不同体重的多囊卵巢综合征者伴发代谢综合征的相关因素和预测指标

High risk factors and predictors of metabolic syndrome in polycystic ovary syndrome patients with and without obesity

目的分析不同体重类型多囊卵巢综合征(PCOS)患者合并代谢综合征(MS)的临床特征,研究不同体重PCOS患者发生MS的相关因素和预测指标。方法 PCOS患者425例,分为肥胖型与非肥胖型,比较2组患者合并MS与未合并MS者的体征、内分泌激素及代谢特征,分析其相关性和预测指标。结果肥胖型与非肥胖型PCOS者MS的发生率分别为56.58%及5.13%(P<0.001)。无论是肥胖型还是非肥胖型PCOS患者合并MS者OGTT及IRT各项结果均高于非MS者。但非肥胖型PCOS合并MS者0.5 h、1 h、2 h、3 h PG结果均高于肥胖型合并MS者,且2 h PG和3 h PG的差异具统计学意义(P分别为0.000和0.021)。肥胖型PCOS患者年龄、舒张压、TG、FPG与MS的发生正相关,HDL与MS的发生负相关,而非肥胖型PCOS患者腰围、TG与MS的发生呈正相关,多毛评分、HDL与MS的发生呈负相关。ROC曲线中,非肥胖型PCOS各项指标的曲线下面积最大者为腹围,而肥胖组PCOS患者则为TG。结论肥胖型PCOS患者MS的发生率远高于非肥胖型。肥胖型PCOS可选择TG、非肥胖型可选择腹围作为筛查MS的预测指标。

Objective To analyze the clinical features of different weight types of polycystic ovary syndrome（ PCOS） patients with metabolic syndrome（ MS）,and investigate the high risk factors and predictors of the different patients. Methods Total 425 patients with PCOS were classified into obesity and non-obesity groups. The signs,sex hormones and metabolic characteristics were compared between the two groups. Results The prevalence of MS in PCOS with and without obesity were 56. 58% and 5. 13%,respectively（ P〈0. 01）. Both in obesity and non-obesity PCOS patients,indexes of OGTT and IRT were all higher in MS group than that without MS. However,in patients who with MS,the 0. 5 h PG,1 h PG,2 h PG and 3 h PG level were all higher in non-obesity patients than that in obesity patients,and the P value of 2 h PG and 3 h PG were 0. 000 and 0. 021 respectively. There was observed a positive correlation between MS and the ages,diastolic pressure,TG,FPG in obesity PCOS patients,as well as waistlines,TG in non-obesity PCOS patients. HDL was observed to be negatively correlated with MS in both obesity and non-obesity PCOS patients. Hirsutism score had negative relation with risk of MS in non-obesity PCOS patients. In the ROC curve,the area under curve of waistline was the biggest in non-obesity PCOS patients,as TG level in obesity PCOS patients. Conclusion The prevalence of MS is significantly higher in obesity PCOS patients than that in non-obesity. TG and waistline can be considered as the screening indexes for MS in obesity PCOS patients and non-obesity PCOS patients,respectively.