Polycystic ovaries in adolescents and the relationship with menstrual cycle patterns, luteinizing hormone, androgens, and insulin
Polycystic ovaries in adolescents and the relationship with menstrual cycle patterns, luteinizing hormone, androgens, and insulin
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DOI：
10.1016/s0015-0282(00)00584-7
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发表时间：
2000-07-01
影响因子：
6.7
通讯作者：
Schoemaker, J
中科院分区：
文献类型：
--
作者：
van Hooff, MHA;Voorhorst, FJ;Schoemaker, J
研究目的：评估不适当的LH分泌、高雄激素血症和高胰岛素血症在多囊卵巢（PCO）和多囊卵巢综合征的发生中可能发挥的作用。设计：观察性。设置：一般人群样本。参与者：58名月经周期规律的青少年，50名月经周期不规律的青少年，29名月经过少的青少年（年龄16.7 ± 0.9岁）。干预措施：经腹盆腔超声检查和静脉穿刺。主要结果指标：PCO; LH、雄烯二酮和睾酮水平;过夜空腹胰岛素浓度;月经过少。结果：PCO的患病率随着月经周期模式的不规则而显著增加，如研究所示，在月经周期规则的女孩中，PCO的患病率为9%，月经周期不规则者占28%，月经过少者占45%。PCO女孩的LH和雄激素浓度显著升高; PCO女孩与卵巢正常女孩相比，胰岛素水平和葡萄糖-胰岛素比值无差异。月经过少的PCO患者雄激素和LH浓度最高，胰岛素浓度和葡萄糖-胰岛素比值与月经周期正常、卵巢正常的PCO患者相同，腰围和臀围较宽，但腰臀比正常。结论：青少年PCO与月经周期不规律、月经过少和/或雄激素和LH水平升高有关;但与胰岛素水平或葡萄糖-胰岛素比没有发现任何关系。因此，高胰岛素血症是否是PCO或多囊卵巢综合征发生的重要因素值得怀疑。（Fertil Steril（R）2000;74：49-58. (C)2000年由美国生殖医学学会出版）。
Study Objective: To evaluate the possible role of inappropriate LH secretion, hyperandrogenism, and hyperinsulinemia in the development of polycystic ovaries (PCO) and the polycystic ovary syndrome.Design: Observational.Setting: General population samples.Participants: 58 adolescents with regular menstrual cycles, 50 with irregular menstrual cycles, and 29 with oligomenorrhea (age 16.7 +/- 0.9 years).Interventions: Transabdominal pelvic ultrasonography and vena puncture.Main Outcome Measures: PCO; LH, androstenedione, and testosterone levels; overnight fasting insulin concentrations; and oligomenorrhea.Results: The prevalence of PCO increased significantly with the irregularity of the menstrual cycle pattern, as illustrated by the study, finding PCO in 9% of the girls with regular menstrual cycles, 28% of those with irregular menstrual cycles, and 45% of oligomenorrheic girls. The LH and androgen concentrations were significantly higher in girls with PCO; the insulin levels and the glucose-insulin ratio did not differ when the girls with PCO were compared with girls with normal ovaries. Oligomenorrheic girls with PCO had the highest androgen and LH concentrations; their insulin concentrations and glucose-insulin ratio were in the same range as girls with regular menstrual cycles and normal ovaries; and both their hip and waist girths were wider, although their waist-hip ratio was normal.Conclusions: PCO in adolescents is associated with irregular menstrual cycles, oligomenorrhea, and/or high androgen and LH levels; but no relationship was found with the insulin level or glucose-insulin ratio. Thus, it is doubtful that hyperinsulinemia is an important factor in the development of PCO or polycystic ovary syndrome. (Fertil Steril(R) 2000;74:49-58. (C) 2000 by American Society for Reproductive Medicine).