胰岛素抵抗和非胰岛素抵抗多囊卵巢综合征患者的临床特征

Clinical characteristics of polycystic ovary syndrome with and without insulin resistance

目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗患者的临床特征。方法选择临床诊断为PCOS,同时葡萄糖负荷60、120min血胰岛素≥160mU/L的患者33例为胰岛素抵抗组,选择胰岛素及糖负荷后60、120min血胰岛素正常的PCOS患者130例作为对照组。对比两组患者早卵泡期或闭经状态下各项性激素、体重指数、各个时点的血糖水平以及葡萄糖曲线下面积。结果①胰岛素抵抗组的睾酮和体重指数水平比对照组高(P<0.05),而黄体生成素水平比对照组低(P<0.05);②糖负荷后各时点的血糖以及葡萄糖曲线下面积,胰岛素抵抗组均高于对照组(P<0.05)。结论两组PCOS患者性激素有不同改变,胰岛素抵抗者以睾酮升高为主,而非胰岛素抵抗患者则以黄体生成素升高为主要变化,肥胖可能是胰岛素抵抗的一个原因,胰岛素抵抗更容易出现糖耐量的异常。

Objective To investigate the clinical characteristics of polycystic ovary syndrome （PCOS） with insulin resistance. Methods Insulin resistant group was consisted of 33 PCOS patients whose serum insulin level after glucose loading at 60 minutes or 120 minutes were more than 160 mU/L,and non-insulin resistant group was composed of 130 PCOS patients whose serum insulin level after glucose loading at 60 minutes or 120 minutes were normal. The sex hormone, body weight index （BMI ） , blood glucose and the area under glucose curve at the stage of follicle and menopausal period were compared in both groups. Results Testosteone and BMI in the insulin resistant group was significantly higher than those in the control group （ P 〈 0.05 ） , while luteinizing hormone level was lower in the insulin resistant group than those in the control group（ P 〈 0.05 ）. Blood glucose after glucose load and the area under glucose curve were higher in the insulin resistant group than those in the control group （ P 〈 0.05 ）. Conclusion There are significant differences in the levels of sexual hormones between PCOS patients with and without insulin resistance. In insulin resistance group the elevated testosteone level is significant while the luteinizing hormone is the main change in non-insulin resistance group. Obesity may be one of the main reasons for insulin resistant PCOS. It is easier for the patients suffering from abnormal glucose tolerance.