Asymptomatic Volunteers with a Polycystic Ovary Are a Functionally Distinct but Heterogeneous Population
Asymptomatic Volunteers with a Polycystic Ovary Are a Functionally Distinct but Heterogeneous Population
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DOI：
10.1210/jc.2008-2771
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发表时间：
2009-05-01
影响因子：
5.8
通讯作者：
Rosenfield, Robert L.
中科院分区：
文献类型：
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作者：
Mortensen, Monica;Ehrmann, David A.;Rosenfield, Robert L.
背景/目标：我们的目的是确定多囊卵巢（V-PCO）无症状志愿者的卵巢功能。参与者：非多毛型多囊卵巢综合征（V-PCO）（n = 32）和超声检查正常卵巢（V-NO）志愿者（n = 21）相互比较，并与符合美国国家卫生研究院标准的多囊卵巢综合征（PCOS）患者（n = 90）进行比较。结果：V-PCO患者17-羟孕酮（17 OHP）对GnRHag反应的分布介于V-NO、正常对照组和PCOS患者之间，V-PCO患者17 OHP对GnRHag反应的分布介于V-NO、正常对照组和PCOS患者之间。然而，V-PCO人群具有异质性。有53%（32例中的17例）功能正常，17 OHP反应和游离睾酮水平如V-NO。共有25%（32例中的8例）游离睾酮升高，因此符合PCOS的鹿特丹标准;其中三分之一对GnRHag测试有17 OHP高反应性。其余22%（32例中的7例）对GnRHag有17 OHP高反应性，但游离睾酮正常。69%的PCOS患者对GnRHag的17 OHP高反应性升高。卵巢体积与17 OHP反应显着相关，只有在PCOS，仅占10%的variation.Conclusions：许多无症状的志愿者有PCO。他们是一个独特的，但异质性，人口方面的卵巢功能，范围从正常（53%）到隐匿性PCOS的鹿特丹标准（25%）。近四分之一（22%）的患者有典型的PCOS类型的卵巢功能障碍，但没有高雄激素血症，称为“失调的PCO”;他们或他们的后代可能有PCOS的风险。在建立卵巢功能正常值时，必须考虑卵巢超声特征。（临床内分泌代谢杂志94：1579-1586，2009）
Context/Objective: Our objective was to determine the ovarian function of asymptomatic volunteers with a polycystic ovary (V-PCO).Participants: Non-hirsute eumenorrheic V-PCO (n = 32) and volunteers with ultrasonographically normal ovaries (V-NO) (n = 21) were compared with one another and with polycystic ovary syndrome (PCOS) patients who met National Institute of Health criteria (n = 90).Design/Setting/Interventions: GnRH agonist (GnRHag), ACTH, and oral glucose tolerance tests were prospectively performed in a General Clinical Research Center.Results: The distribution of 17-hydroxyprogesterone (17OHP) responses to GnRHag of V-PCO formed a distinct population intermediate between that of V-NO, the reference population, and PCOS. Nevertheless, the V-PCO population was heterogeneous. There were 53% (seventeen of 32) that were functionally normal, with 17OHP responses and free testosterone levels like V-NO. A total of 25% (eight of 32) had an elevated free testosterone, thus meeting Rotterdam criteria for PCOS; one third of these had 17OHP hyperresponsiveness to GnRHag testing. The remaining 22% (seven of 32) had 17OHP hyperresponsiveness to GnRHag, but normal free testosterone. Of PCOS, 69% had elevated 17OHP hyperresponsiveness to GnRHag. Ovarian volume correlated significantly with 17OHP responses only in PCOS, accounting for just 10% of the variance.Conclusions: Many asymptomatic volunteers have a PCO. They are a distinct, but heterogeneous, population with respect to ovarian function, ranging from normal (53%) to occult PCOS by Rotterdam criteria (25%). Nearly one quarter (22%) had the typical PCOS type of ovarian dysfunction without hyperandrogenemia, termed a "dysregulated PCO"; they or their offspring may be at risk for PCOS. Ovarian ultrasonographic characteristics must be considered when establishing norms for ovarian function. (J Clin Endocrinol Metab 94: 1579-1586, 2009)