肥胖型多囊卵巢综合征患者临床和内分泌代谢特征

Clinical and Endocrine Metabolism Characteristics of Obese Women with Polycystic Ovary Syndrome

目的探讨肥胖型多囊卵巢综合征（polycysticovarysyndrome，PCOS）患者的临床和内分泌代谢特征。方法将180例PCOS患者按照体重指数（BMI）分成两组：肥胖型PCOS患者（BMI〉25ks／m2）和正常体重型PCOS患者（BMI≤25ks／m2）。每位患者都进行高雄激素血症检查，并测定空腹胰岛素、空腹血糖、卵泡刺激激素（FSH）、黄体生成素（LH）、雌二醇（E2）、泌乳素（PRL）、孕酮和睾酮的水平，并进行统计学分析。结果180例PCOS患者中，有85例超重肥胖女性（47．2％）和95例体重正常的女性（52．8％）。与非肥胖型PCOS患者相比，肥胖型PCOS女性月经初潮年龄增大、流产次数和月经紊乱比例明显增加，差异有统计学意义（P〈0．05）。肥胖型PCOS患者高雄激素血症和黑棘皮病患病率明显增高，并且代谢和性激素的平均水平也偏高。结论超重和肥胖型PCOS患者的月经初潮年龄增大、流产次数和月经紊乱比例较大。空腹血糖、空腹胰岛素、FSH、LH和睾酮水平高的患者更易发生雄激素过多症和黑棘皮病。

Objective To explore clinical and endocrine metabolism of obese women with polycystic ovary syn- drome（PCOS）. Methods 180 patients with PCOS were divided into two groups：obese PCOS patients（ BMI 〉 25 kg/ m2） and normal weight PCOS patients （BMI ≤25 kg/m2）. Hyperandrogenism, fasting insulin, fasting blood -glucose, follicle - stimulating hormone （ FSH ）, luteinizing hormone （ LH ）, estradiol （ E2 ）, prolactin （ PRL ）, progesterone and testosterone were detected and artalyzed. Results 85 patients （47.2%） were overweight and 95 patients （52.8%） were normal weight. Menarche age, abortion times and menstrual disorder proportion were significantly higher in obese patients with PCOS（P 〈 0.05 ）. Morbidity of hyperandrogenism and acanthosis nigricans, mean level of metabolism and hormones were significantly higher in obese patients with PCOS. Conclusion Menarche age, abortion times, and menstrual disorder proportion are higher in overweight and obese patients with PCOS. Hyperandrogenism and acanthosis nigricans are prone to occurred in patients with higher levels of fasting blood - glucose, fasting insulin, FSH, LH and testosterone.