Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups
Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups
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DOI：
10.1016/j.fertnstert.2005.01.096
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发表时间：
2005-06-01
影响因子：
6.7
通讯作者：
Azziz, R
中科院分区：
文献类型：
--
作者：
Chang, WY;Knochenhauer, ES;Azziz, R
目的：我们检验多囊卵巢综合征（PCOS）的三种临床表型代表同一代谢紊乱形式的假设，设计：前瞻性队列分析。环境：以大学为基础的三级医疗。患者：316名连续未经治疗的多囊卵巢综合征患者。干预:没有。主要结局指标：每位受试者接受了排卵功能、体质、痤疮和多毛的评估；血清游离睾酮和总睾酮(T)、17-羟孕酮（17-HP）、DHEAS；空腹血糖和胰岛素水平。使用稳态评估模型方程（HOMA-IR和homa - β细胞）评估胰岛素抵抗和p细胞功能。结果：48%的受试者存在Oligo+HA+多毛表型，29%的受试者存在Oligo+HA表型，23%的受试者存在Oligo+多毛表型。这三种表型在平均体重指数、腰臀比、种族组成、少排卵程度、痤疮患病率或高雄激素症状家族史方面没有差异。然而，表现出Oligo+HA+多毛症表型的受试者年龄最小，高雄激素血症、高胰岛素血症和β细胞功能的程度最大；Oligo+多毛症表型的患者年龄最大，且高雄激素血症、高胰岛素血症程度最轻。细胞功能。具有Oligo+HA表型的受试者表现出中等程度的高雄激素血症和代谢功能障碍。结论：PCOS的三种临床表型不代表同一种代谢障碍的形式，可能是不同程度代谢功能障碍的结果；更高程度的β细胞功能和循环胰岛素水平有利于多毛症和高雄激素血症的发展。(c) 2005年，美国生殖医学学会。
Objective: We tested the hypothesis that the three clinical phenotypes of polycystic ovary syndrome (PCOS) represent forms of the same metabolic disorder,Design: Prospective cohort analysis.Setting: University-based tertiary care.Patient(s): Three-hundred sixteen untreated consecutive women diagnosed as having PCOS.Intervention(s): None.Main Outcome Measure(s): Each subject underwent an evaluation of ovulatory function, body habitus, acne, and hirsutism;, serum free and total testosterone (T), 17-hydroxyprogesterone (17-HP), and DHEAS; and fasting plasma glucose and insulin levels. Insulin resistance and P-cell function were assessed using the homeostatic assessment model equation (HOMA-IR and HOMA-beta-cell, respectively).Result(s): The Oligo+HA+Hirsutism phenotype was present in 48% of subjects, Oligo+HA in 29%, and Oligo+Hirsutism in 23%. The three phenotypes did not differ in mean body mass index, waist-to-hip ratio, racial composition, degree of oligo-ovulation, prevalence of acne, or family history of hyperandrogenic symptomatology. However, Subjects demonstrating the Oligo+HA+Hirsutism phenotype were the youngest and had the greatest degrees of hyperandrogenemia, hyperinsulinemia, and beta-cell function; patients with the Oligo+Hirsutism phenotype where the oldest and had the mildest degrees of hyperandrogenemia, hyperinsulinemia. and beta-cell function. Subjects with the Oligo+HA phenotype demonstrated intermediate degrees of hyperandrogenemia and metabolic dysfunction.Conclusion(s): We conclude that the three clinical phenotypes of PCOS do not represent forms of the same metabolic disorder and may be the result of varying degrees of metabolic dysfunction; greater degrees of beta-cell function and circulating insulin levels favored the development of hirsutism, and frank hyperandrogenemia. (c) 2005 by American Society for Reproductive Medicine.