Characteristics of different phenotypes of polycystic ovary syndrome in a Bulgarian population

Aim. Our aim was to investigate the percentage occurrence of different phenotypes of polycystic ovary syndrome (PCOS) in a Bulgarian population, and their clinical, biochemical and hormonal characteristics.

Methods. The study included 70 women with PCOS, diagnosed according to the European Society of Human Reproduction & Embryology/American Society for Reproductive Medicine criteria. The women were divided into four phenotypes: hyperandrogenism (HA) + oligo-/anovulation (OA) + polycystic ovaries at ultrasound (PCO) (full-blown syndrome, phenotype A); HA + OA (former National Institutes of Health definition, phenotype B); OA + PCO (phenotype C); and HA + PCO (phenotype D). Serum levels of testosterone, immune-reactive insulin, sex hormone-binding globulin, dehydroepiandrosterone sulfate and lipid metabolism parameters were measured. Free androgen index and homeostasis model assessment of insulin resistance were calculated. Body mass index and waist-to-hip ratio were assessed.

Results. The percentages of phenotypes A, B, C and D in a Bulgarian population are 58.6%, 11.4%, 10.0% and 20.0%, respectively. The women with the classical form of PCOS (phenotypes A and B) were more obese, had more strongly expressed hyperandrogenemia, and were more insulin-resistant compared with the women of phenotypes C and D.

Conclusion. There is a significant difference in anthropometric, hormonal and metabolic indices between the classical form and the clinical variants of PCOS in the studied Bulgarian population.     

Different phenotypes of polycystic ovary syndrome in Turkish women: clinical and endocrine characteristics

Abstract

This study presents the differences in clinical, endocrine and metabolic parameters among different polycystic ovary syndrome (PCOS) phenotypes in Turkish women. Four hundred and ten women with PCOS were evaluated, while 97 healthy women served as controls. PCOS were defined by oligo-anovulation (OA), hyperandrogenism (HA) and polycystic ovaries on ultrasound (PCO). Patients were subdivided into four phenotypes: OA?+?HA?+?PCO (phenotype 1), OA?+?HA (phenotype 2), HA?+?PCO (phenotype 3), OA?+?PCO (phenotype 4). Phenotypes 1–4 were present in 47.1%, 13.2%, 21.2% and 18.5% of patients, respectively. They were also divided into three groups according to the BMI (<25?kg/m²; 25≤ and ≤30?kg/m²; and >30?kg/m²). ANOVA and Tukey post-hoc HSD tests were used. The LH levels and LH/FSH ratio were higher in phenotype 1 and 2 than phenotype 3. The LDL-C levels were higher in women with phenotype 1 and 4 than in women with phenotype 2. Women with BMI <25?kg/m² had higher levels of LH, LH/FSH ratio, and the HDL-C than other two groups. The levels of TG, LDL, fasting insulin and HOMA-IR increased with increasing BMI in four phenotypes. Results suggest that obesity seems to be the primary cause of metabolic disturbances in PCOS women.     

Phenotypic variation in anti-Mullerian hormone (AMH) production per follicle in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovarian morphology (PCOM): an observational cross-sectional study

This observational study compares the ratio of serum anti-Mullerian hormone (AMH) to the total antral follicle count (AFC) (as a marker of AMH production per follicle) in the various phenotypes of women with polycystic ovary syndrome (PCOS) and isolated polycystic ovarian morphology (PCOM). Two hundred and sixty-two women were recruited. Women with PCOS were divided into four phenotypes based on the diagnostic inclusion criteria of oligo-anovulation (OA), hyperandrogenism (HA) and polycystic ovarian morphology (PCOM). These included Group A (OA?+?HA?+?PCOM), Group B (OA?+?HA), Group C (HA?+?PCOM) and Group D (OA?+?PCOM). A ratio of serum AMH to total AFC was calculated and expressed as the AMH/AFC ratio which was compared in the phenotypes of PCOS and isolated PCOM. The median AMH/AFC ratios in PCOS-A, PCOS-D, PCOS-C and PCOM were 1.5, 1.6, 1.2 and 1.1, respectively. There were significant differences in the groups compared [F(3, 238)?=?6.14, p?=?0.000)]. The ratios were significantly higher in the oligo-anovulatory phenotypes PCOS-A and PCOS-D than the PCOM (p?=?0.004 and 0.002, respectively). There was no significant difference in the ratio between ovulatory phenotype PCOS-C and PCOM (p?=?0.59). The role of androgens and LH in per-follicle AMH production remains limited. The findings support the hypothesis of a key role for AMH in the mechanism of anovulation in PCOS.     

