Clinical and Ultrasound Features of Normocyclic Non-Hyperandrogenic Adolescents in Early Gynecological Life.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Anna Maria Fulghesu, Stefano Di Michele, Ilaria Zangaris, Martina Cordella, Elena Pittui, Giulia Scalise, Salvatore Giovanni Vitale, Stefano Angioni
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Abstract

Objective: This study aimed to determine the prevalence of polycystic ovarian morphology (PCOM) in healthy postmenarcheal girls and assess whether it represents a crucial physiological phase in gynecological development. Additionally, it evaluated if an elevated stromal-to-surface area (S/A) ratio could identify individuals at risk of developing polycystic ovarian syndrome (PCOS).

Design: This is an observational cross-sectional study.

Participants: A total of 302 healthy postmenarcheal girls aged 14-18 were included in the study.

Setting: The study was conducted at the Pediatric and Adolescent Gynecology Service of the University Hospital Duilio Casula, Monserrato, University of Cagliari, from 2020 to 2023.

Methods: Participants were divided into three groups: normal ovarian morphology (NOM), PCOM with normal S/A ratio (PCOM-NS), and PCOM with increased S/A ratio (PCOM-IS). Anthropometric, clinical, hormonal, and ultrasound (US) characteristics were analyzed.

Results: The overall prevalence of PCOM was 43% (95% CI: 0.37-0.49). Among 302 subjects, 171 (57%) exhibited NOM, 90 (30%) showed PCOM-NS, and 41 (13%) had PCOM-IS. The age and years of postmenarcheal life were significantly lower in the PCOM-NS group than in the NOM group. PCOM-NS exhibited a higher waist-to-hip ratio, hirsutism prevalence, and follicle count per ovarian section. PCOM-IS was associated with elevated androgen levels. A significant reduction in the PCOM pattern was observed after the third postmenarcheal year, while the NOM pattern increased significantly beyond 5 years postmenarche.

Limitations: The study is limited by its cross-sectional design, which precludes establishing causality. Additionally, the exclusion of certain participants due to technical limitations in US evaluation may introduce selection bias.

Conclusions: PCOM may represent a normal physiological phase in ovarian development during early adolescence, predominantly observed in the first 1-3 years postmenarche. An increased S/A ratio could help identify adolescents who may benefit from monitoring for potential PCOS development.

正常周期非高雄激素青少年早期妇科生活的临床和超声特征。
目的:本研究旨在了解多囊卵巢形态学(Polycystic Ovarian Morphology, PCOM)在健康月经后女孩中的患病率,并评估其是否代表了妇科发育的一个关键生理阶段。此外,该研究还评估了基质与表面面积(S/A)比值升高是否可以识别患有多囊卵巢综合征(PCOS)的个体。设计:观察性横断面研究。环境:本研究于2020年至2023年在卡利亚里大学蒙塞拉托的polilinico Universitario Duilio Casula儿科和青少年妇科服务中心进行。参与者:共有302名年龄在14-18岁的健康绝经后女性被纳入研究。方法:将参与者分为卵巢形态正常组(NOM)、S/A比正常组(PCOM- ns)和S/A比增高组(PCOM- is)。分析了人体测量学、临床、激素和超声(US)特征。结果:PCOM的总患病率为43% (95% CI: 0.37-0.49)。302例受试者中,171例(57%)出现NOM, 90例(30%)出现PCOM-NS, 41例(13%)出现PCOM-IS。PCOM-NS组的年龄和月经后生活年数明显低于NOM组。PCOM-NS表现出更高的腰臀比(WHR)、多毛症患病率和每卵巢切片的卵泡计数。PCOM-IS与雄激素水平升高有关。PCOM模式在月经初潮后第3年显著减少,而NOM模式在月经初潮后第5年显著增加。局限性:该研究受限于其横断面设计,这排除了建立因果关系。此外,由于超声评估的技术限制而排除某些参与者可能会引入选择偏倚。结论:PCOM可能代表了青春期早期卵巢发育的正常生理阶段,主要发生在初潮后的前1-3年。增加的S/A比率可以帮助识别可能从监测潜在多囊卵巢综合征发展中受益的青少年。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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