胰岛素抵抗和非胰岛素抵抗多囊卵巢综合征患者的对比研究

Comparative Study of Polycystic Ovary Syndrome with and without Insulin Resistance

目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗(IR)患者的临床特征。方法选取48例PCOS患者,将稳态模型胰岛素抵抗指数(HOMA-IR)>3.8或葡萄糖及胰岛素曲线下面积比值(AUC葡萄糖/AUC胰岛素)<1.0的PCOS患者作为IR组(30例),上述两个标准均不符合的PCOS患者作为非IR组(18例)。比较IR组和非IR组患者的体质指数(BMI)、血脂水平及各项性激素水平。结果 (1)IR组患者BMI及肥胖者所占比例均显著高于非IR组,差异有统计学意义(P<0.05);(2)IR组患者三酰甘油、载脂蛋白B水平均显著高于非IR组,而高密度脂蛋白、载脂蛋白AⅠ水平则显著低于非IR组,差异均有统计学意义(P<0.05);(3)IR组患者黄体生成素水平显著低于非IR组,睾酮水平则显著高于非IR组,差异亦有统计学意义(P<0.05)。结论 (1)存在IR的PCOS患者更容易出现血脂异常;(2)PCOS患者性激素有不同改变,存在IR者以睾酮升高为主而非IR患者则以黄体生成素升高为主。

Objective To investigate the clinical characteristics of polycystic ovary syndrome（PCOS） patients with insulin resistance.Methods Retrospective analysis is carried out in 48 PCOS patients.The insulin resistant group included 30 PCOS patients with homeostasis model assessment of insulin resistance（HOMA-IR） above 3.8 or insulin to glucose ratio of area under curve（AUCG/AUCI） below 1.0.The non-insulin resistant group was composed of 18 PCOS patients that met neither of the above two standards.Body mass index（BMI）,sex hormone levels,and lipid levels of the two groups were compared.Results The body mass index（BMI） and proportion of obese subjects were higher in the insulin resistant group than in the non-insulin resistant group,with significant difference between the two groups（P0.05）.Levels of triglyceride（TG） and Apolipoprotein B（ApoB） were higher,while levels of high density lipoprotein（HDL） and Apolipoprotein AⅠ（Apo AⅠ） were lower in the insulin resistant group than in the non-insulin resistant group,with significant difference between the two groups（P0.05）.Level of luteinizing hormone（LH） was lower,while level of Testosterone（T） was higher in the insulin resistant group than in the non-insulin resistant group,with significant difference between the two groups（P0.05）.Conclusion PCOS patients with insulin resistance are more likely to suffer from lipid abnormalities.Remarkable difference exists in the levels of sex hormone between PCOS patients with or without insulin resistance,with testosterone levels elevated in the insulin resistant group,while luteinizing hormone levels elevated in the non-insulin resistant group.