Daughters of polycystic ovary syndrome pregnancies and androgen levels in puberty: a Meta-analysis

Abstract

Purpose: To provide an overview and critical analysis of the literature related to the circulating androgen levels of daughters of PCOS mothers during prepubertal and pubertal stage who have not yet been diagnosed with PCOS or precocious puberty. Methods: We critically considered and meta-analyzed observational studies comparing androgens concentration in daughters of PCOS mothers compared to daughters of mothers without PCOS. A literature search was conducted in MEDLINE, Scopus and other sources from 01/09/2021 until 01/12/2021. The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The primary outcome included total testosterone levels whereas the secondary outcomes included 17a-hydroxyprogesterone (17-OHP), androstenedione (Δ4Α) and Sex Hormone Binding Globulin (SHBG) levels respectively. Results: Our search yielded 1073 studies, 9 of which were included in our analysis. The results are presented differently according to pubertal stage. Pubertal daughters of PCOS mothers exhibited significantly higher total testosterone (pooled mean difference 14.95 (95%CI: 6.98 to 22.93), higher 17-OHP (pooled mean difference 0.11 (95%CI: 0.02 to 0.20) and lower SHBG levels (pooled mean difference −10.48 (95%CI: −16.46 to −4.61). Instead, prepubertal daughters of PCOS mothers presented greater SHBG levels (pooled mean difference 7.79 (95%CI: 0.03 to 15.54) compared to controls. No difference was found in Δ4Α levels in both groups. Conclusion: The onset of puberty is a critical point in the development of the disease and an early intervention may be imperative.

摘要

目的:对未被诊断为多囊卵巢综合征(PCOS)或性早熟的多囊卵巢综合征(PCOS)母亲的女儿关于在青春期前和青春期阶段循环中雄激素水平的相关文献进行综述和严格分析。方法:我们对比较了PCOS母亲的女儿与无PCOS母亲的女儿雄激素浓度的观察性研究进行了审慎考量和Meta分析。在MEDLINE、Scopus和其他来源数据库进行文献检索, 检索时限为2021年9月1日至2021年12月1日。该研究遵循了系统综述和荟萃分析优先报告的条目(PRISMA), 主要结果包括总睾酮水平, 次要结果分别包括17a-羟孕酮(17-OHP)、雄烯二酮(Δ4Α)和性激素结合球蛋白(SHBG)水平。结果:我们检索出了1073篇文献, 其中9篇纳入了我们的分析。随青春期阶段的不同结果表现不同, 处于青春期的PCOS母亲的女儿表现出更高水平的总睾酮(合并的均数差为14.95, 95%置信区间：6.98至22.93), 以及更高水平的17-OHP (合并的均数差为0.11, 95%置信区间：0.02至0.20), 和较低水平的SHBG(合并的均数差为-10.48, 95%置信区间：−16.46至−4.61)。相反, 与对照组相比, 处于青春期前的PCOS母亲的女儿表现出更高水平的SHBG(合并的均数差为7.79, 95%置信区间：0.03至15.54)。两组的Δ4Α水平无差异。结论:青春期的发动是本病发展的关键点, 早期干预可能是必要的。

Keywords:

• PCOS
• daughters
• androgens
• testosterone
• puberty
• prepuberty
• meta-analysis

关键词:

• 多囊卵巢综合征
• 女儿
• 雄激素
• 睾酮
• 青春期
• 青春期前期
• Meta分析

Acknowledgements

O.V is a student of the MSc program “Research in Female Reproduction” and this study was conducted for his master’s thesis project.

Ethics statement

This article is based on previously conducted studies and does not contain any studies with human subjects or animals performed by the authors.

Author contributions

Conceptualization, O.V. and G.V.; formal analysis, C.C.; methodology, O.V. and C.C.; investigation, O.V. and G.V.; writing—original draft preparation, O.V. and G.V.; writing—review and editing, O.V, G.V. I.L., G.M., O.T., and M.E.; visualization, O.V.; supervision NF.V. All authors have read and agreed to the published version of the manuscript

Disclosure statement

The authors declare that they have no competing interests.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Appendices

The following supporting information is additional to the main text Table S1: Summary of critical appraisal of included studies using the Newcastle–Ottawa Quality Assessment Scale.

Data availability statement

The data sets generated and analyzed for this review are available upon reasonable request to the authors.