Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance
Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance
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DOI：
10.1210/jc.2005-1666
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发表时间：
2006-02-01
影响因子：
5.8
通讯作者：
Dunaif, A
中科院分区：
文献类型：
--
作者：
Coviello, AD;Legro, RS;Dunaif, A
背景：患有多囊卵巢综合征（PCOS）的成年女性代谢综合征（MBS）的患病率增加。MBS的患病率在青少年中也在增加。目的：我们的目的是检验这一假设，即与普通人群相比，患有PCOS的青春期女孩的MBS患病率增加，并确定与PCOS中MBS风险增加相关的因素。设计和设置：我们在学术医学中心和普通临床研究中心进行了一项横断面病例对照研究。参与者：参与者包括49名患有PCOS的青春期女孩和165名来自第三次全国健康和营养检查调查的女孩（NHANES III）相似年龄和种族背景的青少年人群。主要结果测量：我们根据目前提出的青少年MBS标准评估MBS的患病率。结果：37%患有PCOS的青春期女孩患有MBS，而NHANES III女孩为5%（P < 0.0001）。正常体重指数（BMI）的女孩没有MBS，而11%的超重和63%的肥胖PCOS女孩有MBS，而NHANES III女孩分别为0和32%。调整BMI后，患有多囊卵巢综合症的女孩患MBS的可能性是年龄匹配的NHANES III女孩的4.5倍（比值比，4.5; 95%置信区间，1.1-17.7; P = 0.03）。在调整BMI和胰岛素抵抗后，PCOS女孩的生物可利用睾酮每四分位数增加，MBS的几率高3.8倍（比值比，3.8; 95%置信区间，1.4-10.2; P = 0.008）。结论：PCOS少女的MBS患病率高于一般青少年人群。高雄激素血症是MBS的危险因素，与肥胖和胰岛素抵抗无关。
Context: Adult women with polycystic ovary syndrome (PCOS) have an increased prevalence of the metabolic syndrome (MBS). The prevalence of MBS is also increasing in adolescents.Objective: Our objective was to test the hypothesis that the prevalence of MBS is increased in adolescent girls with PCOS compared with the general population and to determine the factors associated with an increased risk of the MBS in PCOS.Design and Setting: We conducted a cross-sectional case-control study at academic medical centers with general clinical research centers.Participants: Participants included 49 adolescent girls with PCOS and 165 girls from the Third National Health and Nutrition Examination Survey (NHANES III) adolescent population of similar age and ethnic background.Main Outcome Measure: We assessed the prevalence of MBS according to currently proposed adolescent MBS criteria.Results: Thirty-seven percent of adolescent girls with PCOS had MBS compared with 5% of NHANES III girls (P < 0.0001). None of the girls of normal body mass index (BMI) had MBS, whereas 11% of overweight and 63% of obese girls with PCOS had MBS compared with 0 and 32% of NHANES III girls, respectively. Girls with PCOS were 4.5 times more likely to have MBS than age-matched NHANES III girls after adjusting for BMI (odds ratio, 4.5; 95% confidence interval, 1.1-17.7; P = 0.03). The odds of having the MBS were 3.8 times higher for every quartile increase in bioavailable testosterone in girls with PCOS after adjusting for BMI and insulin resistance (odds ratio, 3.8; 95% confidence interval, 1.4-10.2; P = 0.008).Conclusions: Adolescent girls with PCOS have a higher prevalence of MBS than the general adolescent population. Hyperandrogenemia is a risk factor for MBS independent of obesity and insulin resistance.