Abstract：
UNASSIGNED: Two decades after the Rotterdam 2003 consensus workshop, there have been considerable advances in elucidating the pathophysiology and epidemiology of polycystic ovary syndrome (PCOS). This has prompted the re-examination of the features that characterise this common condition. Current definitions have led to great heterogeneity in the prevalence of PCOS and have contributed to inconsistent treatment protocols and assessment of therapeutic outcomes. Diagnosis is further complicated by the lack of universal agreement on threshold cut-offs for ovarian dysfunction and ethnic differences in hirsutism; both of which are key features in the definitions that are commonly used currently. These challenges often result in dissatisfaction with medical care among PCOS patients and their physicians.
UNASSIGNED: Our factor analysis mathematically identified anti-Mullerian hormone (AMH), associated polycystic ovarian morphology (PCOM) and serum testosterone as the only significant cluster associated with menstrual cycle length variability.
UNASSIGNED: As such, we propose a simplified criteria wherein the presence of at least 2 of the 3 features below would be sufficient to define PCOS: (1) chronic oligo-ovulation or anovulation as indicated by oligomenorrhea (cycle lengths >35 days) or amenorrhea; (2) PCOM: raised AMH ≥37.0 pmol/L instead of transvaginal ultrasound assessment of ovaries; and (3) Androgen excess, or raised serum androgens above the laboratory reference for women. Further studies are required to examine whether the proposed criteria would reduce diagnostic confusion and improve care and outcomes, especially among patients of East Asian ethnicities.
UNASSIGNED: Our factor analysis mathematically identified anti-Mullerian hormone (AMH), associated polycystic ovarian morphology (PCOM) and serum testosterone as the only significant cluster associated with menstrual cycle length variability.
UNASSIGNED: As such, we propose a simplified criteria wherein the presence of at least 2 of the 3 features below would be sufficient to define PCOS: (1) chronic oligo-ovulation or anovulation as indicated by oligomenorrhea (cycle lengths >35 days) or amenorrhea; (2) PCOM: raised AMH ≥37.0 pmol/L instead of transvaginal ultrasound assessment of ovaries; and (3) Androgen excess, or raised serum androgens above the laboratory reference for women. Further studies are required to examine whether the proposed criteria would reduce diagnostic confusion and improve care and outcomes, especially among patients of East Asian ethnicities.
摘要：
■鹿特丹2003年共识研讨会二十年后，在阐明多囊卵巢综合征(PCOS)的病理生理学和流行病学方面取得了相当大的进展.这促使人们重新审视表征这种常见状况的特征。目前的定义导致PCOS患病率的巨大异质性，并导致治疗方案和治疗结果的评估不一致。由于对卵巢功能障碍的阈值截止值和多毛症的种族差异缺乏普遍共识，诊断变得更加复杂。这两者都是当前常用定义中的关键特征。这些挑战通常导致PCOS患者及其医生对医疗护理的不满。
■我们的因子分析在数学上确定了抗苗勒管激素（AMH），相关的多囊卵巢形态（PCOM）和血清睾酮是唯一与月经周期长度变异性相关的显着簇。
■因此，我们提出了一个简化的标准，其中至少存在以下3个特征中的2个足以定义PCOS：（1）月经少发（周期长度>35天）或闭经表明的慢性排卵或无排卵；（2）PCOM：提高AMH≥37.0pmol/L，而不是经阴道超声评估卵巢；（3）雄激素过量，或提高血清雄激素高于女性的实验室参考。需要进一步的研究，以检查拟议的标准是否会减少诊断混乱，改善护理和结果，尤其是东亚种族的患者。
■我们的因子分析在数学上确定了抗苗勒管激素（AMH），相关的多囊卵巢形态（PCOM）和血清睾酮是唯一与月经周期长度变异性相关的显着簇。
■因此，我们提出了一个简化的标准，其中至少存在以下3个特征中的2个足以定义PCOS：（1）月经少发（周期长度>35天）或闭经表明的慢性排卵或无排卵；（2）PCOM：提高AMH≥37.0pmol/L，而不是经阴道超声评估卵巢；（3）雄激素过量，或提高血清雄激素高于女性的实验室参考。需要进一步的研究，以检查拟议的标准是否会减少诊断混乱，改善护理和结果，尤其是东亚种族的患者。
