控制体重对PCOS合并胰岛素抵抗患者治疗效果的影响

Effect of weight control on the therapeutic effect of patients with PCOS combined with insulin resistance

目的:探讨肥胖与非肥胖的PCOS合并胰岛素抵抗的患者内分泌指标差异及治疗效果的差异以及治疗后体重下降对内分泌指标改善的影响。方法:118例合并胰岛素抵抗的PCOS患者按照体重指数分为非肥胖组72例、肥胖组46例和按照治疗后体重指数的下降分为BMI下降<2、BMI下降≥2组各59例,观察其治疗前后内分泌指标及其改善情况。结果:PCOS合并胰岛素抵抗患者肥胖组LH、T、TG、LDL、Fins、HOMA-IR明显高于非肥胖组,差异均有统计学意义(P<0.01),FSH两组差异无统计学意义(P>0.05);治疗后肥胖组与非肥胖组LH、T、TG、LDL、Fins、HOMA-IR的变化无明显差异(P>0.05);治疗后BMI下降≥2组较BMI下降<2组LH、T、TG、LDL、Fins、HOMA-IR下降更明显,差异有统计学意义(P<0.01)。结论:PCOS合并胰岛素抵抗患者肥胖较非肥胖者存在更为明显的内分泌及代谢异常,但初诊时体重指数对治疗效果无影响;治疗后体重下降的程度对PCOS合并胰岛素抵抗的患者内分泌及代谢指标改善有影响。

Objective： To explore the differences of endocrine indexes and therapeutic effects between obese patients with polycystie ovary syndrome （PCOS） combined with insulin resistance and non- obese patients with PCOS combined with insulin resistance, and study the effect of weight loss after treatment on the improvement of endocrine indexes. Methods： 118 patients with PCOS combined with insulin resistance were divided into non -obesity group （72 patients） and obesity group （46 patients） according to body mass index （BMI）, BMI falling level 〈2 group （59 patients） and BMI falling level ≥2 group （59 patients） according to the falling level of BMI after treatment; the endocrine indexes before and after treatment and improvement after treatment were observed. Results： The levels of LH, T, TG, LDL, Fins, HOMA - IR in obesity group were significantly higher than those in non - obesity group （ P 〈 0. 01 ）, there was no significant difference in the level of FSH （ P 〉 0. 05 ） . After treatment, the falling levels of LH, T, TG, LDL, Fins and HOMA - IR in BMI failing level ≥ 2 group were significantly higher than those in BMI failing level 〈 2 group （ P 〈 0.01 ） . Conclusion： Compared with non - obese patients, the obese patients with PCOS combined with insulin resistance have more apparent endocrine abnormality and metabolic disturbance, but BMI has no impact on therapeutic effect during the first visit; after treatment, the failing degree of body weight improves the endocrine and metabolic indexes of patients with PCOS combined with insulin resistance.