Hypergonadotrophinaemia with reduced uterine and ovarian size in women born small-for-gestational-age
Hypergonadotrophinaemia with reduced uterine and ovarian size in women born small-for-gestational-age
复制标题
DOI：
10.1093/humrep/deg351
复制
发表时间：
2003-08-01
影响因子：
6.1
通讯作者：
de Zegher, F
中科院分区：
文献类型：
--
作者：
Ibáñez, L;Potau, N;de Zegher, F
背景技术背景：胎儿生长受限与婴儿早期和初潮后早期FSH分泌过多以及青春期子宫和卵巢缩小有关。目前尚不清楚这些生殖异常是否分别持续到婴儿晚期和生殖年龄范围。方法：我们报告了两个年龄组女孩的随访结果。一组婴儿[n = 26; n = 10出生适合胎龄（阿加）和n = 16出生小于胎龄（SGA）]在4月龄时接受研究，在12月龄时再次进行评估。一组青少年（n = 28）在14岁时接受研究，在18岁时再次接受评估;该组由一个年龄相似的横向队列（n = 19）补充，共47名年轻女性（n = 27阿加; n = 20 SGA）。在婴儿中，仅测量血清FSH;青少年进行内分泌代谢筛查，超声评估子宫卵巢大小，并通过双能X线吸收测定法评估身体成分。研究结果：SGA组4个月和12个月时血清FSH水平高于阿加组，SGA组14岁和18岁时血清FSH水平高于阿加组（均P < 0.01）。纵向超声评估揭示了青春期后期子宫大小的增加，这在SGA中不如阿加女孩明显。相反，卵巢体积在两个亚组中保持稳定。18岁时纵向和横向结果的汇编证实了SGA女孩子宫尺寸的持续减小（与20%相似; P < 0.005）和卵巢体积（与40%相似; P < 0.0001）;此外，SGA女孩不仅显示FSH持续升高，（与50%相似; P < 0.001），但也有LH和空腹胰岛素升高，以及腹部脂肪过多（均P < 0.01）。结论：出生SGA的年轻女性的妇科特征是高促性腺激素血症和子宫和卵巢缩小。
BACKGROUND: Fetal growth restraint has been associated with FSH hypersecretion in early infancy and in early post-menarche, and with reduced uterine and ovarian size in adolescence. It is unknown whether these reproductive anomalies persist, respectively, into late infancy and into the reproductive age range. METHODS: We report follow-up findings in two age groups of girls. A cohort of infants [n = 26; n = 10 born appropriate-for-gestational-age (AGA) and n = 16 born small-for-gestational-age (SGA)], who had been studied at the age of similar to4 months, was assessed again at the age of 12 months. A cohort of teenagers (n = 28), who had been studied at the age of similar to14 years, was assessed again at the age of similar to18 years; this group was complemented by a transversal cohort of similar age (n = 19) for a total of 47 young women (n = 27 AGA; n = 20 SGA). In infants, only serum FSH was measured; adolescents underwent endocrine-metabolic screening, ultrasound assessment of uterine-ovarian size, and evaluation of body composition by dual X-ray absorptiometry. RESULTS: Serum FSH levels were higher in SGA than AGA infant girls at 4 and 12 months, and higher in SGA than AGA adolescents at 14 and 18 years (all P < 0.01). Longitudinal ultrasound assessments disclosed a late-adolescent increment of uterine size that was less obvious in SGA than AGA girls. In contrast, ovarian volume remained stable in both subgroups. Compilation of longitudinal and transversal results at 18 years of age corroborated the persistent reduction in the uterine size of SGA girls (by similar to 20%; P < 0.005) and in their ovarian volume (by similar to40%; P < 0.0001); moreover, SGA girls displayed not only a persistent elevation of FSH (by similar to 50%; P < 0.001), but also a rise of LH and fasting insulin, as well as an excess of abdominal fat (all P < 0.01). CONCLUSIONS: The gynaecology of young women born SGA was found to be characterized by hypergonadotrophinaemia and by a reduced uterine and ovarian size.