The presentation and medical course of PCOS in adolescents across the United States

美国青少年多囊卵巢综合症的表现和医学过程

基本信息

批准号：
10667067
负责人：
Melanie G Cree
金额：
$ 38.17万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-05 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10667067
关键词：
Acanthosis Nigricans Acne Address Adolescence Adolescent Adult Affect Alanine Transaminase Androgens Androstenedione Anovulation Anxiety Area Australia Biological Blood Pressure Body Weight Body Weight decreased Body mass index Caring Characteristics Chronic Clinical Cluster Analysis Contraceptive Agents Country Data Databases Dermatologic Development Diabetes Mellitus Diagnosis Disease Eating Disorders Estrogens Ethnic Origin Familial disease Family Fasting Future Genomics Geography Glucose Glycosylated hemoglobin A Goals Guidelines Health Heterogeneity High Density Lipoproteins High Prevalence Hirsutism Hispanic Hormones Hour Hyperandrogenism Hypergravity Hyperlipidemia Hypertension Institution Insulin Insulin Resistance International Laboratories Life Style Life Style Modification Lifestyle Therapy Luteinizing Hormone Measures Medical Menstruation Mental Depression Mental disorders Metabolic Metabolic Diseases Metformin Methods Modeling Multicenter Studies Natural History Non-Insulin-Dependent Diabetes Mellitus OGTT Obesity Obstructive Sleep Apnea Overweight Patients Pattern Pharmaceutical Preparations Phenotype Polycystic Ovary Syndrome Population Population Heterogeneity Pregnancy Process Prospective Studies Puberty Race Recommendation Recording of previous events Registries Research Research Personnel Sampling Sex Hormone-Binding Globulin Site Symptoms Teenagers Testosterone Time United Kingdom United States Weight Woman Work Youth cohort community center comorbidity diagnostic criteria direct application ethnic difference ethnic diversity experience fasting glucose follow-up girls improved indexing insulin sensitivity metabolic phenotype non-alcoholic fatty liver non-alcoholic fatty liver disease novel therapeutics personalized approach personalized medicine personalized therapeutic predicting response psychologic racial difference racial diversity reproductive response therapeutically effective treatment response waist circumference

Acanthosis Nigricans Acne Address Adolescence Adolescent Adult Affect Alanine Transaminase Androgens Androstenedione Anovulation Anxiety Area Australia Biological Blood Pressure Body Weight Body Weight decreased Body mass index Caring Characteristics Chronic Clinical Cluster Analysis Contraceptive Agents Country Data Databases Dermatologic Development Diabetes Mellitus Diagnosis Disease Eating Disorders Estrogens Ethnic Origin Familial disease Family Fasting Future Genomics Geography Glucose Glycosylated hemoglobin A Goals Guidelines Health Heterogeneity High Density Lipoproteins High Prevalence Hirsutism Hispanic Hormones Hour Hyperandrogenism Hypergravity Hyperlipidemia Hypertension Institution Insulin Insulin Resistance International Laboratories Life Style Life Style Modification Lifestyle Therapy Luteinizing Hormone Measures Medical Menstruation Mental Depression Mental disorders Metabolic Metabolic Diseases Metformin Methods Modeling Multicenter Studies Natural History Non-Insulin-Dependent Diabetes Mellitus OGTT Obesity Obstructive Sleep Apnea Overweight Patients Pattern Pharmaceutical Preparations Phenotype Polycystic Ovary Syndrome Population Population Heterogeneity Pregnancy Process Prospective Studies Puberty Race Recommendation Recording of previous events Registries Research Research Personnel Sampling Sex Hormone-Binding Globulin Site Symptoms Teenagers Testosterone Time United Kingdom United States Weight Woman Work Youth cohort community center comorbidity diagnostic criteria direct application ethnic difference ethnic diversity experience fasting glucose follow-up girls improved indexing insulin sensitivity metabolic phenotype non-alcoholic fatty liver non-alcoholic fatty liver disease novel therapeutics personalized approach personalized medicine personalized therapeutic predicting response psychologic racial difference racial diversity reproductive response therapeutically effective treatment response waist circumference

