性雄激素状态及心脏代谢状况的变化

Change in Androgenic Status and Cardiometabolic Profile of Middle-Aged Women with Polycystic Ovary Syndrome.

作者信息

van der Ham Kim, Koster Maria P H, Velthuis Birgitta K, Budde Ricardo P J, Fauser Bart C J M, Laven Joop S E, Louwers Yvonne V

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.

Department of Radiology, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

出版信息

J Clin Med. 2023 Aug 11;12(16):5226. doi: 10.3390/jcm12165226.

Abstract

Understanding the cardiovascular disease (CVD) risk for women with polycystic ovary syndrome (PCOS) at reproductive age is crucial. To investigate this, we compared the cardiometabolic profiles of different PCOS groups over a median interval of 15.8 years. The study focused on three groups: (1) women with PCOS who were hyperandrogenic at both initial and follow-up screening (HA-HA), (2) those who transitioned from hyperandrogenic to normoandrogenic (HA-NA), and (3) those who remained normoandrogenic (NA-NA). At initial and follow-up screenings, both HA-HA and HA-NA groups showed higher body mass indexes compared to the NA-NA group. Additionally, at follow-up, the HA-HA and HA-NA groups exhibited higher blood pressure, a higher prevalence of hypertension, elevated serum triglycerides and insulin levels, and lower levels of HDL cholesterol compared to the NA-NA group. Even after adjusting for BMI, significant differences persisted in HDL cholesterol levels and hypertension prevalence among the groups (HA-HA: 53.8%, HA-NA: 53.1%, NA-NA: 14.3%, < 0.01). However, calcium scores and the prevalence of coronary plaques on CT scans were similar across all groups. In conclusion, women with PCOS and hyperandrogenism during their reproductive years exhibited an unfavorable cardiometabolic profile during their post-reproductive years, even if they changed to a normoandrogenic status.

摘要

了解育龄期多囊卵巢综合征(PCOS)女性的心血管疾病(CVD)风险至关重要。为了对此进行研究,我们在15.8年的中位时间间隔内比较了不同PCOS组的心脏代谢特征。该研究聚焦于三组:(1)在初次和随访筛查时均为高雄激素血症的PCOS女性(HA-HA),(2)从高雄激素血症转变为正常雄激素水平的女性(HA-NA),以及(3)始终保持正常雄激素水平的女性(NA-NA)。在初次和随访筛查时,HA-HA组和HA-NA组的体重指数均高于NA-NA组。此外,在随访时,与NA-NA组相比,HA-HA组和HA-NA组的血压更高、高血压患病率更高、血清甘油三酯和胰岛素水平升高,而高密度脂蛋白胆固醇水平更低。即使在调整体重指数后,各组之间高密度脂蛋白胆固醇水平和高血压患病率仍存在显著差异(HA-HA:53.8%,HA-NA:53.1%,NA-NA:14.3%,<0.01)。然而,所有组的CT扫描钙评分和冠状动脉斑块患病率相似。总之,生殖期患有PCOS和高雄激素血症的女性在生殖后期表现出不良的心脏代谢特征,即使她们转变为正常雄激素状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2503/10455407/584a27a15dcd/jcm-12-05226-g001.jpg

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