多囊卵巢综合征与代谢综合征关系的研究

Investigation between polycystic ovary syndrome and metabolic syndrome

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)、胰岛素抵抗及代谢综合征(metabolicsyndrome,MS)的关系。方法临床收集101例PCOS患者的血糖、胰岛素、血脂、性激素等指标,按稳态模型(HOMA)计算胰岛素抵抗指数(HOMA-IR),依照4个不同的标准美国国家胆固醇教育计划成人治疗方案第三次报告(ATPⅢ)(2005年)、国际糖尿病联盟(IDF)(2005年)、中华医学会糖尿病学分会(CDS)(2004年)和《中国成人血脂异常防治指南》制定联合委员会(JCDCG)(2007年),计算PCOS患者中MS的发生率。并将患者分为PCOS伴MS和PCOS不伴MS两组就相关指标进行比较。结果①根据ATPⅢ(2005)I、DF(2005)、CDS(2004)、JCDCG(2007)MS诊断标准,PCOS中MS的发病率分别为45.5%、43.6%、31.7%、32.7%。②PCOS伴MS和PCOS不伴MS的患者临床指标的比较:在年龄、腰围、腰臀比(WHR)、收缩压、空腹血糖(FBG)、胰岛分泌指数(HOMA-β)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、黄体激素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)、泌乳素(PRL)方面,两组差异无统计学意义;在体质量指数(BMI)、舒张压、餐后2小时血糖(PBG)、空腹胰岛素、餐后2小时胰岛素、甘油三酯(TG)、血尿酸方面,PCOS伴MS较PCOS不伴MS显著升高,在HOMA-IR则显著降低,差异有统计学意义。结论按照MS的4个定义ATPⅢ(2005)I、DF(2005)、CDS(2004)J、CDCG(2007)标准,PCOS患者中均有较高的MS的患病率。PCOS伴MS患者存在较明显的胰岛素抵抗,肥胖尤其是腹型肥胖与MS、胰岛素抵抗密切相关。

Objective To investigate the polycystic ovary syndrome（PCOS）,insulin resistance and metabolic syndrome（MS） relationship. Methods Clinical collections were conducted for 101 cases of PCOS patients with blood glucose,insulin,blood lipids, sex hormones and other indicators. Homeostasis model（HOMA） insulin resistance index （HOMA-IR） was calculated. According to four different standards-ATP Ⅲ（ 2005 ）, IDF （ 2005 ）, CDS （ 2004）, JCDCG （2007）,incidence of MS in PCOS patients was calculated. Patients were divided into PCOS with MS and PCOS not accompanied by MS to compare their relevant indicators. Results ①According to the ATP m （2005） ,IDF（2005） ,CDS （2004）,JCDCG （2007） MS diagnostic criteria, the incidence rates of MS in PCOS were 45.5%, 43.6%, 31.7%, 32.7%. OThe comparison of two clinical indicators： in age, waist circumference, WHR, systolic blood pressure, fast blood glucose, H OMA-β, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, luteotrophic hormone, follicle-stimulating hormone, estradiol, testosterone, prolactin were no significant difference between the two groups. In the BMI, diastolic blood pressure, postprandial blood sugar, fast insulin, 2 h insulin, triglycerides,blood uric acid, PCOS with MS was significantly higher, while HOMA-IR was significantly reduced. Conclusion In accordance with the definition of MS-ATP Ⅲ （2005） ,IDF（2005） ,CDS（2004） ,JCDCG（2007） standard, PCOS patients have a higher prevalence of MS. PCOS patients with MS present obvious insulin resistance, obesity, especially abdominal obesity,which are closely related to MS and insulin resistance.