Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters
Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters
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DOI：
10.1210/jc.2004-2279
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发表时间：
2005-05-01
影响因子：
5.8
通讯作者：
Lobo, RA
中科院分区：
文献类型：
--
作者：
Carmina, E;Chu, MC;Lobo, RA
在高雄激素女性中，可以观察到几种表型。这包括患有典型多囊卵巢综合征（C-PCOS）的女性，排卵（OV）PCOS的女性，以及患有特发性高雄激素血症（IHA）的女性，其发生在卵巢正常的女性中。在排除其他原因的情况下，我们将1993年至2004年连续出现的290名高雄激素女性分为这三个亚组。目的是比较肥胖、胰岛素抵抗和血脂异常的患病率，以及这些不同表型与年龄匹配的正常体重的排卵对照组（n = 85）和其他与体重指数（BMI）匹配的C-PCOS女性（n = 42）中C反应蛋白和同型半胱氨酸的增加。虽然BMI影响空腹血清胰岛素和定量胰岛素敏感性检查指数，但这些胰岛素抵抗标志物在C-PCOS（n = 204）中最大，其次是OV-PCOS（n = 50），然后是IHA（n = 33）。雄激素水平在OV-PCOS和IHA中相似，但在C-PCOS中较高，而促性腺激素在所有组中相似。血脂异常在C-PCOS和OV-PCOS中最高，在IHA中正常。C-反应蛋白在C-PCOS和OV-PCOS中升高，但在IHA中没有升高。同型半胱氨酸仅在C-PCOS中升高。总体而言，肥胖（BMI> 30）的患病率在C-PCOS中为29%，在OV-PCOS中为8%，在IHA中为15%，胰岛素抵抗（定量胰岛素敏感性检查指数< 0.33）在C-PCOS中为68%，在OV-PCOS中为36%，在IHA中为26%。至少有一个心血管风险标志物升高的患病率在C-PCOS中为45%，在OV-PCOS中为38%，在IHA中没有增加（6%）。这些结果表明，在高雄激素女性中，代谢和心血管风险参数异常的患病率在C-PCOS中最高，其次是OV-PCOS，然后是IHA女性。此外，在OV-PCOS和IHA中，年龄和体重相似，但OV-PCOS的代谢和心血管风险的患病率更高，多囊卵巢的发现可能是一个重要的修正因素。
In hyperandrogenic women, several phenotypes may be observed. This includes women with classic polycystic ovary syndrome (C-PCOS), those with ovulatory (OV) PCOS, and women with idiopathic hyperandrogenism (IHA), which occurs in women with normal ovaries. Where other causes have been excluded, we categorized 290 hyperandrogenic women who were seen consecutively for this complaint between 1993 and 2004 into these three subgroups. The aim was to compare the prevalence of obesity, insulin resistance, and dyslipidemia as well as increases in C-reactive protein and homocysteine in these different phenotypes with age-matched ovulatory controls of normal weight ( n = 85) and others matched for body mass index (BMI) with women with C-PCOS ( n = 42). Although BMI affected fasting serum insulin and the Quantitative Insulin-Sensitivity Check Index, these markers of insulin resistance were greatest in C-PCOS ( n = 204), followed by OV-PCOS ( n = 50) and then IHA ( n = 33). Androgen levels were similar in OV-PCOS and IHA but were higher in C-PCOS, whereas gonadotropins were similar in all groups. Lipid abnormalities were highest in C-PCOS and OV-PCOS and were normal in IHA. C-reactive protein was elevated in C-PCOS and OV-PCOS but not IHA. Homocysteine was elevated only in C-PCOS. Overall, the prevalence of obesity (BMI> 30) was 29% in C-PCOS, 8% in OV-PCOS, and 15% in IHA and insulin resistance ( Quantitative Insulin-Sensitivity Check Index< 0.33) was 68% in C-PCOS, 36% in OV-PCOS, and 26% in IHA. The prevalence of having at least one elevated cardiovascular risk marker was 45% in C-PCOS 38% in OV-PCOS and was not increased on IHA (6%). These results suggest that among hyperandrogenic women the prevalence of abnormal metabolic and cardiovascular risk parameters is greatest in C-PCOS, followed by OV-PCOS and then women with IHA. Moreover, in that in OV-PCOS and IHA, ages and weights were similar yet the prevalence of metabolic and cardiovascular risk was greater in OV-PCOS, the finding of polycystic ovaries may be a significant modifying factor.