Key diagnostic criteria for adolescent polycystic ovary syndrome adjusted for age-specific hormonal and metabolic status standard


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Aim. To specify the diagnostic criteria, clinical and laboratory features of PCOS in female adolescents. Materials and methods. The study comprised 130 girls aged 15 to 17 years with PCOS diagnosed by the Rotterdam criteria. The control group consisted of 30 healthy girls of a similar age with a regular menstrual cycle. The study participants underwent a complete clinical and laboratory workup with an expanded hormonal prof ile and a pelvic ultrasound examination. Results. Highly specific PCOS markers in girls aged 15-17 years include oligo- or amenorrhea with menarche and hirsutism, an ovarian volume of both ovaries > 10.70 cm3, ovarian-uterine index > 3.95, LH/FSH ratio> 1.23, AMH level> 7.20 ng/ml, testosterone > 1.15 nmol /L, and androstenedione > 11.45 ng/ml with a free androgen index > 2.75 (for each criterion, sensitivity and specificity is 75.0-93.0% and 0 83.0-93.0%, respectively). The diagnostic accuracy of PCOS reaches 92% with the logistic regression equation as follows: logit = 85.73- (1.73 x AMH) - (0.12 x Leptin) less than 70.72. Conclusion. The study determined threshold levels of AMH, free androgen index, androstenedione, testosterone, LH/FSH, values of ovarian volume and ovarian-uterine index, which have high sensitivity and specif icity and may be recommended for the diagnosis of PCOS in patients aged 15 - 17 years.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Elena Khashchenko

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: khashchenko_elena@mail.ru
Candidate of Medical Sciences, Researcher 2nd gynecological department (gynecology of children and adolescents)

Elena Uvarova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: elena-uvarova@yandex.ru
MD, professor, head of the 2nd gynecological department (gynecology of children and adolescents)

Tatyana Ivanets

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: t_ivanets@oparina4.ru
MD, Head of the Clinical Diagnostic Laboratory

Fatima Mamedova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: mamedova_f@mail.ru
candidate of medical sciences, doctor of the department of ultrasound diagnostics in neonatology and pediatrics

Mikhail Vysokikh

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: m_vysokikh@oparina4.ru
candidate of biological sciences, Head. mitochondrial medicine laboratory

Pavel Borovikov

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: p_borovikov@oparina4.ru
Head. bioinformatics laboratory

Ivan Balashov

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: i_balashov@oparina4.ru
specialist of the bioinformatics laboratory

Әдебиет тізімі

  1. Уварова Е.В. Детская и подростковая гинекология. Руководство для врачей. М.: Литтерра; 2009. 238 с.
  2. Yetim A., Yetim Q., Bag F., Erol O.B., Qig G., Ugar A. et al. Anti-Mullerian hormone and inhibin-A, but not inhibin-B or insulin-like peptide-3, may be used as surrogates in the diagnosis of polycystic ovary syndrome in adolescents: preliminary results. J. Clin. Res. Pediatr. Endocrinol. 2016; 8(3): 288-97. http:// dx.doi.org/10.4274/jcrpe.3253.
  3. Tsikouras P., Spyros L., Manav B., Zervoudis S., Poiana C., Nikolaos T. et al. Features of polycystic ovary syndrome in adolescence. J. Med. Life. 2015; 8(3): 291-6.
  4. Goodman N.F., Cobin R.H., Futterweit W., Glueck J.S., Legro R.S., Carmina E. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome. Endocr. Pract. 2015; 21(11): 1291-300. http:// dx.doi.org/10.4158/EP15748.DSC.
  5. Dumesic D.A., Oberfield S.E., Stener-Victorin E., Marshall J.C., Laven J.S., Legro R.S. Scientific statement on the diagnostic criteria,epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr. Rev. 2015; 36(5): 487-525. http://dx.doi.org/10.1210/er.2015-1018.
  6. Solomon C.G., Hu F.B., Dunaif A., Rich-Edwards J., Willett W.C., Hunter D.J. Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. JAMA. 2001; 286(19): 2421-6.
  7. Fauser B.C., Tarlatzis B.C., Rebar R.W., Legro R.S., Balen A.H., Lobo R. et al. Consensus on women’s health. Aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS. Consensus Workshop Group. Fertil. Steril. 2012; 97: 28-38. http://dx.doi.org/10.1016/j. fertnstert.2011.09.024.
  8. Azziz R., Carmina E., Dewailly D., Diamanti-Kandarakis E., Escobar-Morreale H.F., Futterweit W. et al. The androgen excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil. Steril. 2009; 91(2): 456-88. http://dx.doi.org/10.1016/j.fertnstert.2008.06.035.
  9. Pinola P., Piltonen T.T., Puurunen J., Vanky E., Sundstrom-Poromaa I., Stener-Victorin E. et al. Androgen profile through life in women with polycystic ovary syndrome: A Nordic Multicenter Collaboration Study. J. Clin. Endocrinol. Metab. 2015; 100(9): 3400-7. http://dx.doi.org/10.1210/jc.2015-2123.
  10. Legro R.S., Arslanian S.A., Ehrmann D.A., Hoeger K.M., Murad M.H., Pasquali R. et al. Diagnosis and treatment of polycystic ovary syndrome: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2013; 98(12): 4565-92. http://dx.doi.org/10.1210/jc.2013-2350.
  11. Merino P.M., Villarroel С., Jesam C., Lopez P., Codner E. New diagnostic criteria of polycystic ovarian morphology for adolescents: impact on prevalence and hormonal profile. Horm. Res. Paediatr. 2017; 88(6): 401-7. http://dx.doi. org/10.1159/000481532.
  12. Демидов В.Н., Зыкин Б.И. Ультразвуковая диагностика в гинекологии. М.: Медицина; 1990. 224 с.
  13. GUdUcUa N., Kutayb S.S., Gormugc U., Kavakd Z.N., Dundera I. High DHEAS/ free testosterone ratio is related to better metabolic parameters in women with PCOS. Gynecol. Endocrinol. 2015; 31(6): 495-500. http://dx.doi.org/10.3109/ 09513590.2015.1022862.
  14. Чернуха Г.Е., Блинова И.В., Купрашвили М.И. Эндокринно-метаболические характеристики больных с различными фенотипами синдрома поликистозных яичников. Акушерство и гинекология. 2011; 2: 70-6.
  15. Буралкина Н.А., Уварова Е.В. Параметры овариального резерва девочек 15-17 лет с гармоничным половым и физическим развитием. Репродуктивное здоровье детей и подростков. 2010; 32(3): 20-8.
  16. Григоренко Ю.П., Уварова Е.В., Огрызкова В.Л., Ашрафян Л.А. Эхографические маркеры синдрома поликистозных яичников у девочек-подростков по данным комплексной трехмерной трансректальной эхографии. Гинекология. 2015; 17(2): 77-80.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Bionika Media, 2019