Metabolic and Reproductive Features before and during Puberty in Daughters of Women with Polycystic Ovary Syndrome
Metabolic and Reproductive Features before and during Puberty in Daughters of Women with Polycystic Ovary Syndrome
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DOI：
10.1210/jc.2008-2836
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发表时间：
2009-06-01
影响因子：
5.8
通讯作者：
Bhasin, Shalender
中科院分区：
文献类型：
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作者：
Sir-Petermann, Teresa;Codner, Ethel;Bhasin, Shalender
背景：在多囊卵巢综合征（PCOS）女性的一级亲属中，有相当大比例的女性可能存在患PCOS的风险。然而，目前尚不清楚多囊卵巢综合征在青春期发育的哪个阶段发生激素和代谢异常。目的：研究多囊卵巢综合征（PCOS）患者的女儿在青春期前期的生殖和代谢特征，这一阶段性腺轴被激活，多囊卵巢综合征可能会出现临床表现。设计：研究99名PCOSd[30名青春期前和69名青春期（Tanner II-V）]和84名对照女性（Cd）的女儿（20名青春期前和64名青春期）。进行口服葡萄糖耐量试验、GnRH激动剂试验（醋酸leuprolide， 10 μ g/kg sc）和经腹超声检查。测定促性腺激素、性类固醇、SHBG、葡萄糖、胰岛素和脂质。结果：根据Tanner分期分布，两组的实足年龄和体重指数SD评分相近。PCOSd患者卵巢体积和2小时胰岛素水平在Tanner分期均明显高于Cd患者。在Tanner期IV和V期，PCOSd患者的基础睾酮和刺激后LH、睾酮和17-羟孕酮浓度显著高于cd。结论：高胰岛素血症和卵巢体积增大在PCOSd患者青春期开始前就存在，并在青春期发育期间持续存在。多囊卵巢综合征的生化异常出现在青春期后期。考虑到早期发病和改变的性质，PCOSd构成了代谢和生殖障碍的高风险群体。[J] .中华内分泌杂志，2004,22(3):393 - 393。
Context: A significant proportion of the first-degree female relatives of women with polycystic ovary syndrome (PCOS) maybe at risk for developing PCOS. However, it is not known at which stage of pubertal development the hormonal and metabolic abnormalities ensue in PCOS.Objective: The aim of the study was to assess the reproductive and metabolic profiles of daughters of women with PCOS (PCOSd) during the peripubertal period, a stage during which the gonadal axis is activated and PCOS may become clinically manifest.Design: Ninety-nine PCOSd [30 prepubertal and 69 pubertal (Tanner II-V)] and 84 daughters of control women (Cd) (20 prepubertal and 64 pubertal) were studied. An oral glucose tolerance test, a GnRH agonist test (leuprolide acetate, 10 mu g/kg sc), and a transabdominal ultrasound were performed. Gonadotropins, sex steroids, SHBG, glucose, insulin, and lipids were determined.Results: Both groups had similar chronological ages and body mass index SD scores according to Tanner stage distribution. Ovarian volume and 2-h insulin were significantly higher in PCOSd compared to Cd at all Tanner stages. In Tanner stages IV and V, basal testosterone and poststimulated LH, testosterone, and 17-hydroxyprogesterone concentrations were significantly higher in PCOSd compared to Cd.Conclusions: Hyperinsulinemia and an increased ovarian volume are present in PCOSd before the onset of puberty and persist during pubertal development. The biochemical abnormalities of PCOS appear during late puberty. Considering the early onset and the nature of the alterations, PCOSd constitute a high-risk group for metabolic and reproductive derangements. (J Clin Endocrinol Metab 94: 1923-1930, 2009)