多囊卵巢综合征患者静息心率与糖脂代谢及血压等指标关系的研究

Relationship among resting heart rate,glycolipid metabolism and blood pressure in patients with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)患者静息心率与心血管疾病相关危险因素的关系。方法采用对照的研究方法,收集2011年8月至2012年6月,海军总医院生殖中心就诊育龄期妇女,年龄为25～35岁,选取PCOS患者(77例)为PCOS组,正常妇女(73例)为正常对照组,分别测定体重、血压、静息心率、血脂,并进行糖耐量及胰岛素释放试验。采用独立样本的t检验及偏相关分析评价PCOS患者静息心率与心血管疾病危险因素的关系。结果 (1)PCOS组静息心率为(82.09±7.86)/min,显著高于正常对照组(79.55±5.66)/min(P<0.05),PCOS组体重指数(BMI)、血压(收缩压和舒张压)、空腹及餐后血糖及胰岛素均高于正常对照组(P<0.05);(2)静息心率与BMI、收缩压、空腹胰岛素、餐后1h胰岛素、甘油三酯具有相关性(r分别为0.177、0.191、0.199、0.204、0.216,P均<0.05);(3)把两组再分成肥胖组与非肥胖组后比较,PCOS非肥胖组静息心率、收缩压、餐后1 h血糖、血脂等均高于正常肥胖组;(4)多因素线性回归分析显示:在控制BMI、舒张压、空腹血糖及空腹胰岛素等因素后,收缩压升高(β=0.237)及甘油三酯升高(β=0.222)是静息心率增快的显著危险因素。结论 PCOS患者静息心率的增快与收缩压及甘油三酯的升高有密切相关性,并随着收缩压及甘油三酯等心血管疾病相关风险因素的增加,PCOS患者的静息心率也随之增快。

Objective： To investigate the relationship among resting heart rate, glycolipid metabolism and blood pressure in patients with polycystic ovary syndrome（PCOS）. Methods： Seventy seven patients with PCOS and seventy three healthy women volunteers as control were enrolled in the study in Department of Reproductive, Navy General Hospital from August 2011 to June 2012. The two groups were divided to four subgroups according to obese or non-obese. The serum levels of lipids, fasting blood glucose, blood glucose after meal, fasting insulin and insulin after meal were measured. The body weight, blood pressure and resting heart rate were calculated. Independent-samples t- test and partial correlation analysis were used to evaluate the relationship between resting heart rate and cardiovascular risk factors in patients with PCOS. Results： （1）The resting heart rate 1-（82.09±7.86）/min vs. （79.55±5.66）/mini, body mass index （BMI）, blood pressure, blood glucose and insulin in PCOS group were significantly higher than those in control（P〈0.05）. （2）The resting heart rate was significantly correlated with BMI, systolic pressure, fasting insulin, insulin after 1 hour meal, and triglyceride（r=0.177, 0.191, 0.199, 0.204, 0.216 respectively, all P〈0.05）. （3）The resting heart rate, systolic pressure, lipids and blood glucose after 1 hour in non-obese subgroup of PCOS were significantly higher than those in obese group of control. （4） After exclusion of confounding factors, such as BMI, diastolic pressure, fasting blood glucose and fasting insulin, the increase of systolic pressure （β= 0. 237） and triglyceride level（β= 0. 222） was independent risk factors for resting heart rate（P〈0.05）by multivariate linear regression analysis. Conclusions： The study indicates that increase of resting heart rate in PCOS patient is associated with increase of systolic pressure and triglyceride level. The resting heart rate in PCOS group is higher than that in control group along with increase of systolic pressure and triglyceride level.