代谢性综合征青少年月经紊乱的频率和变异

Anna A. Sinkina, I. Nikitina, Svetlana A. Smiіan, T. V. Babar
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摘要

生殖障碍和代谢综合征(MS)之间的相关性问题是众所周知的,但是关于青少年中这些疾病的频率和性质的数据非常有限。本研究的目的是:在代谢综合征的背景下,确定和分析青春期女孩月经紊乱的频率和结构,并研究这些紊乱与未来可能出现的生殖健康紊乱的相关性。材料和方法。为了实现这一目标,2011年至2021年在苏梅地区临床围产期中心对随机选择的2000例10至18岁女孩门诊病历(主要登记表№025/o)进行了回顾性分析。月经周期根据FIGO 2018分类进行评估。病理性月经初潮被定义为早(10年)或晚(15年后)月经功能发作。根据鹿特丹标准(2003)诊断多囊卵巢综合征(РCOS):少排卵或无排卵(每年月经期≤6次);临床或实验室高雄激素症(多毛症/痤疮)和/或高雄激素血症(血液中游离睾酮水平升高);经阴道超声检查发现多囊卵巢(每个卵巢2 - 9mm大小的卵泡≥15个)。结果表明:青春期女性超重合并多发性硬化症患者中,月经功能障碍发生率为71.1%。此外,这类患者中最常见的月经紊乱变体为少月经(60.0%),其表现频率与超重程度直接相关。研究发现,近82%确诊多发性硬化症的女孩未来患多囊卵巢综合征(PCOS)的风险很高。结论。结果发现,人群中儿童青少年肥胖率为27.1%,儿童期青少年肥胖率为41.5%。有月经综合症的青少年中有很大比例的人月经不规律(71.1%),明显高于健康女孩(19%)。在月经综合征和肥胖女生的月经紊乱中,经期过少占多数(分别为60.0%和52%)。此外,少月经的频率受肥胖程度的显著影响。近82%确诊月经综合征的女孩至少有三项标准中的两项,这使她们未来患多囊卵巢综合征的风险很高。
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FREQUENCY AND VARIANTS OF MENSTRUAL DISORDERS IN ADOLESCENTS WITH METABOLIC SYNDROME
The problem of the correlation between reproductive disorders and metabolic syndrome (MS) is well known, but data on the frequency and nature of these disorders among adolescents are extremely limited. The aim of the study: is to determine and analyze the frequency and structure of menstrual disorders in adolescent girls on the background of metabolic syndrome, as well as to study the correlation of these disorders with possible reproductive health disorders in the future. Materials and methods. To achieve this goal, a retrospective analysis of randomly selected 2,000 outpatient medical records (primary registration form № 025/o) of girls aged 10 to 18 years was performed at the Sumy Regional Clinical Perinatal Center from 2011 to 2021. The menstrual cycle was assessed according to the FIGO 2018 classification. Pathological menarche was defined as early (up to 10 years) or late (after 15 years) onset of menstrual function. Polycystic ovarian syndrome (РCOS) was diagnosed according to the Rotterdam criteria (2003): oligo‑ or anovulation (≤ 6 menstrual periods per year); clinical or laboratory hyperandrogenism (hirsutism/acne) and/or hyperandrogenemia (increased levels of free testosterone in the blood); polycystic ovaries during transvaginal ultrasound (≥ 15 follicles 2–9 mm in size in each ovary). Results. The results showed that in adolescent girls with overweight and MS, the frequency of menstrual dysfunction was observed in 71.1% of cases. Moreover, the most common variant of menstrual disorders in this category of patients was oligomenorrhea (60.0%), and the frequency of its manifestations was directly dependent on overweight degree. It was found that almost 82% of girls with confirmed MS had a high risk of developing polycystic ovarian syndrome (PCOS) in the future. Conclusion. It was found that the incidence of obesity in children and adolescents in the population was 27.1%, and the incidence of menstrual syndrome among children and adolescents with obesity was 41.5%. A significant proportion of adolescents with menstrual syndrome had menstrual irregularities – 71.1%, which was significantly higher than in healthy girls – 19%. Among menstrual disorders in girls with menstrual syndrome and obesity, oligomenorrhea prevailed (60.0% and 52%, respectively). Moreover, the frequency of oligomenorrhea was significantly affected by the degree of obesity. Almost 82% of girls with confirmed menstrual syndrome had at least two of the three criteria, which put them at high risk for developing polycystic ovarian syndrome in the future.
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