A cross-sectional comparison of clinical and endocrine parameters among phenotypes of polycystic ovarian syndrome in iranian population

Background and objective

Polycystic ovary syndrome (PCOS), as a major hormonal issue among reproductive age women, is categorized into four phenotypes regarding hyperandrogenism, oligo-anovulation and polycystic ovary morphology. This study aims to compare and predict the phenotypes based on metabolic and hormonal parameters.

抗苗勒管激素与不同表型多囊卵巢综合征发病特征的相关性分析

目的探讨不同表型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒管激素(AMH)及性激素指标水平,并评估AMH与这些指标的相关性。方法应用UNION免疫分析仪和Uni Cel Dx I800免疫分析系统检测702例PCOS患者和118例健康女性(对照组)AMH和其他性激素水平,并进行超声下窦卵泡计数(AFC)和卵巢体积测量。应用Pearson分析进行双变量相关分析。结果 PCOS患者的卵泡刺激素(FSH)低于对照组,其中无排卵或稀发排卵(OA)+高雄激素血症(HA)+多囊卵巢(PCO)组与对照组间的差异具有统计学意义(P0.05)。黄体生成素(LH)、L H/F S H、AMH均显著高于对照组。血清睾酮(T)水平在O A+H A组和O A+H A+P C O组显著升高。各组间泌乳素(P R L)、雌二醇(E2)水平无明显差异。A M H与F S H呈负相关,与L H、L H/F S H、T、A F C、左卵巢体积和右卵巢体积呈正相关。结论血清AMH浓度可以反映窦卵泡的数目和血清T的浓度高低,可作为PCOS诊断与监测指标之一,提高PCOS诊断的简便性,在临床上有广泛的应用前景。     

Pelvic floor dysfunction and polycystic ovary syndrome

The purpose of this study was to compare the prevalence of pelvic floor dysfunction (PFD) symptoms in patients with and without polycystic ovary syndrome (PCOS) and among different PCOS phenotypes. This was a case–control study. All participants were assessed using ultrasonography to determine the presence or absence of polycystic ovaries (PCO) and allocated to the case or control group (having healthy females whose husbands were diagnosed with male infertility). The case group was then further subdivided into the three phenotypes according to the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA) and PCO on ultrasonography. Pelvic ?oor dysfunction was assessed by the Pelvic Floor Distress Inventory-20 (PFDI-20). Briefly, the reported pelvic organ prolapse (POP) symptoms were higher in PCOS group (p?=?0.05). The mean PFD score in the HA?+?M?+?PCO group was higher compared to other phenotypes although the difference did not reach significant level (p?>?0.05). However, there was a significant positive correlation between luteinising hormone (LH) level and the POP symptom portion of the PFDI-20 (p?相似文献   

The frequency of metabolic syndrome is higher among PCOS Brazilian women with menstrual irregularity plus hyperandrogenism

Polycystic ovary syndrome (PCOS) has a heterogeneous phenotypic distribution that can potentially lead to variations in metabolic repercussions. A cross-sectional study was conducted with 372 women of reproductive age (146 of whom were ovulatory and 226 with PCOS) divided into groups according to PCOS phenotype: (i) complete phenotype involving menstrual irregularity (MI), hyperandrogenism (H), and ultrasound (US) findings of polycystic ovaries (132 patients); (ii) MI + H (18 patients); (iii) MI + US (51 patients); and (iv) H + US (25 patients). The frequencies of metabolic syndrome (MetS) were 45.4%, 38.9%, 33.3%, 36%, and 8.2% for the MI + H + US, MI + H, MI + US, H + US, and control groups (P < .01), respectively. In logistic regression, body mass index ([BMI] odds ratio [OR]: 1.1, 95% confidence interval [CI] 1.1-1.2) and the association of the complete phenotype with MI + H (OR: 5.8 CI95% [2.2-15.8) were independent predictors of the occurrence of MetS. The defining characteristics of MetS were more frequently found in women with PCOS than in controls, regardless of the phenotype (P < .01 for each variable). In conclusion, the frequency of MetS is similar for various PCOS phenotypes among young Brazilian women from the Southeast region of the country, although only BMI and the presence of MI + H, regardless of the presence of US findings, were more predictive of the development of MetS.     

