PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors
PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors
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DOI：
10.1111/j.1471-0528.2006.01008.x
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发表时间：
2006-10-01
影响因子：
5.8
通讯作者：
Fauser, B. C. J. M.
中科院分区：
文献类型：
--
作者：
Broekmans, F. J.;Knauff, E. A. H.;Fauser, B. C. J. M.
目的比较新鹿特丹标准(鹿特丹标准)与美国国立卫生研究院(NIH)制定的标准诊断的多囊卵巢综合征(PCOS)在正常促性腺激素(WHO-II)无排卵妇女中的患病率，评估肥胖及相关因素在这些妇女中的发生率。设计基于大型无排卵筛查数据库的队列研究。建立两个大型生殖医学三级转诊中心。在这两个类别中，评估和比较肥胖、高血糖和胰岛素抵抗的患病率，并分析它们与应用的诊断标准的差异的关系。主要结果指标WHO-II无排卵组诊断多囊卵巢综合征的患病率。结果ROTT-PCOS组的肥胖、高血糖和胰岛素抵抗发生率是NIH-PCOS组的1.5倍以上(91%比55%)。特别是，超声扫描有卵巢功能障碍和多囊卵巢，但没有高雄激素血症的妇女被添加到PCOS诊断组。与NIH-PCOS组相比，ROTT-PCOS组肥胖、高血糖和胰岛素抵抗的发生率较低。与NIH-PCOS组相比，ROTT-PCOS组中没有雄激素过剩的肥胖妇女的代谢谱不同，高血糖和高胰岛素血症的发生率较低，尽管体重分布相似。结论本研究结果表明，根据新的鹿特丹共识标准，代谢紊乱程度较轻的少/无排卵妇女将被添加到PCOS妇女的异质性组中。
Objective The current report aims to compare the prevalence of polycystic ovary syndrome (PCOS) diagnosed according to the new Rotterdam criteria (Rott-PCOS) versus the previous criteria as formulated by the National Institutes of Health (NIH) (NIH-PCOS) in women with normogonadotropic (WHO-II) anovulation and assess the frequency of obesity and related factors determined in these women.Design Cohort study based on large anovulation screening database.Setting Two large tertiary referral centres for reproductive medicine.Population WHO-II normogonadotropic, anovulatory, infertility cases.Methods WHO-II cases were extracted from the screening database and classified according to both the Rotterdam and NIH criteria for PCOS. Within these two classes, the prevalence of obesity, hyperglycaemia and insulin resistance was assessed and compared and their relation to the difference in diagnostic criteria applied was analysed.Main outcome measures Prevalence of diagnosis PCOS in the WHO-II anovulation group. Prevalence of obesity, hyperglycaemia and insulin resistance in the two diagnostic classes.Results The Rott-PCOS group appeared to be more than 1.5 times larger than the group classified as NIH-PCOS (91 versus 55% of the WHO-II cohort). Especially, women with ovarian dysfunction and polycystic ovaries at ultrasound scan, but without hyperandrogenism, were added to the PCOS diagnostic group. The Rott-PCOS exhibited a lower frequency of obesity, hyperglycaemia and insulin resistance compared with the NIH-PCOS group. Obese women in the Rott-PCOS group without androgen excess had a different metabolic profile compared with obese women in the NIH-PCOS group, with lower rates of hyperglycaemia and hyperinsulinism, despite comparable distributions of body weight.Conclusion The present findings indicate that with the new Rotterdam consensus criteria, oligo/anovulatory women with less severe metabolic derangement will be added to the heterogeneous group of women with PCOS.