rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2024-27-1-55-60yuszmurosped-534Research ArticleОБЗОРЫREVIEWSСиндром гиперандрогении у девочек-подростковSyndrome of hyperandrogenism in adolescent girlshttps://orcid.org/0000-0002-3253-4512АдамянЛейла ВладимировнаAdamyanLeila V.

Доктор мед. наук, проф., акад. РАН, гл. специалист по акушерству и гинекологии Минздрава России, каф. репродуктивной медицины и хирургии ФПДО «МГМСУ им. А.И. Евдокимова»; руководитель отделения оперативной гинекологии ФГБУ «НМИЦ АГП им. В.И. Кулакова» Минздрава России

e-mail: detskgyn@yandex.ru, endogyn@yandex.ru,

detskgyn@yandex.ruhttps://orcid.org/0000-0002-4540-6341СибирскаяЕлена ВикторовнаSibirskayaElena V.

Доктор мед. наук, проф. каф. репродуктивной медицины и хирургии ФДПО «МГМСУ им. А.И. Евдокимова», проф. каф. акушерства и гинекологии им. акад. Г.М. Савельевой ПФ «РНИМУ им. Н.И. Пирогова», гл. внештатный специалист-гинеколог детского и юношеского возраста Минздрава МО; руководитель Центра охраны репродуктивного здоровья подростков МО; зав. хирургическим гинекологическим отделением РДКБ ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»

e-mail: elsibirskaya@yandex.ru

elsibirskaya@yandex.ruhttps://orcid.org/0000-0001-8579-2227ШарковСергей МихайловичSharkovSergey M.

Доктор мед. наук, проф. каф. детской хирургии и урологии-андрологии им. проф. Л.П. Александрова Сеченовского Университета

e-mail: sharkdoc@mail.ru

sharkdoc@mail.ruhttps://orcid.org/0000-0002-6844-3321ПивазянЛаура ГоровнаPivasyanLaura G.

Ординатор 2-го года ФГБУ «НМИЦ АГиП им. В.И. Кулакова» Минздрава России

e-mail: laurapivazyan98@gmail.com

2nd year resident of the Medical Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Moscow, 117997, Russian Federation

e-mail: laurapivazyan98@gmail.com

laurapivazyan98@gmail.comhttps://orcid.org/0000-0001-8462-3894СаркисоваАнтонина ИвановнаSarkisovaAntonina I.

Ординатор 2 года ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России

e-mail: sarkisova_ai@mail.ru

sarkisova_ai@mail.ruhttps://orcid.org/0000-0002-6004-4369АнаньеваВера СергеевнаAnanevaVera S.

Студентка 6-го курса каф. акушерства и гинекологии № 1 Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России (Сеченовский Университет)

e-mail: veraan-cheb@yandex.ru

veraan-cheb@yandex.ruФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава РоссииMoscow University of Medicine and Dentistry named after A.I. Evdokimov; Medical Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; Российская детская клиническая больница ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииMoscow University of Medicine and Dentistry named after A.I. Evdokimov; Pirogov Russian National Research Medical University; Russian Children’s Clinical Hospital, Pirogov Russian National Research Medical UniversityФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)I.M. Sechenov First Moscow Medical University (Sechenov University); Morozovskaya Children’s Municipal Clinical HospitalФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава РоссииMedical Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииPirogov Russian National Research Medical UniversityФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)I.M. Sechenov First Moscow Medical University (Sechenov University)2024040420242715560Copyright © Адамян Л.В., Сибирская Е.В., Шарков С.М., Пивазян Л.Г., Саркисова А.И., Ананьева В.С., 20242024Адамян Л.В., Сибирская Е.В., Шарков С.М., Пивазян Л.Г., Саркисова А.И., Ананьева В.С.Adamyan L.V., Sibirskaya E.V., Sharkov S.M., Pivasyan L.G., Sarkisova A.I., Ananeva V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/534

Диагноз гиперандрогении (ГА) может основываться на клинических проявлениях или на определении содержания андрогенов в крови. ГА в перипубертатном периоде могут вызывать синдром поликистозных яичников (СПКЯ), неклассические формы врождённой гиперплазии коры надпочечников (ВГКН), андрогенпродуцирующие опухоли, ожирение, идиопатический гирсутизм, синдром Кушинга, экзогенные андрогены, гиперпролактинемия и другие причины. Физиологическая ГА пубертатного периода, в отличие от патологических состояний, проходит в течение 2 лет. СПКЯ поражает 4–21% женщин репродуктивного возраста и 6–18% девочек-подростков. Пока нет единых диагностических критериев СПКЯ у девочек-подростков. Для постановки диагноза необходимо наличие как минимум 3 признаков: нарушения менструального цикла, клиническая и биохимическая ГА и поликистоз яичников, а также исключение других причин ГА. Диагностика неклассических форм ВГКН включает определение концентраций 17-гидроксипрогестерона в крови и тест с адренокортикотропным гормоном. Целью лечения при ГА является регулирование менструального цикла и улучшение качества жизни девочек. Важный этап — изменение образа жизни у пациенток с СПКЯ и ожирением. Эффективными методами фармакотерапии при симптомах ГА и нарушениях менструального цикла являются комбинированные оральные контрацептивы и антиандрогены.

Участие авторов

Участие авторов:Адамян Л.В., Сибирская Е.В., Пивазян Л.Г., Шарков С.М. — концепция и дизайн исследования, редактирование;Саркисова А.И., Ананьева В.C. — сбор и обработка материала, написание текста;Адамян Л.В., Пивазян Л.Г. — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 22

Поступила 22.12.2023Принята к печати 30.01.2024Опубликована 28.02.2024

The diagnosis of hyperandrogenism may be based on clinical manifestations or on determining the blood level of androgens. Causes of hyperandrogenism in the peripubertal period are polycystic ovary syndrome (PCOS), non-classical forms of congenital adrenal hyperplasia (NCCAH), androgen-producing tumors, obesity, idiopathic hirsutism, and other rare causes. Physiological hyperandrogenism of peripubertal period passes within 2 years. PCOS affects from 4 to 21% of women of reproductive age and from 6 to 18% of adolescent girls. To date, there is no consensus on the diagnostic criteria for PCOS in teenage girls. At least, three symptoms are necessary: menstrual disorders, clinical and biochemical hyperandrogenism and polycystic ovaries. Diagnosis of NCCAH includes measurement of the level of 17-hydroxyprogesterone and a test with adrenocorticotropic hormone. The purpose of the treatment of these diseases is to reduce the manifestations of hyperandrogenism, regulate the menstrual cycle and improve the quality of life. Effective methods of pharmacotherapy are combined oral contraceptives and antiandrogens. An important stage is lifestyle changes in PCOS and obesity patients.

For correspondence

For correspondence: Laura G. Pivazyan, 

Contribution

Contribution:Adamyan L.V., Sibirskaya E.V., Pivazyan L.G., Sharkov S.M. — concept and design of the study, editing the text;Sarkisova A.I., Ananyeva V.S. — collecting and processing material, writing the text;Adamyan L.V., Pivazyan L.G. — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: December 22, 2023Accepted: January 30, 2024Published: February 28, 2024

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The authors declare that there are no conflicts of interest present.