广东地区455例多囊卵巢综合征患者糖脂代谢特征

Study on glucolipid metabolism among 455 polycystic ovary syndrome patients in Guangdong

目的研究多囊卵巢综合征(PCOS)患者内分泌及糖脂代谢特征,以指导临床治疗。方法依据2003年鹿特丹诊断标准纳入PCOS患者455例,按照体重指数和胰岛素抵抗指数分组,比较不同分类患者的性激素、血糖、胰岛素及血脂水平。结果 (1)肥胖组和非肥胖组分别为152例和303例,肥胖组PCOS患者T、FPG、FINS、2 h-PG、2 h-INS、HOMA-IR、TG、LDL、Apo-B高于非肥胖组,FSH、LH、HDL低于非肥胖组,差异有统计学意义(P<0.05);(2)胰岛素抵抗组217例(IR组)和非胰岛素抵抗组238例(NIR组),IR组PCOS患者BMI、FPG、FINS、2h-PG、2h-INS、HOMA-IR、TG高于NIR组,LH、HDL低于NIR组,差异有统计学意义(P<0.05)。结论 (1)非肥胖的PCOS患者表现为下丘脑-垂体-卵巢轴功能紊乱,肥胖的PCOS患者更容易出现胰岛素抵抗;(2)PCOS患者存在脂代谢异常,以肥胖型PCOS患者和胰岛素抵抗型PCOS患者血脂紊乱更为明显。

Objective To understand the endocrine and glucolipid metabolism characteristics of women with polyeystic ovarian syndrome （PCOS）, in order to guide the clinical treatment. Methods 455 PCOS patients were enrolled and divided into different groups according to their body mass index （ BMI ） and insulin resistance index, and compared their sex hormones, blood glucose, insulin and lipid levels. Results （ 1 ） The obesity group and non-obesity group were 152 cases and 303 cases, obesity group had higher level in testosterone（T）, fasting plasma glucose （FPG）, fasting insulin （FINS）, 2h-plasma glucose （2h-PG）, 2 hour fasting insulin（ 2h-INS）, homeostasis model assessment （ HOMA-IR ）, triglyceride （ TG）, low density lipoprotein cholesterol （LDL） and Apo-B than those of non-obesity group, while the level of follicle stimulating （ FSH ） , luteinizing hormone （ LH ） , high density lipoprotein cholesterol （HDL） lower than non-obesity group, all the differences were statistically significant （P 〈 0.05 ） ; （2） Insulin resistance group （ IR group） were 217 cases and the group without insulin resistance （ NIR Group） were 238 eases ,IR group had higher level in body mass index（ BMI）, fasting plasma glucose（FPG）, fasting insulin（ FINS）, 2h-plasma glucose （2h=PG）, 2 hour fasting insulin （2h-INS）, HOMA-IR and triglyceride （TG） than those of the group without insulin resistance, while luteinizing hormone（LH） and high density lipoprotein cholesterol （HDL） were lower than the group without insulin resistance, all the differences were statistically significant （P 〈0.05 ）. Conclusion （1）PCOS patients with non-obesity showed hypothalamic - pituitary-ovarian axis dysfunction, and PCOS patients with obesity were more likely to have insulin resist. （2）PCOS patients had abnormal lipid metabolism, especially on PCOS patients with obesity or insulin resistance.