不同年龄多囊卵巢综合征患者中代谢综合征发生情况分析

Prevalence of metabolic syndrome among different age groups of women with polycystic ovary syndrome

目的研究不同年龄多囊卵巢综合征（PCOS）患者合并代谢综合征（MS）的发生情况。方法多囊卵巢综合征患者332例，按照年龄分A组（〈20岁）、B组（20～29岁）、C组（≥30岁）。比较3组患者中MS的发生率，MS发生相关的各项临床特征、内分泌及代谢指标。结果3组患者中MS的患病率分别为7．69％、21，45％和48．39％（P〈0．01）。3组患者BMI、血压及黑棘皮征的发生无统计学差异，但腹围及腰臀比（WHR）差异存在统计学意义（均P〈005）。C组患者TG[（1．58±0．75）mmol／L]、LDL—C[（2．84±0．76）mmol／L]、FPG[（4．844-0．70）mmol／L]最高，HDL—C[（1．27±0．30）mmol／L]最低，差异存在统计学意义（均P〈0．05），而T、LH／FSH、2hPG、FIN、胰岛素敏感指数（ISI）、稳态模型IR指数（HOMA—IR）3组间均无统计学差异。比较各组内MS各项指标（除腹围外）的发生率，HDL—C降低在3组患者中均是最高的，血糖异常在3组中均是最低的。而在3组问比较MS各项指标的发生率，结果示HDL—C降低及血糖异常的发生C组最高，A组最低，差异存在统计学意义（均P〈0．05），TG升高及血压异常的发生在3组间无统计学差异。结论PCOS患者中MS的患病率随年龄增大而增高。向心性肥胖、HDL—C降低、血糖异常的发生率增高是高年龄PCOS患者MS患病率增加的主要原因。

Objective To investigate the prevalence of metabolic syndrome （MS）among different age groups of women with polycystic ovary syndrome （PCOS）. Methods Three hundreds and thirty two women with polycystic ovary syndrome were divided into group A （aged 〈20y）, group B （aged 20-29y） and group C （aged ≥30y）. The prevalence of MS, clinical manifestations, hormonal profile and metabolic abnormalities were compared among groups. Results The prevalence rate of MS in groups A, B and C was 7.69%, 21.45% and 48.39%,respectively （P〈0.005）. BMI, blood pressure and the rate of acanthosis nigricans did not differ among three groups. The waist circumference and waist-hip rate （WHR） of group C was the highest. The levels of TG （ 1.58 ± 0.75mmol/L）, LDL-C （2.84 ± 0.76 mmol/L）and FPG （4.84 ± 0.70 mmol/L）of group C were highest, while the level of HDL-C of group C was lowest（P〈0.05 ）among three groups. However, no differences were observed in the levels of total testosterone （T）, LH/FSH, 2hPG, fasting insulin （FIN）, ISI and HOMA-IR. Among all components of MS, low serum HDL-C was the most common abnormality in all age groups, while high serum glucose was the least common one. The rates of low serum HDL-C and high serum glucose in group C were the highest, and those in group A were the lowest. No differences were found in the prevalence of hypertriglyceridemia and high blood pressure among three age groups. Conclusion Patients with PCOS in elder aged group have a higher prevalence of MS than that of younger group, which may be associated with central obesity, low serum HDL-C and high serum glucose in the elder patients.