A Pilot Study-Early Indicators-Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)通常被认为是青春期或成人的一种疾病，但越来越多的证据表明，它的起源可能更早，早期迹象(PCO，胰岛素抵抗)可能在儿童时期就可以检测到，因为症状可能首先出现在青春期。然而，在青春期前和青春期早期的女孩中，还没有研究过卵巢形态、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，卵巢增大和/或PCO的出现是否在青春期前和青春期早期女孩的胰岛素抵抗、中枢性肥胖(内脏脂肪)和血脂异常的发生之前、之后或无关仍有待确定。 该项目将加强由弗兰克·M·比罗博士领导的研究小组通过辛辛那提大学(儿童？S医院医学中心)进行的成长女性(GUF)研究。GUF计划对大约450-500名6-7岁的小学白人和非裔美国女孩进行队列研究，纵向跟踪五年，计划于2004年9月开始每半年一次的在校考试。这些女孩将每半年进行一次体检(检查轮次)，以确定身体尺寸、中心肥胖症和青春期状况，并收集空腹血液样本。该项目将增加一个组成部分，以开发评估腹部超声和生物标记物的临床体征的方法，以研究儿童早期多囊卵巢综合征的起源。在第一轮数据收集(2004年9月至11月)中招募和测量的大约500名6-7岁女孩的样本上，我们将测量胰岛素抵抗的生物标记物(空腹血清胰岛素、血糖和血脂)，并检查通过人体测量确定的肥胖和区域脂肪分布与胰岛素抵抗指标之间的横断面关系。在GUF研究的第二年，对于200名青春期前或青春期早期女孩，年龄7-8岁，我们将通过腹部超声(PCO、卵巢体积和形态、内脏脂肪)和生物标记物(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多囊卵巢综合征青春期前和青春期早期生物标志物和临床体征的明确研究的基础或试点。

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.