Is hyperandrogenemia protective for fibrocystic breast disease in PCOS?

The aim of this study is to evaluate the fibrocystic breast disease rates and its association with different clinical, endocrine and metabolic parameters between main polycystic ovary syndrome (PCOS) phenotypes. One hundred thirty two consecutive women were included in the study. Body mass index, serum follicle-stimulating hormone, luteinizing hormone (LH), progesterone, estradiol, testosterone, dehydroepiandrosterone sulphate, fasting glucose, low density lipoprotein (LDL-C), total cholesterol, high density lipoprotein, insulin, insulin sensitivity and fibrocystic breast disease rates were compared among different phenotypes of PCOS. Group 1: Polycystic ovaries (PCO)-anovulation (n = 32), Group 2: Hyperandrogenemia (HA)-anovulation (n = 28), Group 3: HA-PCO (n = 29), Group 4: HA-PCO-anovulation (n = 43). There were statistically significant differences between the different phenotype groups in terms of waist-hip ratio (p = 0.006), serum LDL-C (p = 0.008), LH (p = 0.002), estradiol (p = 0.022), fasting glucose (p = 0.001), progesterone (p = 0.007), free testosterone levels (p < 0.001) and Ferriman-Gallwey (FG) scores (p < 0.001). Different phenotype groups had significantly different fibrocystic breast disease rates. (p = 0.016). Higher free testosterone >3 pg/dl was protective for fibrocystic disease (RR = 0.316, 95:% CI 0.109-0.912, p = 0.033). Higher FG scores were more protective for fibrocystic disease (RR = 0.005, 95:% CI 0.001-0.042, p < 0.001). Group 3 ovulatory PCOS patients with PCO and hyperandrogenemia phenotype had lower risk to develop fibrocystic disease, while higher rates were observed in group 1 anovulatory-normoandrogenemic PCOS patients. Hyperandrogenemia is protective for fibrocystic diseases in PCOS.     

济南市汉族育龄妇女PCOS患病状况的初步调查

目的:探讨济南市汉族育龄妇女多囊卵巢综合征(PCOS)患病状况及其临床特点。方法:以2003年ESHRE/ASRM建议诊断标准,按流行病学整群抽样方法调查济南市1027例育龄妇女中PCOS的患病状况。结果:(1)以ESHRE/ASRM 3条指标符合2条的原则检出PCOS 85例,群体患病率为6.46%;(2)检出的PCOS中稀发排卵、多囊样卵巢(PCO)、高睾酮(T)血症、临床高雄(F-G≥6多毛和痤疮)分别占89.4%、72.94%、57.65%、38.8%(1.18%和38.8%);每两项指标组合:稀发排卵+PCO、稀发排卵+高T、PCO+高T分别占60%、45.9%、38.8%;符合3条指标而临床、生化高雄仅有其一者占48.2%,两者均有占11.8%;不孕占7.06%、肥胖占8.23%。按汉族妇女F-G≥2分标准,群体PCOS中多毛率为37.65%。结论:(1)PCOS占济南市汉族育龄妇女的6.46%。(2)ESHRE/ASRM标准总体上是适合济南汉族育龄妇女PCOS检出的标准,多项指标可提高检出的特异度;(3)多毛作为临床高雄指标F-G≥2分更适于汉族人群。     

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

AIM: Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). METHODS: The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver-operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk. RESULTS: There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%. CONCLUSION: As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.     