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项目摘要

1 Polycystic ovary syndrome (PCOS), one of the most common endocrinopathies in women, presents with 2 anovulation and hyperandrogenism in adolescence. In addition to reproductive abnormalities, PCOS is 3 frequently associated with obesity and metabolic complications including diabetes, non-alcoholic fatty liver 4 disease, obstructive sleep apnea, hypertension and hyperlipidemia. Additionally, women with PCOS are more 5 likely to suffer from mental health disorders and significant dermatologic manifestations. PCOS is a chronic 6 heterogeneous familial disorder and thus symptoms, signs and co-morbidities at time of diagnosis vary. Despite 7 the high prevalence and gravity of comorbidities associated with PCOS, widely effective therapeutic options are 8 lacking. Recommended therapies for PCOS treatment in women not seeking pregnancy include estrogen 9 containing contraceptives (EC), lifestyle modification, and metformin. Recently there has been a call for more 10 individualized and personalized therapeutic approaches, however there is little biologic basis to recommend one 11 therapy over another. Further, despite the availability of these treatment options for over 40 years, research on 12 their efficacy in youth with PCOS is limited to small studies. Additionally, due to puberty specific hormone 13 changes, adolescents have lower insulin sensitivity than adults. Indeed, a number of studies have established 14 that youth with diabetes or obesity respond less to metformin than adults. Thus, data from medication trials in 15 adult women cannot be applied in youth with PCOS. 16 No mechanism is currently available in the United States to query the early natural history and response to 17 existing medications in a diverse population of youth with PCOS. Using 18 institutions, e found that reproductive abnormalities are more severe in girls without obesity, and metabolic 19 co-morbidities are more common in girls with obesity. Additionally, we and others have found that PCOS 20 presentation, especially as relates to comorbidities, may reflect underling racial and ethnic differences. The 21 overall goal of the project is to describe the presenting reproductive and metabolic phenotypes, natural history, 22 and response to therapy in a large sample of geographically, ethnically and racially diverse youth with PCOS. We 23 hypothesize that presentations of PCOS in adolescence will vary by family history, obesity, and race and ethnicity 24 status, and that unique factors at diagnosis can be used to identify those that respond to EC, metformin or 25 lifestyle therapies. SA1) Describe the presentation and co-morbidities at the time of diagnosis of PCOS in youth 26 in the United States SA2) Determine the response to common medications (lifestyle, EC, metformin). This 27 cohort represents a very diverse population of youth with PCOS, and the database is the first of its kind for youth 28 with PCOS. This work will establish how early phenotypes can inform more individualized approaches toward 29 initial therapy. These efforts are a critical first step towards developing data-informed personalized treatment 30 plans to improve the long-term health of girls with PCOS. pooled retrospective data from 6 w

1多囊卵巢综合征（PCOS）是女性最常见的内分泌病之一， 2青春期的高音和过度雄激素。除了生殖异常，PCOS是 3经常与肥胖和代谢并发症有关，包括糖尿病，非酒精脂肪肝 4疾病，阻塞性睡眠呼吸暂停，高血压和高脂血症。此外，PCOS的女性更多 5可能患有精神健康障碍和严重的皮肤病表现。 PCOS是慢性 6诊断时的异质性家族障碍，因此症状，体征和合并症各不相同。尽管 7与PCOS相关的合并症的高患病率和重力，广泛有效的治疗选择是 8缺乏。建议在不寻求怀孕的妇女中用于PCOS治疗的疗法包括雌激素 9包含避孕药（EC），生活方式修饰和二甲双胍。最近有一个呼吁 10种个性化和个性化的治疗方法，但是几乎没有生物学基础可以推荐一种 11治疗另一种治疗。此外，尽管有40多年的这些治疗选择可用，但研究 12他们在PCOS青年中的功效仅限于小型研究。另外，由于青春期特异性激素 13变化，青少年的胰岛素敏感性低于成年人。确实，已经建立了许多研究 14糖尿病或肥胖症的青年对二甲双胍的反应少于成人。因此，来自药物试验的数据 15名成年妇女不能应用于PCOS的青年。 16美国目前没有任何机制来查询早期自然历史和对 PCOS的17种现有药物中的现有药物。使用 18机构，E发现没有肥胖和代谢的女孩的生殖异常更为严重 19个合并症在肥胖女孩中更为普遍。此外，我们和其他人发现PCOS 20演讲，尤其是与合并症有关的演讲可能反映了种族和种族差异的基础。这 21该项目的总体目标是描述呈现的生殖和代谢表型，自然历史， 22和对PCOS的大量地理，种族和种族多样化的青年对治疗的反应。我们 23假设PCOS在青春期的演讲将因家族史，肥胖和种族与种族而异 24状态，诊断时的独特因素可用于识别那些对EC，二甲双胍或 25种生活方式疗法。 SA1）描述在青年人诊断PCO时的表现和合并症 26在美国SA2）确定对常见药物（生活方式，EC，二甲双胍）的反应。这 27队列代表了PCOS的年轻人，数据库是青年的第一个。 28与PCOS。这项工作将确定如何早期表型可以告知更多个性化的方法 29初始疗法。这些努力是开发数据知识的个性化处理的关键第一步 30计划改善PCOS女孩的长期健康状况。从6的汇总回顾性数据 w