不孕症非肥胖型与肥胖型多囊卵巢综合征肥胖指标对比研究

Comparison on Obesity Indexes among Infertility Patients with OB PCOS,NOB PCOS and without PCOS

目的:对比肥胖型(OB)与非肥胖型(NOB)多囊卵巢综合征(PCOS)患者以及体重指数(BMI)正常的非PCOS不孕症患者之间内分泌代谢、向心性肥胖等指标,探讨对非肥胖型PCOS不孕症临床治疗的指导。方法:选择2009年1月至2012年4月不孕症PCOS的OB型、BMI≥25 kg/m2患者67例(OB组)和PCOS的NOB型、BMI<25 kg/m2患者152例(NOB组)为研究组,并同期选择非PCOS不孕症、BMI<25 kg/m2的111例患者为对照组。检测3组空腹血糖(FBG)、空腹胰岛素值(FINS)、胰岛素抵抗指数(HOMA-IR)值;测量人体肥胖指标;超声检测腹部脂肪厚度等指标,并进行对比分析。结果:①3组间FBG、FINS及HOMA-IR值两两比较,差异均有统计学意义(P<0.05),其中OB组最高,对照组最低。②OB组的腰围、臀围、腹围和腰臀比均大于NOB组及对照组(P<0.05);而NOB组仅腹围大于对照组(P<0.05)。③OB组的肝前脂肪厚度、肝前皮下脂肪厚度、内脏脂肪厚度及腹部皮下脂肪厚度均大于NOB组和对照组(P<0.05),而NOB组的内脏脂肪厚度及腹部皮下脂肪厚度大于对照组(P<0.05)。结论:肥胖型PCOS患者存在更严重的高雄激素血症、高胰岛素血症以及胰岛素抵抗;非肥胖型PCOS的BMI在正常范围,但高雄激素血症可能导致内脏脂肪堆积,临床制定治疗方案时宜给予考虑。

Objective： To investigate the differences in metabolic profiles and obesity indexes among obese（OB） PCOS patients, Non-obese（NOB） PCOS, and infertility patients with normal weight, and to ex- plore the treatment for NOB PCOS. Methods： A total of 67 women with OB PCOS（ BMI I〉25 kg/m2） and 152 NOB PCOS（ BMI 〈 25 kg/m2） were inoluded as research group（OB group and NOB group respective- ly）. 111 women without PCOS（ BMI 〈25 kg/m2） as normal controls were included. Several indexes including fasting blood glucose （ FBG）, fasting insulin （ FINS）, Insulin resistance index （ HOMA-IR）, obesity indexes, abdomen subcutaneous fat thickness were detected and compared among the three groups. Results.. There were significant difference in serum FBG, FINS and HOMA-IR among the three groups（ P 〈0.05）, among which the indexes were highest in OB group and lowest in control group. （2）The hipline,waistline and hipline/waistline ratio in OB group were higher than those in NOB group and control group（ P 〈 0.05）. Waist- line in NOB group was higher than that in control group （P 〈 0.05）. ~Prehepatic fat thickness, prehepatic subcutaneous fat thickness, visceral fat thickness, and abdomen subcutaneous fat thickness in OB group were the higher than those in NOB group and control group（P〈0.05）. Visceral fat thickness and abdomen subcutaneous fat thickness in NOB group were thicker than control group （ P 〈 0. 05）. Conclusions. There are more severe hyperandrogenemia,hyperinsulinemia and insulin resistance in OB PCOS infertility patients. Moreover,although the BMI of NOB PCOS is normal,the hyperandrogenism can lead to visceral fat accumu- lation,which should be taken into consideration when giving a treatment plan.