Early Indicators of Polycystic Ovary Syndrome

由于症状可能首先出现在青春期，多囊卵巢综合征（PCOS）通常被认为是青春期或成年人的疾病，但越来越多的证据表明，其起源可能更早，早期症状（PCO，胰岛素抵抗）可能在儿童时期就可检测到。然而，还没有在青春期前和青春期早期的女孩中进行的研究，在大约5-8岁时，已经检查了卵巢形态、大小、中心性肥胖和胰岛素抵抗的生物标志物之间的关系，因此仍然需要确定卵巢增大和/或PCO的出现是否在胰岛素抵抗的发展之前、之后或与胰岛素抵抗的发展无关，中心性肥胖（内脏脂肪），以及青春期前和青春期早期女孩的血脂异常。 该项目将加强成长女性（GUF）的研究，正在通过辛辛那提大学（儿童？的医院医疗中心[CCHMC]）的研究小组，由博士弗兰克M。比罗GUF计划对大约450-500名6-7岁的小学白色和非裔美国女孩进行队列研究，纵向跟踪5年，每半年进行一次校内考试，考试定于2004年9月开始。女孩将每半年进行一次体格检查（检查轮次），以确定体型、中心性肥胖和青春期状态，并采集空腹血液标本。该项目将增加一个组成部分，以开发评估腹部超声临床体征的方法和用于研究PCOS早期起源的生物标志物。在第一轮数据收集（2004年9月至11月）中招募并测量的约500名6-7岁女孩的样本中，我们将测量胰岛素抵抗的生物标志物（空腹血清胰岛素、血糖和脂质），并检查肥胖和局部脂肪分布（通过人体测量法测定）与胰岛素抵抗指标之间的横截面关系。在GUF研究的第二年，对200名7-8岁青春期前或青春期早期女孩的子样本，我们将通过腹部超声测量已知与PCOS后期发展相关的因素（PCO、卵巢体积和形态、内脏脂肪）和生物标志物（空腹血清胰岛素、血糖和血脂），并检查卵巢大小和形态、肥胖和局部脂肪分布之间的横截面关系，和胰岛素抵抗的指标。该项目的研究结果将作为基础或试点，以开发关于青春期前和青春期早期生物标志物和PCOS临床体征的确定性研究。

Because signs may first appear with puberty, polycystic ovary syndrome (PCOS) is generally considered a disease of adolescence or adults, but there is increasing evidence that its origins may be earlier and that early signs (PCO, insulin resistance) may be detectable in childhood. However, there have been no studies in prepubertal and early pubertal girls, at about ages 5-8 years, that have had examined the relationships among ovarian morphology, size, central adiposity and biomarkers of insulin resistance, and it therefore remains to be established whether ovarian enlargement and/or the appearance of PCO precedes, is subsequent to, or is unrelated to the development of insulin resistance, central adiposity (visceral fat), and dyslipidemia in prepubertal and early pubertal girls. This project will augment the Growing Up Female (GUF) study, being conducted through the University of Cincinnati (Children?s Hospital Medical Center [CCHMC]) by a research team headed by Dr. Frank M. Biro. The GUF is planned to be a cohort study of approximately 450-500 elementary school white and African-American girls, ages 6-7, followed longitudinally for five years with semi-annual in-school examinations that are scheduled to begin in September of 2004. The girls will have semi-annual physical exams (examination rounds) to determine body size, central adiposity, and pubertal status and for the collection of fasting blood specimens. This project will add a component to develop methods for assessing clinical signs on abdominal ultrasound and biomarkers for the study of the early childhood origins of PCOS. On the sample of approximately 500 6-7 year old girls recruited and measured in the first round of data collection (September-November, 2004), we will measure biomarkers of insulin resistance (fasting serum insulin, plasma glucose, and lipids) and examine the cross-sectional relationships among adiposity and regional fat distribution, as determined by anthropometry, and indicators of insulin resistance. In the second year of the GUF study, for a subsample of 200 prepubertal or early pubertal girls, ages 7-8 years, we will measure factors known to be associated with the later development of PCOS on abdominal ultrasound (PCO, ovarian volume and morphology, visceral fat) and biomarkers (fasting serum insulin, plasma glucose, and lipids) and to examine the cross-sectional relationships among ovarian size and morphology, adiposity and regional fat distribution, and indicators of insulin resistance. The findings from this project will either serve as a basis or as a pilot to develop a definitive study on the prepubertal and early pubertal biomarkers and clinical signs of PCOS.