Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women
Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women
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DOI：
10.1001/archinte.166.19.2081
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发表时间：
2006-10-23
影响因子：
--
通讯作者：
Escobar-Morreale, Hector F.
中科院分区：
文献类型：
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作者：
Alvarez-Blasco, Francisco;Botella-Carretero, Jose I.;Escobar-Morreale, Hector F.
背景：令人惊讶的是，多囊卵巢综合征(PCOS)在未经选择的超重或肥胖女性中的患病率尚不清楚，尽管肥胖在PCOS患者中很常见。本研究旨在对西班牙未经选择的超重和肥胖绝经前妇女的多囊卵巢综合征的患病率进行无偏见的估计。方法：所有在2002年5月至2005年12月期间向卡哈尔大学内分泌科报告超重或肥胖饮食治疗的绝经前妇女都是前瞻性招募的。由于任何其他原因被推荐的女性被自动排除在外，以避免选择偏见。多囊卵巢综合征的诊断依赖于临床和/或生化高雄激素血症、少排卵和排除继发性原因。结果：在113名连续招募的女性中，32名(28.3%)被诊断为多囊卵巢综合征(PCOS)(95%可信区间20.0%-36.6%)。考虑到肥胖程度时，多囊卵巢综合征的患病率没有差异。3例表现为高雄激素血症而无少排卵，2例为特发性多毛，2例为慢性月经过少，无临床或生化高雄激素血症，2例月经过少伴高催乳素血症，排除了PCOS的诊断。其余72名女性(63.7%)未发现高雄激素血症或生殖异常。结论：西班牙超重和肥胖女性多囊卵巢综合征的患病率为28.3%，与我国瘦身女性5.5%的多囊卵巢综合征患病率相比，差异显著。因此，在寻求减肥建议的超重和肥胖绝经前妇女中，必须常规排除多囊卵巢综合征。
Background: Surprisingly, the prevalence of polycystic ovary syndrome ( PCOS) in otherwise unselected overweight or obese women is unknown, despite obesity being frequent in patients with PCOS. We conducted the present study to obtain an unbiased estimate of the prevalence of PCOS in unselected overweight and obese premenopausal women from Spain.Methods: All premenopausal women reporting to the Department of Endocrinology, Hospital Universitario Ramon y Cajal, for dietary treatment of overweight or obesity from May 2002 to December 2005 were prospectively recruited. Women referred for any other reason were automatically excluded to avoid selection bias. Diagnosis of PCOS relied on the presence of clinical and/or biochemical hyperandrogenism, oligo-ovulation, and exclusion of secondary causes. Anthropometric measurements, hirsutism scores, and androgen, gonadotropin, metabolic, and lipid profiles were obtained.Results: Of a total of 113 consecutive women recruited, 32 (28.3%) were diagnosed as having PCOS (95% confidence interval, 20.0%-36.6%). The prevalence of PCOS was not different when considering the degree of obesity. Another 3 women presented with hyperandrogenemia without oligo-ovulation, 2 had idiopathic hirsutism, 2 had chronic oligomenorrhea without clinical or biochemical hyperandrogenism, and 2 had oligomenorrhea with hyperprolactinemia, precluding the diagnosis of PCOS. The remaining 72 women (63.7%) had no evidence of hyperandrogenism or reproductive abnormalities.Conclusions: Our results demonstrate a 28.3% prevalence of PCOS in overweight and obese women from Spain, which is markedly increased compared with the 5.5% prevalence of PCOS in lean women of our country. Therefore, PCOS must be routinely ruled out in overweight and obese premenopausal women seeking advice for weight loss.