多囊卵巢综合征胰岛素抵抗患者的临床特征

Clinical Characteristics of Insulin Resistant Women with Polycystic Ovary Syndrome

目的 :探讨多囊卵巢综合征 (polycystic ovary syndrome PCOS)胰岛素抵抗患者的临床表现特征。方法 :选择诊断为 PCOS、及糖负荷后 6 0 min或 12 0 min血胰岛素≥ 16 0 m IU/ L的患者 37例为胰岛素抵抗 PCOS 组。随机选择胰岛素及糖负荷 6 0 min、12 0 m in血胰岛素正常的 PCOS患者 37例为对照组 PCOS 组。对比两组 PCOS患者早卵泡期或闭经状态下各项性激素、卵巢体积、体重指数 (body mass index BMI)。结果 :1PCOS 组的平均睾酮 (testosteroneT)值、雄烯二酮 (androstenedione A)值、BMI均显著高于 PCOS 组 (P<0 .0 5 )。 2 PCOS 组中高水平睾酮、特别是高水平雄烯二酮及肥胖患者的构成比显著高于 PCOS 组 (P<0 .0 5 ) ;而高 L H患者则显著低于 PCOS 组 (P<0 .0 5 )。结论 :在胰岛素抵抗的 PCOS患者中 ,几乎全部伴有雄烯二酮的异常升高 ,高雄激素血症是其特有的临床特征。胰岛素抵抗并非 PCOS共同表现特征 ,它在一定程度上与体重有一定的依存关系 ,提示对

Objectives:To investigate the clinical characteristics of insulin resistant women with polycystic ovary syndrome(PCOS).Methods:PCOS Group I was composed of 37 women with PCOS whose serum insulin level after glucose loading at 60 minutes or 120 minutes were more than 160 mIU/L,and PCOS groupⅡwas composed of 37 women with PCOS whose serum insulin level after glucose loading was normal.Levels of serum sex hormones,ovarian volume,body mass index(BMI)and other abnormalities between the two groups were compared.Results:①Average testosterone,androstenedione and BMI were significantly higher among PCOS group I than those among PCOS groupⅡ( P <0.05),②The incidences of elevated serum testosterone,especially elevated serum androstenedione,and women with obesity among PCOS group I were markedly higher than among PCOS group Ⅱ ( P <0.05),while high serum LH level was significantly lower than among PCOS groupⅡ( P <0.05).Conclusion:The key factor responsible for hyperandrogenemia among insulin resistant women with PCOS may be insulin resistance;High serum androstenedione and high incidence of obesity were clinical characteristics of such kind of women with PCOS.