女性不孕患者胰岛素抵抗的临床特征研究

Clinical characteristics of infertile females with insulin resistance

目的研究不孕妇女中胰岛素抵抗(IR)的分布情况,探讨其与患者临床特征之间的关系。方法回顾分析907名不孕妇女的糖代谢及基础性激素数据,以空腹胰岛素(FINS)及稳态评估模型(HOMA-IR)评估患者IR状态,分析可能与IR有关的临床特征。结果取研究人群的FINS、HOMA-IR 75%位点值为生理高限值,FINS≥9.61 mIU/L或HOMA-IR≥2.20者被认为处于IR状态。IR组月经稀发发生率及超重者比例显著高于非IR组(P<0.01),但多囊卵巢综合征(PCOS)发生率相似(P>0.05)。IR组基础睾酮(T)值较非IR组显著升高(P<0.05)。多元回归分析示IR与BMI、是否超重以及T值有显著联系(P<0.01)。结论月经稀发的不孕女性患者中更易存在IR状态,与是否合并PCOS无关,同时,BMI的增加使IR的发生率更高。

Objective To investigate the distribution of insulin resistance （m） in infertile females, and to explore rela- tionships between IR and other clinical characteristics. Methods Nine hundred and seven infertile women were recruited into this retrospective study. Fasting insulin（FINS） and homeostasis model assessment of insulin resistance （HOMA-IR） were used to assess whether these patients were IR or not. Clinical characteristics were compared between IR group and Non-IR group,whose relationships with IR were then analyzed. Results The 75th percentiles of FINS and HOMA-IR were used as cut-off values of IR. FINS〉~9.61 mlU/L or HOMA-IR〉~2.20 was considered to be IR. Incidences of oligo- menorrhea and overweight significantly increased in IR group than in Non-IR（ P 〈 0.01 ） , however,the incidence of poly- cystic ovary syndrome （PCOS） was comparable （ P 〉 O. 05 ）. The value of testosterone （T） in IR group increased signifi- cantly（P 〈 0.05 ）. Multiple regression analysis showed IR was significantly related with BMI （or whether overweight or not） and T（ P 〈 0.05 ）. Conclusion Oligomenorrheic infertile females may be prone to m, which was aggravated by the increase of BMI,with or without PCOS.