Evidence-based approach for the use of ultrasound in the management of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy, affecting 5-10% of women in the reproductive age group, with a wide spectrum of phenotypes. The cardinal features are hyperandrogenism, ovulatory dysfunction and/or polycystic ovary (PCO) appearance. Three major diagnostic criteria for PCOS have been proposed by the National Institute of Health (NIH 1990), the Rotterdam European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine sponsored PCOS Consensus Workshop Group (ESHRE/ASRM 2003) and the recent task force of the Androgen Excess Society (AES 2006). The PCO appearance is not a prerequisite for the diagnosis of PCOS. The aim of this review was to assess the available evidence in order to highlight the role of ultrasound in the diagnosis and management of PCOS. The evidence supports positive correlation between ultrasound features and biochemical indices of PCOS suggesting that ultrasound could play a role in prediction of PCOS severity and prognosis. Recent advances in ultrasonography resulted in a change of emphasis on the relative importance of total ovarian volume, follicle number and ovarian stromal changes in the diagnosis of PCO. In particular, ovarian stromal area/total area (S/A) ratio seems to have the most efficient diagnostic performance for hyperandrogenism. Three-dimensional (3D) ultrasound is a relatively new imaging modality that has the potential to improve the sensitivity and specificity of ultrasound without adding much to the practical management of the syndrome. In addition to its role in the definition of PCO, ultrasound is helpful to predict fertility outcome in patients undergoing treatment.     

Prevalence of polycystic ovaries and polycystic ovary syndrome in lesbian women compared with heterosexual women

OBJECTIVE: To determine the prevalence of polycystic ovaries (PCO) and polycystic ovarian syndrome (PCOS) in lesbian women compared with heterosexual women undergoing fertility treatment. DESIGN: A prospective observational study. SETTING: The London Women's clinic and The Hallam Medical Center. Tertiary referral fertility setup. PATIENT(S): Six hundred eighteen women undergoing ovarian stimulation with or without IUI treatment between November 2001 and January 2003. Of these, 254 were self-identified as lesbians and 364 were heterosexual women. INTERVENTION(S): Baseline pelvic ultrasound examination and blood tests conducted to measure biochemical parameters such as FSH, LH, E(2), PRL, T, androstenedione (A), sex hormone-binding globulin (SHBG), and DHEAS were performed between day 2 and 3 of each woman's menstrual cycle. Tubal patency tests were performed by hysterosalpingography or laparoscopy. MAIN OUTCOME MEASURE(S): Biochemical parameters. RESULT(S): Eighty percent of lesbian women, compared with 32% of the heterosexual women, had PCO on pelvic ultrasound examination. Thirty-eight percent of lesbian women, compared with 14% of heterosexual women, had PCOS. There were no significant differences in the androgen concentrations between lesbian and heterosexual women with normal ovaries. However, lesbian women with PCO and PCOS had significantly higher androgen concentrations compared with heterosexual women with PCO and PCOS. Tubal disease was as common in lesbian women as in heterosexual women. CONCLUSION(S): There is a significantly higher prevalence of PCO and PCOS in lesbian compared with heterosexual women. Lesbian women with either PCO or PCOS had more pronounced hyperandrogenism than did heterosexual women with either PCO or PCOS.     

Early trophoblast invasion and placentation in women with different PCOS phenotypes

This study evaluated the impact of different phenotypes of polycystic ovary syndrome (PCOS) on early trophoblast invasion and placentation. Pregnant patients with different PCOS phenotypes and healthy pregnant women, matched for age and body mass index, were enrolled. Histological analysis of trophoblastic and decidual tissue and macroscopic and microscopic assessment of the placentas were performed. Implantation-site vessels with endovascular trophoblast differed significantly among PCOS phenotypes. Placental weight, thickness, density and fetal–placental weight ratio were significantly different in the full-blown and non-polycystic ovary (PCO) phenotypes versus the ovulatory and non-hyperandrogenic phenotypes. The incidence of macroscopic placental lesions was only significantly different between controls and the full-blown and non-PCO phenotypes. The overall incidence of microscopic placental lesions was significantly different among PCOS phenotypes and was significantly higher in the full-blown and non-PCO phenotypes than in the ovulatory and non-hyperandrogenic phenotypes. The rates of chorionic villitis and intervillositis were significantly higher in full-blown and non-PCO phenotypes than in ovulatory and non-hyperandrogenic phenotypes. In conclusion, alterations in early trophoblast invasion and placentation observed in PCOS vary widely according to phenotype.     

