多囊卵巢综合征患者的胰岛素抵抗临床特征及相关因素分析

Analysis on clinical characteristics and related factors of insulin resistance of polycystic ovary syndrome

目的探讨多囊卵巢综合征患者的胰岛素抵抗的临床特征,并对影响因素进行相关性分析。方法分析76例接受治疗的多囊卵巢综合征患者的临床资料,将40例胰岛素抵抗的患者作为观察组,选取36例非胰岛素抵抗的患者作为对照组。比较两组血脂水平、激素水平、葡萄糖耐量、胰岛素抵抗指数及其与BMI、GAUC的相关性。结果观察组患者体质指数水平明显高于对照组(χ2=3.499,P=0.001);观察组患者TG(t=5.980,P<0.001)、HDL(t=7.812,P<0.001)水平显著高于对照组;两组研究对象TC(t=1.386,P=0.170)和LDL(t=1.851,P=0.068)水平差异不明显;两组孕酮(P)、睾酮(T)、雌二醇(E2)、催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)水平比较,差异无统计学意义(P>0.05);观察组FPG(t=2.225,P=0.029)、FINS(t=5.668,P<0.001)、GAUC(t=5.017,P<0.001)、HOMA-IR(t=5.087,P<0.001)水平明显高于对照组;PCOS胰岛素抵抗患者HOMA-IR与BMI(r=0.549,P<0.001)、GAUC(r=0.549,P<0.001)呈显著的正相关。结论 PCOS胰岛素抵抗患者HOMA-IR与BMI、GAUC呈现显著的正相关关系,肥胖和葡萄糖耐量的降低可以增加PCOS胰岛素抵抗患者的发病风险。

Objective To explore the clinical characteristics of insulin resistance of polycystic ovary syndrome（ PCOS）,analyze the correlation of influencing factors. Methods The clinical data of 76 PCOS patients treated in the hospital was analyzed,then the cases were divided into observation group（ 40 cases with insulin resistance） and control group（ 36 cases without insulin resistance）. The levels of blood lipids,hormones,glucose tolerance,insulin resistance indexes in the two groups were compared,their correlations with body mass index（ BMI） and GAUC were analyzed. Results BMI in observation group was statistically significantly higher than that in control group（ χ^2= 3. 499,P = 0. 001）; the levels of triglyceride（ TG） and high-density lipoprotein（ HDL） in observation group were statistically significantly higher than those in control group（ t = 5. 980,P〈0.001; t = 7. 812,P〈0.001）; there was no statistically significant difference in the levels of total cholesterol（ TC） and low-density lipoprotein（ LDL） between the two groups（ t = 1. 386,P = 0. 170; t = 1. 851,P = 0. 068）;there was no statistically significant difference in the levels of progesterone（ P）,testosterone（ T）,estradiol（ E2）,prolactin（ PRL）,luteinizing hormone（ LH）,follicle-stimulating hormone（ FSH） between the two groups（ P〉0. 05）; fasting plasma glucose（ FPG） level,fasting insulin（ FINS） level,GAUC,and HOMA-IR in observation group were statistically significantly higher than those in control group（ t =2. 225,P = 0. 029; t = 5. 668,P〈0.001; t = 5. 017,P〈0.001; t = 5. 087,P〈0.001）; in observation group,HOMA-IR was significantly positively correlated with BMI（ r = 0. 549,P〈0.001） and GAUC（ r = 0. 549,P〈0.001）. Conclusion HOMA-IR is significantly positively correlated with BMI and GAUC in PCOS patients with insulin resistance,obesity and decrease of glucose tolerance can increase the risk of PCOS patients with insulin resistance.