不同年龄段和不同体重指数的PCOS患者特征分析

Characteristic analysis of polycystic ovary syndrome patients with different age and body mass index

目的了解不同年龄段和不同体重指数（BMI）的多囊卵巢综合征（PCOS）患者的临床、生化特征及性激素情况。方法按照2011年制定的中国PCOS的诊断标准,回顾性收集了在北京协和医院妇科内分泌和妇女健康中心就诊的PCOS患者352例。根据年龄分成4组：20岁以下组、20~〈25岁组、25~〈30岁组以及30岁以上组,了解4组的月经状态、BMI以及痤疮、多毛、黑棘皮症的发生情况;并比较4组患者性激素水平、硫酸脱氢表雄酮（DS）、空腹血糖（GLU）和胰岛素（INS）及血脂状况;再根据BMI分为两组：BMI≥24kg/m2为超重或肥胖组、BMI〈24kg/m2为体重正常组,了解两组的上述指标。结果 （1）按年龄段分组：雌二醇（E2）、黄体生成素/卵泡刺激素（LH/FSH）比值、泌乳素（PRL）、睾酮（T）水平随年龄段提高有所下降,但无统计学差异（P〉0.05）;30岁以上组DS水平显著低于〈30岁的其他3组（P〈0.05）;总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、CLU及BMI在30岁以上组较20岁以下组显著增高（P〈0.01）,而高密度脂蛋白（HDL-C）显著降低（P〈0.01）。（2）按BMI分组：超重或肥胖组中多毛和黑棘皮症的发生率显著高于体重正常组（P〈0.01）;超重或肥胖组的LH/FSH比值显著低于体重正常组（P〈0.01）;超重或肥胖组LDL-C、TG、CLU和空腹胰岛素显著高于体重正常组,而HDLC显著低于体重正常组（P〈0.05）。结论 PCOS患者BMI高者比例显著增高,发生心血管疾病和糖尿病风险显著增加。

Objective：To analyze the clinical,biochemical characteristics and sex hormones of the polycystic ovary syndrome（PCOS）patients with different age and different body mass index（BMI）.Methods：The data of 352 patients with PCOS from Department of Gynecological Endocrinology of Beijing Union Medical College Hospital were retrospectively analyzed.The patients were divided into four groups according to age：under 20 years group,20 to 24years group,25 to 29years group,30years group.The menstrual status,body mass index（BMI）and the occurrence of acne,hairness,acanthosis nigricans in four groups were recorded.The sex hormones level,dehydroepiandrosterone sulfate（DS）,fasting plasma glucose（GLU）,fasting insulin（INS）,blood lipid were compared among the four groups.Then the patients were also divided into two groups according to BMI：overweight or obese group（BMI≥24kg/m2）and normal group（BMI24kg/m2）.The above indicators were also compared between the two groups.Results：Among the four group according to the age：the levels of E2,LH/FSH,PRL,testosterone were not significantly different,and DS levels were significantly lower in 30year group than the otherthree groups（P0.05）.The levels of TC,TG,LDL-C,fasting plasma glucose,BMI in 30year group were significantly increased than those in under 20 years group（P 0.01）,but HDL-C levels were significantly reduced（P0.01）.The incidence of hairness and acanthosis nigricans in overweight or obese group were significantly higher than that in normal group（P0.01）.The LH/FSH ratio was significantly lower in overweight or obese group than that in normal group（P0.01）.LDL-C,TG,GLU,INS in overweight or obese were very significantly higher than those in normal group（P0.01）,but HDL-C were very significantly higher（P0.05）.Conclusions：BMI is significantly increased along with the age in PCOS patients.The risk of cardiovascular disease and diabetes is significantly increased.PCOS patients should control the weight to prevent cardiovascular disease and diabetes.