12月30日訊 –新近研究顯示,盡管她們還年輕,但多囊卵巢綜合征(PCOS)女性的糖尿病和高膽固醇風險增加。
該研究的作者之一,美國舊金山加州大學的Erica T. Wang博士,告訴Reuters Health。“醫(yī)生通常不認為20多歲的年輕女性是需要密切關(guān)注的目標人群,我們的研究表明我們需要密切關(guān)注年輕的PCOS女性。
鑒于即使在PCOS癥狀消失后,(糖尿病和高膽固醇)風險增加也持續(xù)多年,研究結(jié)果強調(diào),保持長期健**活方式的重要性,美國圣地亞哥加州大學的R. Jeffrey Chang博士,在其研究的評論中稱。
據(jù)全國婦女健康信息中心稱,多囊卵巢綜合征發(fā)生于5%至10%的育齡婦女。她們異常升高的雄激素可導致不孕,月經(jīng)不調(diào),毛發(fā)過度生長,卵巢囊腫,伴有體重增加,特別是在腰部。
除了飲食和運動,PCOS可采用降胰島素藥物治療,有時采用激素療法,如避孕藥或降雄激素藥物。
研究發(fā)現(xiàn),PCOS與心臟病的數(shù)種危險因素有關(guān),如肥胖和高血壓,以及糖尿病。但目前仍不清楚PCOS是否與其有關(guān)。調(diào)查中,作者看到1,127名女性參與了青壯年研究之冠狀動脈風險進展----一項在美國4城市開展的有關(guān)白人和非裔美國人之間心臟病風險因素的長期調(diào)查。
研究開始時這些女性年齡為20到32歲,進行為期18年的隨訪。在研究開始時,53名女性患有PCOS。隨訪期結(jié)束時她們當中的12人為晚期2型糖尿病,18人血脂異常。多變量分析顯示,潛在的混雜因素調(diào)整后(包括體重),PCOS女性患糖尿病和高膽固醇風險是非PCOS女性的約2倍。
研究人員在研究的開始時還分析了31名體重正常的女性PCOS患者的風險。結(jié)果發(fā)現(xiàn)這些女性患糖尿病的風險是體重正常的非PCOS女性的3倍。
在研究第14年,對最初的746名研究對象進行了PCOS二次評估。15名女性仍然患有PCOS。“持續(xù)”患有PCOS的女性在接下來的5年發(fā)展為2型糖尿病的風險是7倍多。
事實上,許多女性隨著時間推移,多囊卵巢綜合征癥狀消失,這提示隨著年齡增長,多囊卵巢綜合征變得越來越少見,正如其他的研究所見,Chang博士在他的評論中提到。鑒于這些女性患糖尿病的風險增加,盡管不再有PCOS,但是研究結(jié)果還表明,過量的男性激素分泌可能不是糖尿病風險增加的主要原因,因此,在受此疾病影響的女性中持續(xù)強調(diào)生活方式和行為矯正是必要的。他補充道。
Polycystic Ovary Syndrome and Risk for Long-Term Diabetes and Dyslipidemia.
Wang ET, Calderon-Margalit R
(From the University of California, San Francisco)
OBJECTIVE:To estimate whether women aged 20-32 years who fulfilled National Institutes of Health criteria for polycystic ovary syndrome (PCOS) would be at higher risk for subsequent development of incident diabetes, dyslipidemia, and hypertension, and to estimate whether normal-weight women with PCOS would have the same degree of cardiovascular risk as overweight women with PCOS.
METHODS: We estimated the association of PCOS with incident diabetes, dyslipidemia, and hypertension over a period of 18 years among 1,127 white and African-American women in the Coronary Artery Risk Development in Young Adults cohort. We classified women at baseline (ages 20-32 years) based on self-reported symptoms and serum androgen measures using National Institutes of Health PCOS criteria. We estimated the association of PCOS and subsequent cardiovascular risk factors, independent of baseline body mass index (BMI), using multivariable logistic regression. Additionally, among 746 women with a second assessment of PCOS at ages 34-46 years, we estimated the association of persistent PCOS with cardiovascular risk factors.
RESULTS: Of 1,127 women, 53 (4.7%) met criteria for PCOS at ages 20-32 years. Polycystic ovary syndrome was associated with a twofold higher odds of incident diabetes (23.1% compared with 13.1%, adjusted odds ratio [AOR] 2.4, confidence interval [CI] 1.2-4.9) and dyslipidemia (41.9% compared with 27.7%, AOR 1.9, CI 1.0-3.6) over the course of 18 years; the association with incident hypertension was not significant (26.9% compared with 26.3%, AOR 1.7, CI 0.8-3.3). Normal-weight women with PCOS (n=31) had a threefold higher odds of incident diabetes compared with normal-weight women without PCOS (AOR 3.1, CI 1.2-8.0). Compared with those without PCOS, women with persistent PCOS (n=11) had the highest odds of diabetes (AOR 7.2, CI 1.1-46.5).
CONCLUSION:Polycystic ovary syndrome is associated with subsequent incident diabetes and dyslipidemia, independent of BMI. Diabetes risk may be greatest for women with persistent PCOS symptoms.