多囊卵巢综合征患者肥胖和高雄激素血症与胰岛素抵抗的相关性

Association of obesity and hyperandrogenemia with insulin resistance in women with polycystic ovary syndrome

收集多囊卵巢综合征（PCOS）患者101例，招募30名正常健康志愿者。根据血清雄激素水平及稳态模型评估的胰岛素抵抗指数（HOMA—IR）水平分层分析肥胖、高雄激素和胰岛素抵抗的关系。结果显示，101例PCOS患者中39．8％患者体重正常，24．5％超重，35．7％肥胖。将PCOS患者分为正常雄激素组（睾酮〈0．51μg／L）和高雄激素组（睾酮≥0．51μg/L），两组体重指数（BMI）、空腹血糖（FPG）、甘油三酯（TG）、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）及HOMA—IR均无统计学差异。将PCOS患者分为非胰岛素抵抗组（HOMA—IR〈2．29）和胰岛素抵抗组（HOMA—IR≥2．29），两组血清睾酮水平无统计学差异，胰岛素抵抗组的BMI、FPG、TG、TC、LDL-C明显高于非胰岛素抵抗组（P〈0．05或P〈0．01），HDL．C明显低于非胰岛素抵抗组（P〈0．01）。HOMA—IR与BMI显著相关（P〈0．01），而与血清睾酮水平无显著相关性，提示PCOS患者体重增加与HOMA—IR的相关性独立于血清睾酮水平。

Thirty healthy women and 101 patients with polycystic ovary syndrome （PCOS） were recruited. According to serum testosterone （T） level and homeostasis model assessment for insulin resistance （HOMA-IR）, the correlation of T and body mass index （BMI） with insulin resistance was analyzed. The results showed that there were 39. 8% normal,24. 5% overweight, and 35.7% obese among 101 PCOS patients. However, there were no significantly differences in BMI, fasting plasma glucose （ FPG）, triglyceride （ TG）, total cholesterol （ TC）, low-density lipoprotein-cholesterol（ LDL-C）, high-density lipoprotein-cholesterol （ HDL-C ）, and HOMA-IR levels between PCOS patients with hyperandrogenemia （ T ≥ 0. 51 μg/L） and normal androgenemia （ T 〈 0. 51 μg/L）. BMI, FPG, TG, TC, and LDL-C levels were higher and HDL-C level was lower in patients with insulin resistance （ HOMA-IR ≥ 2. 29 ） than in patients without insulin resistance （ HOMA-IR 〈 2. 29, P 〈 0. 05 or P 〈 0. 01 ）. Serum T levels were not significantly different between two groups. HOMA-IR was significantly correlated with BMI（P〈0. 01 ）, not with serum T, suggesting that the gain of body weight is correlated with insulin resistance independent of serum T level.