A Pilot Study on Early Indicators of Polycystic Ovary Sy

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，在青春期前和青春期早期的女孩中，在大约5-8岁的时候，很少有研究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的出现是在胰岛素抵抗的发展之前、之后还是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？医院医疗中心[CCHMC]）。GUF计划对6-7岁的小学白色和非洲裔美国女孩进行队列研究，纵向随访5年。女孩将进行体格检查，以确定身体大小，中心性肥胖，青春期状态和空腹血液标本的收集。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。我们将测量胰岛素抵抗的生物标志物（空腹血清胰岛素，血糖和血脂），并检查肥胖和局部脂肪分布之间的横截面关系，通过人体测量和胰岛素抵抗指标确定。一项针对青春期前或青春期早期女孩的亚组研究计划通过腹部超声或MRI（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）测量已知与PCOS后期发展相关的因素，并检查卵巢大小和形态、肥胖和局部脂肪分布以及胰岛素抵抗指标之间的横断面关系。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 few 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]). The GUF is planned to be a cohort study of elementary school white and African-American girls, ages 6-7, followed longitudinally for five years. The girls will have physical exams 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. 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. A substudy of prepubertal or early pubertal girls is planned to measure factors known to be associated with the later development of PCOS on abdominal ultrasound or MRI (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.