The presentation and medical course of PCOS in adolescents across the United States

美国青少年多囊卵巢综合症的表现和医学过程

• 批准号: 10667067
• 负责人: Melanie G Cree
• 金额: $ 38.17万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-05 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667067
• 关键词: Acanthosis Nigricans; Acne; Address; Adolescence; Adolescent; Adult; Affect; Alanine Transaminase; Androgens; Androstenedione; Anovulation; Anxiety; Area; Australia; Biological; Blood Pressure; Body Weight; Body Weight decreased; Body mass index; Caring; Characteristics; Chronic; Clinical; Cluster Analysis; Contraceptive Agents; Country; Data; Databases; Dermatologic; Development; Diabetes Mellitus; Diagnosis; Disease; Eating Disorders; Estrogens; Ethnic Origin; Familial disease; Family; Fasting; Future; Genomics; Geography; Glucose; Glycosylated hemoglobin A; Goals; Guidelines; Health; Heterogeneity; High Density Lipoproteins; High Prevalence; Hirsutism; Hispanic; Hormones; Hour; Hyperandrogenism; Hypergravity; Hyperlipidemia; Hypertension; Institution; Insulin; Insulin Resistance; International; Laboratories; Life Style; Life Style Modification; Lifestyle Therapy; Luteinizing Hormone; Measures; Medical; Menstruation; Mental Depression; Mental disorders; Metabolic; Metabolic Diseases; Metformin; Methods; Modeling; Multicenter Studies; Natural History; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Obesity; Obstructive Sleep Apnea; Overweight; Patients; Pattern; Pharmaceutical Preparations; Phenotype; Polycystic Ovary Syndrome; Population; Population Heterogeneity; Pregnancy; Process; Prospective Studies; Puberty; Race; Recommendation; Recording of previous events; Registries; Research; Research Personnel; Sampling; Sex Hormone-Binding Globulin; Site; Symptoms; Teenagers; Testosterone; Time; United Kingdom; United States; Weight; Woman; Work; Youth; cohort; community center; comorbidity; diagnostic criteria; direct application; ethnic difference; ethnic diversity; experience; fasting glucose; follow-up; girls; improved; indexing; insulin sensitivity; metabolic phenotype; non-alcoholic fatty liver; non-alcoholic fatty liver disease; novel therapeutics; personalized approach; personalized medicine; personalized therapeutic; predicting response; psychologic; racial difference; racial diversity; reproductive; response; therapeutically effective; treatment response; waist circumference

1 Polycystic ovary syndrome (PCOS), one of the most common endocrinopathies in women, presents with 2 anovulation and hyperandrogenism in adolescence. In addition to reproductive abnormalities, PCOS is 3 frequently associated with obesity and metabolic complications including diabetes, non-alcoholic fatty liver 4 disease, obstructive sleep apnea, hypertension and hyperlipidemia. Additionally, women with PCOS are more 5 likely to suffer from mental health disorders and significant dermatologic manifestations. PCOS is a chronic 6 heterogeneous familial disorder and thus symptoms, signs and co-morbidities at time of diagnosis vary. Despite 7 the high prevalence and gravity of comorbidities associated with PCOS, widely effective therapeutic options are 8 lacking. Recommended therapies for PCOS treatment in women not seeking pregnancy include estrogen 9 containing contraceptives (EC), lifestyle modification, and metformin. Recently there has been a call for more 10 individualized and personalized therapeutic approaches, however there is little biologic basis to recommend one 11 therapy over another. Further, despite the availability of these treatment options for over 40 years, research on 12 their efficacy in youth with PCOS is limited to small studies. Additionally, due to puberty specific hormone 13 changes, adolescents have lower insulin sensitivity than adults. Indeed, a number of studies have established 14 that youth with diabetes or obesity respond less to metformin than adults. Thus, data from medication trials in 15 adult women cannot be applied in youth with PCOS. 16 No mechanism is currently available in the United States to query the early natural history and response to 17 existing medications in a diverse population of youth with PCOS. Using 18 institutions, e found that reproductive abnormalities are more severe in girls without obesity, and metabolic 19 co-morbidities are more common in girls with obesity. Additionally, we and others have found that PCOS 20 presentation, especially as relates to comorbidities, may reflect underling racial and ethnic differences. The 21 overall goal of the project is to describe the presenting reproductive and metabolic phenotypes, natural history, 22 and response to therapy in a large sample of geographically, ethnically and racially diverse youth with PCOS. We 23 hypothesize that presentations of PCOS in adolescence will vary by family history, obesity, and race and ethnicity 24 status, and that unique factors at diagnosis can be used to identify those that respond to EC, metformin or 25 lifestyle therapies. SA1) Describe the presentation and co-morbidities at the time of diagnosis of PCOS in youth 26 in the United States SA2) Determine the response to common medications (lifestyle, EC, metformin). This 27 cohort represents a very diverse population of youth with PCOS, and the database is the first of its kind for youth 28 with PCOS. This work will establish how early phenotypes can inform more individualized approaches toward 29 initial therapy. These efforts are a critical first step towards developing data-informed personalized treatment 30 plans to improve the long-term health of girls with PCOS. pooled retrospective data from 6 w

