Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: A prospective study
Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: A prospective study
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DOI：
10.1210/jc.83.9.3078
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发表时间：
1998-09-01
影响因子：
5.8
通讯作者：
Azziz, R
中科院分区：
文献类型：
--
作者：
Knochenhauer, ES;Key, TJ;Azziz, R
一般人群中多囊卵巢综合征（PCOS）的患病率估计在2-20%之间。这些报告中的绝大多数研究了欧洲的白人人群，使用了有限的疾病定义，和/或使用了偏见人群，例如寻求医疗保健的人群。为了估计这种疾病在美国的患病率并解决这些局限性，我们前瞻性地确定了369名连续育龄妇女（174名白人和195名黑人，年龄在18-45岁）的PCOS患病率，并在她们就业前体检时进行了检查。测量体毛，采用改进的Ferriman-Gallwey （F-G）法定量体毛。所有的检查最初都由2名训练有素的护士进行，任何F-G得分在3分以上的受试者都由一名医生重新检查，所有患者都一样。在369名女性中，有277名（75.1%）同意完成一份调查问卷，并接受额外的抽血。研究对象不考虑目前使用的雌激素/黄体酮激素（28.5%）。PCOS的定义为：1)排卵少，2)临床高雄激素症（如多毛症）和/或高雄激素血症，3)排除其他相关疾病，如高泌乳素血症、甲状腺异常和非经典肾上腺增生。多毛症的定义是F-G评分为6分或以上，高雄激素血症的定义是总或游离睾酮、雄烯二酮和/或硫酸脱氢表雄酮水平高于控制值的第95个百分位数[即，研究中所有无多毛症（F-G小于或等于5）或痤疮且未接受激素治疗的经期妇女；N = 98]。考虑到所有369名被研究的女性，白人和黑人女性的平均年龄相似（分别为29.4 +/- 7.1岁和31.1 +/- 7.8岁），尽管白人女性的体重低于黑人女性（分别为24.9 +/- 6.1和29.2 +/- 8.1 kg/m）；P < 0.001)。其中，7.6%、4.6%和1.98的F-G得分分别为6分或6分以上、8分或10分，没有显著的种族差异，白人多毛症患病率分别为8.0%、2.8%和1.6%，黑人多毛症患病率分别为7.1%、6.1%和2.1%。在277名同意接受病史和激素评估的女性中，4.0%的女性患有多囊卵巢综合征，其中白人占4.7%（129人中有6人），黑人占3.4%（148人中有5人）。总之，在我们的连续未选择的女性人群中，多毛症的患病率根据所选择的F-G分值在2-8%之间变化，白人和黑人女性之间没有显著差异。使用F-G分数为6分或以上作为多毛症的指示，3.4%的黑人和4.7%的白人患有多囊卵巢综合征。这些数据表明多囊卵巢综合征可能是女性最常见的生殖内分泌疾病之一。
Estimates of the prevalence of the polycystic ovary syndrome (PCOS) in the general population have ranged from 2-20%. The vast majority of these reports have studied White populations in Europe, used limited definitions of the disorder, and/or used bias populations, such as those seeking medical care. To estimate the prevalence of this disorder in the United States and address these limitations, we prospectively determined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women (174 White and 195 Black; aged 18-45 yr), examined at the time of their preemployment physical. Body measures were obtained, and body hair was quantified by a modified Ferriman-Gallwey (F-G) method. All exams were initially performed by 2 trained nurses, and any subject with an F-G score above 3 was reexamined by a physician, the same for all patients. Of the 369 women, 277 (75.1%) also agreed to complete a questionnaire and have additional blood drawn. Subjects were studied regardless of current estrogen/progestin hormonal use (28.5%). PCOS was defined as 1) oligoovulation, 2) clinical hyperandrogenism (i.e. hirsutism) and/or hyperandrogenemia, and 3) exclusion of other related disorders, such as hyperprolactinemia, thyroid abnormalities, and nonclassic adrenal hyperplasia. Hirsutism was defined by a F-G score of 6 or more, and hyperandrogenemia was defined as a total or free testosterone, androstenedione, and/or dehydroepiandrosterone sulfate level above the 95th percentile of control values [i,e, all eumenorrheic women in the study, who had no hirsutism (F-G less than or equal to 5) or acne and were receiving no hormonal therapy; n = 98]. Considering all 369 women studied, White and Black women had similar mean ages (29.4 +/- 7.1 and 31.1 +/- 7.8 yr, respectively), although White women had a lesser body mass than Black women (24.9 +/- 6.1 vs. 29.2 +/- 8.1 kg/m(2), respectively; P < 0.001). Of these 7.6%, 4.6%, and 1.98 demonstrated a F-G score of 6 or more, 8 or 10, respectively, and there was no significant racial difference, with hirsutism prevalences of 8.0%, 2.8%, and 1.6% in Whites, and 7.1%, 6.1%, and 2.1% in Blacks, respectively. Of the 277 women consenting to a history and hormonal evaluation, 4.0% had PCOS as defined, 4.7% (6 of 129) of Whites and 3.4% (5 of 148) of Blacks.In conclusion, in our consecutive population of unselected women the prevalence of hirsutism varied from 2-8% depending on the chosen cut-off F-G score, with no significant difference between White and Black women. Using an F-G score of 6 or more as indicative of hirsutism, 3.4% of Blacks and 4.7% of Whites had PCOS as defined. These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women.