Ovarian hyperthecosis, diabetes and hirsuties in post-menopausal women
Ovarian hyperthecosis, diabetes and hirsuties in post-menopausal women
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DOI：
10.1046/j.1365-2265.1997.1050916.x
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发表时间：
1997-02-01
影响因子：
3.2
通讯作者：
Belchetz, PE
中科院分区：
文献类型：
--
作者：
Barth, JH;Jenkins, M;Belchetz, PE
目的：我们描述了4例卵巢卵泡膜细胞增生症和促性腺激素释放激素对临床和代谢变量的影响。设计开放门诊研究。他们的胸部、上背部和肩部有明显的毛发生长。三个有组织学证实卵巢卵泡膜增生，第四个有大卵巢超声可视化。所有四名妇女都有明显的血管疾病危险因素;高血压、糖尿病和葡萄糖耐受不良，结果促性腺激素释放激素激动剂治疗后血浆雄激素水平显著降低，毛发生长减少，但对雄激素血症无影响。在该报告中描述的绝经期妇女临床上被认为具有高雄激素症，这是由于在上躯干上有明显体毛的病理模式，促性腺激素释放激素治疗对减轻多毛的严重程度非常有效。本报告中绝经后卵泡膜增生症妇女心血管疾病的患病率很高。由于高雄激素血症和胰岛素被认为是绝经前多囊卵巢妇女心血管疾病的危险因素，我们讨论了胰岛素和绝经后卵巢之间的可能关系。
OBJECTIVE We describe four patients with ovarian hyperthecosis and the effects of gonadotrophin releasing hormone on clinical and metabolic variables.DESIGN Open out-patient study.PATIENTS Four women presented with post-menopausal hirsuties. They had significant hair growth across the chest, upper back and shoulders. Three had histologically proven ovarian hyperthecosis and a fourth had large ovaries visualized on ultrasound. All four women had pronounced risk factors for vascular disease; hypertension, hyperlipidaemia and glucose intolerance, and three had already developed symptomatic vascular disease.RESULTS Gonadotrophin releasing hormone agonist therapy resulted in significant reduction in plasma androgens and cosmetic reduction in hair growth but had no effect on hyperlipidaemia.CONCLUSION The post-menopausal women described in this report were clinically considered to have hyperandrogenism due to the pathological pattern of marked body hair over the upper trunk, Treatment with GnRH was very effective at reducing the severity of the hirsuties.The post-menopausal women with hyperthecosis in this report had a high prevalence of cardiovascular disease. Since hyperandrogenism and insulin are considered risk factors for cardiovascular disease in premenopausal women with polycystic ovaries, we discuss the possible relationship between insulin and the post-menopausal ovary.