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多囊卵巢综合征和青少年的下丘脑-垂体-卵巢轴不成熟的月经模式:系统评价和荟萃分析。

Menstrual pattern in polycystic ovary syndrome and hypothalamic-pituitary-ovarian axis immaturity in adolescents: a systematic review and meta-analysis.

机构信息

Laboratório em Ginecologia Molecular e Estrutural da Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

Gynecol Endocrinol. 2024 Dec;40(1):2360077. doi: 10.1080/09513590.2024.2360077. Epub 2024 May 31.

Abstract

OBJECTIVE

To analyze differences in the menstrual pattern, age at menarche, and body mass index (BMI) in adolescents with Hypothalamic-Pituitary-Ovarian (HPO) axis immaturity and Polycystic Ovary Syndrome (PCOS) through a systematic review and meta-analysis.

METHODS

The PubMed, EMBASE, Web of Science, Virtual Health Library, Scopus databases were searched using combinations of descriptors. Study quality was assessed using the Newcastle-Ottawa Scale. For data analysis, the results were grouped into PCOS group and NPCOS group (HPO axis immaturity). We performed a meta-analysis of raw data and the inverse variance method, employing the standardized mean difference, of the age at menarche and BMI of adolescents.

RESULTS

Participants totaled 1,718 from nine selected studies. The meta-analysis showed that the PCOS group had a higher BMI than the NPCOS group (SMD 0.334; CI95% 0.073 - 0.595;  = .012). The degree of heterogeneity of the studies was approximately 40%. No significant difference in age at menarche (SMD - 0.027; CI95% -0.227 - 0.172;  = 0.790) and menstrual patterns was found, but amenorrhea was described only in adolescents with PCOS.

CONCLUSIONS

The main characteristic in menstrual pattern that differentiated PCOS patients from girls with HPO axis immaturity was amenorrhea. Also, the BMI of PCOS patients was nearly one third higher than that of adolescents with HPO axis immaturity.

摘要

目的

通过系统评价和荟萃分析,分析下丘脑-垂体-卵巢(HPO)轴不成熟和多囊卵巢综合征(PCOS)青少年的月经模式、初潮年龄和体重指数(BMI)的差异。

方法

通过组合描述符,在 PubMed、EMBASE、Web of Science、虚拟健康图书馆和 Scopus 数据库中进行搜索。使用 Newcastle-Ottawa 量表评估研究质量。为了数据分析,我们将结果分为 PCOS 组和 NPCOS 组(HPO 轴不成熟)。我们对初潮年龄和青少年 BMI 的原始数据进行了荟萃分析,并采用Inverse Variance 方法,使用标准化均数差(SMD)。

结果

从 9 项选定的研究中,共纳入 1718 名参与者。荟萃分析显示,PCOS 组的 BMI 高于 NPCOS 组(SMD 0.334;CI95% 0.073-0.595;  = .012)。研究的异质性程度约为 40%。初潮年龄(SMD -0.027;CI95% -0.227-0.172;  = 0.790)和月经模式没有显著差异,但闭经仅在患有 PCOS 的青少年中描述。

结论

区分 PCOS 患者和 HPO 轴不成熟的女孩的主要月经模式特征是闭经。此外,PCOS 患者的 BMI 几乎比 HPO 轴不成熟的青少年高三分之一。

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