1多囊卵巢综合征（PCOS）是女性最常见的内分泌疾病之一， 2青春期无排卵与高雄激素血症。除了生殖异常，PCOS是 3.常伴有肥胖和代谢并发症，包括糖尿病、非酒精性脂肪肝 4疾病，阻塞性睡眠呼吸暂停，高血压和高脂血症。此外，患有PCOS的女性 5可能患有精神健康疾病和显著的皮肤病表现。PCOS是一种慢性 6异质性家族性疾病，因此诊断时的症状、体征和共病各不相同。尽管 PCOS合并症的高患病率和严重性，广泛有效的治疗选择是 8缺少推荐的治疗PCOS的妇女不寻求怀孕包括雌激素 9含有避孕药（EC），生活方式改变和二甲双胍。最近有一个呼吁， 10种个性化和个性化的治疗方法，但几乎没有生物学基础推荐一种 11治疗另一个。此外，尽管这些治疗方案的可用性超过40年， 12他们对PCOS青年的疗效仅限于小型研究。此外，由于青春期特有的激素 13变化，青少年胰岛素敏感性低于成人。事实上，许多研究已经证实， 糖尿病或肥胖青年对二甲双胍的反应低于成年人。因此，来自药物试验的数据 15成年女性不能应用于患有PCOS的青年。 16.美国目前没有任何机制可以查询早期自然历史和对 17种现有药物在不同的PCOS青年人群中使用 18个机构，e发现生殖异常在没有肥胖的女孩中更严重， 19合并症在肥胖女孩中更常见。此外，我们和其他人发现PCOS 20表现，特别是与合并症有关的表现，可能反映了潜在的种族和民族差异。的 该项目的总体目标是描述目前的生殖和代谢表型，自然史， 22和对治疗的反应在地理上，种族和种族多样化的PCOS青年的大样本。我们 23假设青春期多囊卵巢综合征的表现因家族史、肥胖、种族和民族而异 24状态，并且诊断时的独特因素可用于识别对EC，二甲双胍或 25种生活方式疗法SA1）描述年轻人诊断PCOS时的表现和合并症 美国26例SA2）确定对常见药物（生活方式、EC、二甲双胍）的反应。这 27队列代表了非常多样化的PCOS青年人群，该数据库是第一个针对青年的数据库。 28、PCOS这项工作将确定早期表型如何为更个性化的方法提供信息， 29第一次治疗这些努力是朝着开发基于数据的个性化治疗迈出的关键的第一步 30项计划旨在改善PCOS女孩的长期健康。 6例患者的汇总回顾性数据 W