304 名因月经过少而转诊的绝经前妇女的内分泌失调患病率。

Hamiyet Yilmaz, Mustafa Demirpence, Umit Belet, Ibrahim Ozkiliç, Ayfer Colak, Savas Ceylan, Muammer Sarıkaya, Erdem Yasar
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引用次数: 0

摘要

简介:我们的目的是对304名因月经量少而就诊的绝经前妇女进行评估,并筛查该人群是否患有库欣综合征:我们的目的是对 304 名因月经量少而到我们诊所就诊的绝经前妇女进行评估,并对这一人群中的库欣综合征(CS)进行筛查:研究对象包括304名因月经量少而到我院就诊的绝经前妇女。对所有患者进行了人体测量和费里曼-高尔维评分,并测量了甲状腺激素、卵泡刺激素(FSH)、黄体生成素(LH)、总睾酮、催乳素、硫酸脱氢表雄酮(DHEA-S)和 17-羟孕酮(17-OHP)的水平。如果基础 17-OHP > 2 ng/mL,我们将评估促肾上腺皮质激素(ACTH)刺激的 17-OHP 水平。通过1毫克地塞米松抑制试验筛查CS,如果皮质醇值大于1.8微克/分升,我们将进行额外的确证试验,必要时进行垂体磁共振成像(MRI)和下蝶窦取样(IPSS):81.57%的病例发现少经的最常见原因是多囊卵巢综合征(PCOS),其次是高泌乳素血症(7.23%)和下丘脑性无排卵(5.26%)。卵巢早衰(POF)的发病率为 1.6%,非典型先天性肾上腺增生症(NCAH)的发病率为 1.97%。有 7 名患者(2.30%)被检测出患有 CS。所有 CS 患者都被发现患有库欣病(CD)。虽然 3 名 CD 患者有典型的症状和体征,但 4 名患者没有任何症状和体征。CD患者的总睾酮值与多囊卵巢综合征组和非多囊卵巢综合征组相似,但与多囊卵巢综合征组和非多囊卵巢综合征组相比,他们的DHEA-S明显更高(CD与多囊卵巢综合征组相比,p = 0.001;CD与非多囊卵巢综合征组相比,p = 0.030):我们发现,即使没有临床症状,少经患者的 CS 患病率也较高。因此,我们建议在对少经和/或多囊卵巢综合症患者进行评估时对 CS 进行常规筛查。雄激素水平(尤其是 DHEA-S 水平)高的患者发生 CS 的可能性更大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of endocrine disorders in 304 premenopausal women referred with oligomenorrhoea.

Introduction: We aimed to evaluate 304 premenopausal women admitted to our clinic for oligomenorrhoea, and to screen for Cushing's syndrome (CS) in this population.

Material and methods: The study included 304 premenopausal women referred to our clinic for oligomenorrhoea. Anthropometric measurements and Ferriman-Gallwey score were evaluated, and thyroid hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, prolactin, dehydroepiandrosterone sulphate (DHEA-S), and 17-hydroxyprogesterone (17-OHP) levels were measured in all patients. If basal 17-OHP was > 2 ng/mL, we evaluated adrenocorticotropic hormone (ACTH)-stimulated 17-OHP levels. CS was screened by 1 mg-dexamethasone suppression test, and if the cortisol value was > 1.8 μg/dL, we performed additional confirmatory tests, and if necessary, pituitary magnetic resonance imaging (MRI) and inferior petrosal sinus sampling (IPSS) were performed.

Results: The most common cause of oligomenorrhoea was polycystic ovary syndrome (PCOS) that was detected in 81.57% of cases, followed by hyperprolactinemia at 7.23% and hypothalamic anovulation at 5.26%. The prevalence of premature ovarian failure (POF) was 1.6%, and non-classical congenital adrenal hyperplasia (NCAH) was 1.97%. CS was detected in 7 (2.30%) patients. All the patients with CS were found to have Cushing's disease (CD). Although 3 patients with CD had classical signs and symptoms, 4 had none. Patients with CD had similar total testosterone values to those in the PCOS and NCAH groups, but they had significantly higher DHEA-S compared to both groups (CD vs. PCOS, p = 0.001 and CD vs. NCAH, p = 0.030).

Conclusions: We found higher prevalence of CS in patients with oligomenorrhoea even in the absence of clinical signs. Therefore, we suggest routine screening for CS during the evaluation of patients with oligomenorrhoea and/or PCOS. The likelihood of CS is greater in patients with high androgen, especially DHEA-S levels.

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