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

Purpose

We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems.

Methods

A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated.

Results

For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83 % sensitivity and 100 % specificity according to the Rotterdam criteria; 83 % sensitivity and 89 % specificity according to the National Institutes of Health (NIH) criteria; and 82 % sensitivity and 93.5 % specificity according to the Androgen Excess Society (AES) criteria.

Conclusions

The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.     

Ovarian enlargement as a possible marker of androgen activity in polycystic ovary syndrome.

This study has been carried out in an attempt to analyze clinical, hormonal and ultrasonography data and to evaluate their possible interrelationships in a group of 72 women with polycystic ovary syndrome (PCOS). Seventeen (23.6%) PCO women were found to have ovarian volume within normal range, while 72.2% had enlarged ovaries. Serum testosterone, androstenedione and DHEAS levels were higher in PCO women with enlarged ovaries when compared to patients who had ovarian volume within normal range, although the difference was not significant. However, when PCO patients were divided into subgroups according to the degree of ovarian enlargement, it was found that patients with the most enlarged ovaries had significantly higher serum androstenedione levels than those with normal ovarian volume (p = 0.039). Significant positive correlation was established between serum androstenedione concentration and ovarian volume (r = + 0.23, p less than 0.05). Hirsutism was found to be equally present in patients with normal ovarian volume (70.6%) and in patients with enlarged ovaries (71.2%) while oligomenorrhea was present more frequently among PCO women who had ovarian volume within normal range (64.7% vs. 40.4%). The results of our study allow us to suggest ovarian enlargement as a marker of excessive androgen production and disturbances of menstrual cycle in polycystic ovary syndrome.     

The prevalence of polycystic ovaries in healthy women

BACKGROUND: To study the prevalence of polycystic ovaries (PCO) in women of reproductive age. METHODS: A total of 189 healthy volunteers aged 20-45 years were examined. The subjects were divided into two groups according to age: < or =35 and > or =36 years. Transvaginal ultrasonography was performed and blood samples were collected on cycle day 1-6. RESULTS: The prevalence of PCO in the entire study population was 14.2% (27/189). In the age group of < or =35 years the prevalence was 21.6% (19/88) and in the age group of > or =36 years 7.8% (8/101). Compared to women with normal ovaries, those with PCO had significantly higher serum testosterone (T) concentrations. Women with PCO tended to have lower serum FSH concentrations and higher LH/FSH ratios than controls. Women with PCO had significantly more irregular cycles (44% vs. 19%, p=0.001) and problems in conceiving (25.9% vs. 9.2%, p=0.01) than women with normal ovaries. CONCLUSIONS: The findings demonstrate that the prevalence of PCO in healthy women varies with age, being more common among women aged < or =35 years than in those aged > or =36 years. Although the hormonal parameters and clinical findings among women with PCO mimicked those of PCOS, it remains unclear if these women will later develop full-blown syndrome.     

Are there differences in ultrasound parameters between Chinese women with polycystic ovaries only and with polycystic ovary syndrome?

OBJECTIVE: We aimed to compare antral follicle count (AFC), ovarian volume, ovarian stromal blood flow between Chinese women with polycystic ovary (PCO) only and polycystic ovary syndrome (PCOS) and to evaluate the effect of age on these ultrasound parameters in these women. STUDY DESIGN: In the second to fourth day of the period, they underwent a transvaginal three-dimensional scanning with power Doppler to determine total AFC, total ovarian volume, total ovarian vascularization index (VI), flow index (FI) and vascularization flow index (VFI). Hormonal profile was also measured. RESULTS: A total of 71 Chinese women were recruited in the study: 39 women with PCO only and 32 women with PCOS. Women with PCO only had significantly lower AFC, ovarian volume, ovarian VI, serum LH, testosterone and DHEAS concentrations but higher serum SHBG concentration when compared with PCOS women. When women with PCO only and PCOS were considered together, the rate of decline of AFC over age was 0.905 follicle per year (95% CI=0.008-1.803, p=0.048) and there was no significant decline of ovarian volume and total ovarian VI, FI and VFI over age. CONCLUSION: PCO only represents a milder end of the PCOS spectrum.     

