多囊卵巢综合征可控危险因素研究

The prevalence of polycystic ovarian syndrome (PCOS) is relatively high. As a common endocrine and metabolic disorder, the adverse effect of PCOS on female is more than reporductive system and involve multiple internal disorders. Due to the unclear pathogeny, patients can't be cured completely by current therapy. If we could find its risk factors and control them, we might decrease its prevelence. This is more economical and effective compare to treatment. Generally speaking, risk factors for metabolic diseases containing nurition, excercise and environmental endocrine disruptors (EEDs). So we hypothesised that those risk factors might also be related to PCOS, while they are not investigated systematically In this study, probability proportionate size sampling (PPS) method will be used to investigate the prevalance of PCOS; a food frequency questionnaire will be validated and used for the target population diet intake, an international physical activity questionnaires which has been validated in our early study will be used to measure physical activity; a new sensitive and simple method of detecting several kinds of EEDs at same time will be established and used to measuring EEDSs in blood samples of participants. Risk factors will be screened by analysing above results and stratigy of PCOS prevention will be estabolished.

多囊卵巢综合征（PCOS）患病率较高，对女性影响远超出妇产科范畴，是一种全身代谢性疾病，且增加多种内科疾病风险。目前病因不清，治疗以对症为主难以解决根本问题。如从预防角度进行研究、发现其可调控的危险因素，并进行干预以降低发病率，效果将远较治疗可靠经济，对人群健康更有意义。通常认为代谢性疾病的可调控危险因素主要包括饮食、运动、环境等，因此我们假设PCOS的危险因素也可能与这些有关，但目前未见系统报道。本研究拟采用人群为基础的分层多阶段概率比例抽样（PPS）法对女性发病状况进行调查；选择符合研究地区饮食特点的问卷对其进行信度效度评价，使用前期经信度效度评估的体力活动问卷，并建立同时检测血清多种环境内分泌干扰物（EEDs）的方法，对人群饮食、体力活动及EEDs等可控因素与PCOS的关系进行多方位研究；获得各年龄段PCOS患病特征，并筛选出该病可调控危险因素，为下一步干预提供科学可靠可行的依据。

多囊卵巢综合征（PCOS）是一种常见的复杂的、异质性的青春期和育龄期妇女内分泌代谢性疾病，危害大，但病因不清，多认为遗传和环境因素协同作用影响PCOS的发生，确切的人群患病率和环境危险因素不明。为了解我国PCOS发病的基本状况，明确环境可控危险因素，降低其患病风险，提高我国女性人群的身体素质，减轻该病的社会经济负担，本项目以社区人群为基础，对人群PCOS的患病情况以及可能的危险因素进行流行病学调查。本研究发现：PCOS的人群患病率（鹿特丹标准）为7.1%，患病高峰年龄是15-24岁，此后患病率随年龄的增加逐渐降低；膳食因素中，总能量摄入过高，脂肪摄入过高以及碳水化合物摄入较低增加PCOS的患病风险，不当的饮食习惯与PCOS之间存在关联。此外，饮酒、食用带皮水果以及使用塑料包装食品增加PCOS的患病风险；长时间静坐、高BMI及每天能量摄入大于消耗量是PCOS患病的危险因素，而家务相关体力活动是PCOS的保护性因素；PCOS患者PAEs总含量及多个亚组物质（DMP、DEP、DBP、BBP、DNO）均明显高于对照组，接触塑料制品是PCOS的独立危险因素；多因素分析提示：EEDs的暴露与PCOS患病有关，血清高水平的EEDs是PCOS发生的危险因素。本研究的结果说明不当的饮食和运动等生活方式增加PCOS的患病风险，为PCOS的临床预防和控制提供了理论基础。