多囊卵巢综合征患者糖耐量异常及相关因素分析

Abnormal glucose tolerance in women with polycystic ovary syndrome and the associated risk factors

目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者糖耐量受损(IGT)和2型糖尿病(NIDDM)的发生率及其高危因素。方法:回顾分析101例PCOS患者口服葡萄糖耐量(OGTT)实验后的临床资料,多因素logistic回归分析探讨PCOS患者糖耐量异常的危险因素。结果:(1)根据葡萄糖耐量实验结果分成糖耐量正常组(NGT)77例与糖耐量异常组(AGT)24例(IGT22例、NIDDM2例),IGT发生率21.8%,NIDDM发生率1.98%;(2)AGT组的年龄、腰臀比(WHR)、体重指数(BMI)、睾酮(T)、空腹血糖(FPG)、2h血糖增高,与NGT组的差异有统计学意义(P<0.05),空腹胰岛素(FINS)、2h胰岛素、稳态模式胰岛素抵抗指数(HOMA-IR)升高,差异有统计学意义(P<0.01)。初潮年龄、黄体生成素/卵泡刺激素(LH/FSH)两组差异无统计学意义(P>0.05);(3)AGT组糖尿病家族史发生率高于NGT组,差异有统计学意义(P<0.01);(4)多因素logistic回归分析显示,年龄、BMI、2型糖尿病家族史、空腹胰岛素升高为PCOS糖耐量异常的高危因素。结论:多囊卵巢综合征发生糖耐量受损、糖尿病的危险性增加,葡萄糖耐量2h血糖水平是监测PCOS糖耐量异常的较好指标。年龄、BMI、2型糖尿病家族史、空腹胰岛素升高是PCOS糖耐量异常发生的危险因素。

Objective：To explore the prevalence of impaired glucose tolerance （IGT） and non-insulin dependent diabetes mellitus （NIDDM） in women with polycystic ovary syndrome （PCOS） and to identify associated risk factors within this population. Methods：Retrospective study was performed in 101 women with PCOS and clinical data were analysed alter oral glucose tolerance tests to identify risk factors for abnormal glucose tolerance（AGT） by using muhivariate lo-gistic regression. Results ：Based on the criteria for IGT and NIDDM, PCOS women were divided into two groups ：77 cases with normal glucose tolerance（NGT） and 24 cases with abnormal glucose tolerance（ IGT and NIDDM）. The prevalence for IGT was 21.8% and that of NIDDM was 1.98%. The mean age, body mass index （ BMI）, waist hip ratio （ WHR）, total testosterone, fasting plasma glucose,2h plasma glucose level were significantly different between AGT and NGT group （P 〈0.05）. Fasting insulin,2h insulin,homeostasis model assessment of insulin resistance （HOMAIR） were significantly higher in AGT group（P 〈0.01 ）. Menarche age and LH/FSH ratio made no difference between the two groups （P 〉 0.05 ）. The incidence of a family history of diabetes was higher in AGT patients （P 〈 0.01 ）. Multivariate logistic regression showed that age, BMI,a family history of diabetes, fasting insulin levels were independent risk factors for AGT. Conclusion ：Women with PCOS are at increased risks for abnormal glucose metabolism. 2h plasma glucose level after oral glucose toerance test is a significant predictor for abnormal glucose tol-erance in women with PCOS. Age, BMI, a family history of diabetes, fasting insulin levels are independent risk factors for abnormal glucose tolerance.