PCOS会影响子代儿童期的代谢特征吗？

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Study question

研究问题

Does polycystic ovary syndrome (PCOS) affect the metabolic characteristics of offspring in childhood?

多囊卵巢综合征（PCOS）会影响子代儿童期的代谢特征吗？

Summary answer

概括结论

Girls born to PCOS mothers had increased cholesterol (CHOL) and low-density lipoprotein cholesterol (LDL) levels, whereas boys had comparable CHOL and LDL levels to controls.

PCOS母亲所生子代中女孩胆固醇（CHOL）和低密度脂蛋白（LDL）水平升高，而男孩的CHOL和LDL水平与对照组相当。

What is known already

已知结论

Maternal PCOS status may negatively influence childhood growth, endocrine and metabolic function. The long-term impact of PCOS on children health is poorly understood. Current findings reported by previous studies are divergent. Propensity score matching can reduce bias where strong confounding by indication is expected.

母体多囊卵巢综合征状态可能对后代生长、内分泌和代谢功能产生负面影响。人们关于PCOS对儿童健康的长期影响知之甚少。既往研究得出的结论存在分歧。倾向性评分匹配可以减少混杂变量引起的较大混淆偏差。

Study design, size, duration

研究设计、规模、持续时间

This was a cohort study including 223 singletons born to women with PCOS and 2326 singletons born to non-PCOS women. All offspring were conceived by in-vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) from January 2001 to January 2018 in reproductive center of Women’s hospital, Zhejiang University, School of medicine. Growth and development parameters and metabolic parameters were collected at age 3-6 years in Follow-up center of Women’s hospital, Zhejiang University, School of medicine.

这是一项队列研究，包括223名PCOS女性所生的单胎和2326名非PCOS女性所生单胎。所有后代均由2001年1月至2018年1月在浙江大学医学院妇女医院生殖中心通过体外受精（IVF）或卵浆内单精子注射（ICSI）受孕的女性所生。在浙江大学医学院妇女医院随访中心收集这些后代3-6岁的生长发育参数和代谢参数。

Participants/materials, setting, methods

参与者/材料、设置、方法

We used the propensity score (PS) to match PCOS women and non-PCOS women in a 1:4 ratio. The variables in the PSM included maternal age at conception, paternal age at conception, maternal height, maternal preconception BMI, IVF or ICSI, fresh-embryo transfer (ET) or frozen-embryo transfer (FET), gender of offspring, age at follow-up, year of follow-up. The PCOS group consisted of 217 patients and the non-PCOS group consisted of 787 patients after PS matching.

我们使用倾向评分（PS）以1:4的比例匹配PCOS妇女和非PCOS妇女。PSM的变量包括母亲年龄、父亲年龄、母亲身高、母亲孕前体质量指数（BMI）、IVF或ICSI、新鲜胚胎移植（ET）或冷冻胚胎移植（FET）、后代性别、随访年龄、随访年份。通过PS匹配后PCOS组由217名患者组成，非PCOS组由787名患者组成。

Main results and the role of chance

主要结果及其意义

Maternal preconception weight (58.3±0.6 vs. 56.0±0.2, P<0.001) and body mass index (BMI) (23.0±0.2 vs. 21.9±0.1, P<0.001) were significantly higher in mothers with PCOS before PS matching. After PS matching, parental demographic characteristics were similar between groups including maternal preconception weight and BMI. In PS matching cohort, the height, weight, BMI of children at age 3-6 years were comparable between PCOS group and non-PCOS group. Singletons born to PCOS women had significantly higher CHOL levels (4.43±0.05 vs. 4.29±0.01, P=0.013) and LDL levels (2.45±0.04 vs. 2.37±0.01, P=0.049) compared with non-PCOS group. Even though the girls had similar BMI in childhood between the two groups(15.26±0.15 vs.15.13±0.80, P=0.449), the girls born to PCOS women still exhibited elevated CHOL levels (4.52±0.08 vs. 4.33±0.04, P=0.024) and LDL levels (2.55±0.06 vs. 2.39±0.03, P=0.007). These differences in CHOL (4.34±0.07 vs. 4.26±0.04, P=0.196) and LDL levels (2.36±0.05 vs. 2.36±0.03, P=0.866) were not observed in male offspring between the two groups.

在PS匹配前，患有PCOS的母亲的孕前体重（58.3±0.6 vs.56.0±0.2，P<0.001）和BMI（23.0±0.2 vs.21.9±0.1，P＜0.001）显著较高。PS匹配后，父母的人口学特征在各组之间相似，包括母亲的孕前体重和BMI。在PS匹配队列中，3-6岁儿童的身高、体重、BMI在PCOS组和非PCOS组之间具有可比性。与非PCOS组相比，PCOS妇女所生单胎的CHOL水平（4.43±0.05 vs.4.29±0.01，P＝0.013）和LDL水平（2.45±0.04 vs.2.37±0.01，P＝0.049）显著较高。尽管两组女孩在儿童时期的BMI相似（15.26±0.15 vs.15.13±0.80，P＝0.449），但PCOS妇女所生的女孩仍然表现出CHOL（4.52±0.08 vs.4.33±0.04，P＝0.024）和LDL水平升高（2.55±0.06 vs.2.39±0.03，P＝0.007）。在两组的男性子代中CHOL（4.34±0.07vs.4.26±0.04，P＝0.196）和LDL（2.36±0.05 vs.2.36±0.03，P＝0.866）的水平并未观察出差异。

Limitations, reasons for caution

局限性，需要注意的地方

Mothers’ weight gain during pregnancy, offspring lifestyle were not available for this study. This was a study carried out in a single center and was therefore susceptible to bias. Further studies remain necessary to fully confirm these results.

本研究未提供母亲在怀孕期间的体重增加情况以及后代的生活方式。这是一项在单一中心进行的研究，因此容易产生偏倚。仍有必要进行进一步的研究以充分证实这些结果。

Wider implications of the findings

研究结果的更广泛含义

Our results support CHOL and LDL lipid metabolism as two of the earliest metabolic abnormalities features of the female offspring born to PCOS women. These findings suggest that further studies are needed to investigate the potential mechanisms and long-term metabolic changes associated with these differences.

我们的研究结果支持CHOL和LDL脂质代谢是PCOS妇女所生女性子代最早的两种代谢异常特征。这些发现表明，需要进一步的研究来探索与这些差异相关的潜在机制和长期代谢变化。

文章来源：

M Tang, Y Zhu, O-013 Metabolic characteristics of offspring born to women with polycystic ovary syndrome in childhood, Human Reproduction, Volume 38, Issue Supplement_1, June 2023, dead093.013, https://doi.org/10.1093/humrep/dead093.013