Incidence of fibrocystic disease of the breast in women with polycystic ovary. Clinico-instrumental study

BACKGROUND: The aim of this study was to assess whether or not there was an association between polycystic ovaries (PCO) and fibrocystic breast disease. It is known that hyperestrogenism and anovulation are involved in the etiology of the fibrocystic breast disease; we evaluated the incidence of this disorder in women with PCO or Polycystic Ovary Sindrome (PCOS) based on ultrasound findings both pelvic and mammographic. METHODS: From January 1995 to December 1997 we performed in our outpatient ultrasound service (I Divisione I Istituto di Clinica Ostetrica e Ginecologica, Università di Roma "La Sapienza") pelvic standard scan on 980 women. Patients between 18 and 30 years of age, not using oral contraceptives, both with Normal Appearing Ovariest (NAO) or with PCO Polycystic Appearing Ovaries (PAO) enrolled in the study, informed and agreed to undergo ultrasound mammography. All the subject were examined using an Aloka SSD ZOOO and Esaote AU3 ultrasound equipment with 3.5 MHz and 10 MHz probes for pelvic and mammographic scan respectively. The relationship between pelvic and mammographic scan findings were studied and the chi 2 analysis was used to examine them. RESULTS: Women by the US findings were allocated into three groups: 203 over 264 showed NAO (group A); 54 had PAO/PCO (group B) and 7 had PCOS (group C). In group A (6.83%) women showed breast pathology. In group B there was association between PCO and breast pathology in 30 (56.98%) women, while in group C on 6 over 7 (91.66%). CONCLUSIONS: This study showed a significant association between PCO and benign pathology. This should encourage the performance of a screening breast sonography in women with PCO.     

汉族育龄多囊卵巢综合征患者的临床特征及分析

目的探讨汉族育龄妇女患多囊卵巢综合征(PCOS)的临床特征。方法根据欧洲人类生殖协会(ESHRE)和美国生殖医学协会(ASRM)提出的,将符合稀发排卵、高雄激素征象及卵巢多囊样表现3项中的2项即可诊断PCOS的标准(即ESHRE/ASRM诊断标准),采用分层整群随机抽样的方法,以问卷方式调查了山东省济南市某地区1027名育龄妇女,对检出的PCOS患者的临床表现、糖代谢特征进行分析;并与同期94名月经正常、已正常生育、无痤疮、无男性毛发分布及无卵巢多囊表现等的妇女(对照组)进行比较。结果(1)1027份调查问卷,收回有效问卷828份(即828名调查对象),问卷反馈率为80·62%。共检出PCOS患者85例,其中≤35岁患者为97·65%(83/85)。(2)同年龄段PCOS患者的月经周期较对照组长,反映临床高雄激素征象及程度的多毛F-G分数、睾酮、游离雄激素指数较对照组高,平均小卵泡数均较对照组多,血清性激素结合球蛋白较对照组降低,以上两者分别比较,差异均有统计学意义(P<0·01)。85例PCOS者的月经稀发程度、F-G分数、痤疮的发生情况、平均小卵泡数,随年龄增长呈现逐渐缩短或降低的趋势。(3)PCOS有不孕史患者的胰岛素抵抗指数为1·49±0·73,无不孕史患者为1·31±0·66,两者比较,差异有统计学意义(t=2·058;P<0·05)。PCOS肥胖患者的空腹胰岛素为(8·50±3·46)mU/L、空腹血糖为(5·70±2·27)mmol/L、胰岛素敏感指数为0·025±0·015;非肥胖患者空腹胰岛素为(5·45±0·54)mU/L、空腹血糖为(4·88±0·45)mmol/L,胰岛素敏感指数为0·044±0·026,以上两者比较,差异均有统计学意义(P<0·01,P<0·05)。结论按照ESHRE/ASRM诊断标准,35岁以下的育龄妇女是PCOS患者的主要群体;PCOS患者的稀发排卵、高雄激素征象、卵巢多囊表现等临床特征随年龄增长而变化;育龄期PCOS合并不孕、肥胖患者存在糖代谢改变,应重视其胰岛素抵抗现象。     

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

Aim. Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO).

Methods. The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver–operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk.

Results. There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%.

Conclusion. As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.