多囊卵巢综合征的胰岛素抵抗特征及相关因素分析

Features of insulin resistance and its relative factors of polycystic ovarian syndrome

目的探讨多囊卵巢综合征与胰岛素抵抗的特点及其相关影响。方法对48名多囊卵巢综合征患者与20名健康女性进行比较研究。按体重指数分为Ⅰ组(正常非肥胖组),Ⅱ组(正常肥胖组),Ⅲ组(综合征非肥胖组),Ⅳ组(综合征肥胖组)。比较体重指数、腰臀围比、OGTT试验及胰岛素释放,血脂、血压、肝功、肾功、稳态模型胰岛素抵抗指数。结果空腹胰岛素值、稳态模型胰岛素抵抗指数Ⅲ组与Ⅰ、Ⅳ组,Ⅳ组与Ⅱ组间比较差异均有显著性(P<0．05);空腹血糖、收缩压、TG、TC值Ⅲ组与Ⅳ组间比较差异有显著性(P<0．05);LDL、HDL值各组间比较差异均无显著性(P>0．05)。稳态模型胰岛素抵抗指数与体重指数、腰臀围比、空腹胰岛素值均呈显著正相关(P<0．01)。结论胰岛素抵抗是多囊卵巢综合征患者代谢异常的基本特征,肥胖是引起胰岛素抵抗、多囊卵巢综合征的危险因素之一。

Objective To explore the features of insulin resistance（IR） and its relative factors of polycystic ovarian syndrome（PCOS）. Methods 48 patients with PCOS were compared with 20 healthy women. According to body mass index（BMI）, they were divided into. group Ⅰ（normal non-fatty group）, group Ⅱ normal fatty group）, group Ⅲ（non-fatty patient＇s group） and group Ⅳ （fatty patient＇s group）. Comparisons were conducted in the BMI, waist/hip ratio（WHR）, OGTT test and insulin release, blood-lipld, blood pressure, liver function, renal function and index of stable IR. Results There were significant differences in fasting insulin level and index of stable IR between group Ⅲ and Ⅰ or Ⅳ , so were there Ⅳ and Ⅱ（P〈0.05）, in fasting blood sugar, systolic pressure, triacy lglyeeroc and cholesterol between Ⅲ and Ⅳ（P〈0.05） and no in low density lopoprotein and high density lopoprotein among the 4 groups（P〉0.05）. The index of stable IR was obviously and positively related to the BMI, WHR and fasting insulin level（P〈0. 01）. Conclusion Insulin resistance is basic feature of abnormal metabolism of poiycystic ovarian syndrome , and obesity is one of risk factors causing insulin resistance and polycystic ovarian syndrome.