伴或不伴非酒精性脂肪肝对多囊卵巢综合征患者代谢指标的影响

Effect of polycystic ovary syndrome with or without nonalcoholic fatty liver disease on the metabolism parameters

目的:分析伴或不伴非酒精性脂肪肝(NAFLD)对多囊卵巢综合征(PCOS)患者代谢指标的影响。方法:测定PCOS伴NAFLD组(PCOS1组27例)和PCOS不伴NAFLD组(PCOS2组23例)的体质指数(BMI)、腰臀比(WHR)、血压(BP)、尿酸(UA)、丙氨酸氨基转移酶(ALT)、皮质醇(F)、黄体生成素(LH)、卵泡刺激素(FSH)、催乳素(PRL)、睾酮(T)、雌二醇(E2)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、脂蛋白a[LP(a)]、空腹血糖(FBG)、空腹胰岛素(FINS)和瘦素(LEP)水平,计算胰岛素抵抗指数(HOMA-IR)。结果:PCOS2组ALT、BMI和WHR低于PCOS1组(P<0.01)。PCOS2组TG、Lp(a)、FINS、LEP水平低于PCOS1组(P<0.05)。PCOS2组F、HDL-C高于PCOS1组(P<0.05)。PCOS1组HOMA-IR与LEP、BMI、Lp(a)呈正相关趋势。PCOS2组HOMA-IR与T呈正相关趋势。结论:PCOS伴NAFLD患者代谢异常以胰岛素抵抗、血脂异常为主要特征;PCOS不伴NAFLD患者以T升高为主要特征。PCOS、NAFLD两种疾病在临床上存在相关性,对伴或不伴NAFLD的PCOS患者在干预和治疗上应采用不同手段。

Objective：To investigate the endocrine and metabolic differences between polycystic ovary syndrome （PCOS） with nonalcoholic fatty liver disease（NAFLD） and without NAFLD.Methods：Body mass index（BMI）,waist-to-hip ratio（WHR）,blood pressure （BP）,uric acid （UA）,alanine transaminase （ALT）,cortiso1 （F）,follicle stimulating hormone （FSH）,prolactin （PRL）,testosterone（T）,estradiol（E2）,luteinizing hormone（LH）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein-cholesterol（LDL-C）,high density lipoprotein-cholesterol（HDL-C）,lipoprotein a[LP（a）],fasting blood glucose（FBG）,fasting serum insulin（FINS） and leptin（LEP） levels were measured in PCOS with NAFLD group（PCOS1 group,total number is 27） and PCOS without NAFLD （PCOS2 group,total number is 23）.The HOMA-IR was measured too.Results：BMI,WHR,ALT,TG,LP （a）,FINS,LEP were lower while HDL-C,F were higher in PCOS2 group than those in PCOS1 group （P 0.05）.HOMA-IR was positively correlated to LEP,BMI,Lp（a） in PCOS1 group,whereas HOMA-IR was positively correlated to T in PCOS2 group.Conclusion：Insulin resistance and dyslipidemia were more frequently observed in PCOS with NAFLD,while PCOS without NAFLD was demonstrated with higher T level.It is definitely that there are a clinical association between PCOS and NAFLD.The intervention and treatment of PCOS should be adopted differently between PCOS with NAFLD and PCOS without NAFLD patients.