Ontogeny of polycystic ovary syndrome and insulin resistance in utero and early childhood.
Ontogeny of polycystic ovary syndrome and insulin resistance in utero and early childhood.
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DOI：
10.1016/j.fertnstert.2013.05.023
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发表时间：
2013-07
影响因子：
6.7
通讯作者：
Bacha, Fida
中科院分区：
文献类型：
--
作者：
Abbott, David H.;Bacha, Fida
关键词：
多囊卵巢综合征是一种普遍的高雄激素性不孕症和心脏代谢紊乱，增加了妇女终身患2型糖尿病的风险。它是遗传性的，而且具有强烈的家族性。由于缺乏病因学，治疗进展被推迟。然而，越来越多的证据表明，子宫内T过量，加上妊娠期高血糖，有助于PCOS的早期分化或其基因型的表型扩增。PCOS女性的女儿早在2个月大时就可检测到异常的内分泌、卵巢和高胰岛素血症特征，儿童期高胰岛素血症的肥胖增强可能导致青春期高雄激素血症和LH过量。这些发现鼓励临床越来越多地关注肥胖和高胰岛素血症伴随卵巢和肾上腺内分泌异常的早期儿童标志物，这些标志物先于可诊断的PCOS表型。他们提出了在怀孕前和怀孕期间或在儿童和青春期进行生活方式或治疗干预的可能性，以减轻PCOS家族遗传易感性的表现。
PCOS is a prevalent hyperandrogenic infertility and cardiometabolic disorder that increases a woman’s lifetime risk of type 2 DM. It is heritable and intensely familial. Progress towards a cure has been delayed by absence of an etiology. Evidence is mounting, however, for in utero T excess, together with gestational hyperglycemia, contributing to either early differentiation of PCOS or phenotypic amplification of its genotypes. Abnormal endocrine, ovarian and hyperinsulinemia traits are detectable as early as 2-months of age in daughters of women with PCOS, with adiposity enhancement of hyperinsulinemia during childhood potentially contributing to hyperandrogenism and LH excess by adolescence. These findings encourage increasing clinical focus on early childhood markers for adiposity and hyperinsulinemia accompanying ovarian and adrenal endocrine abnormalities that precede a diagnosable PCOS phenotype. They raise the possibility for lifestyle or therapeutic intervention prior to and during pregnancy or during childhood and adolescence alleviating the manifestations of a familial genetic predisposition to PCOS.
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