多囊卵巢综合征患者餐后脂代谢紊乱相关因素的研究

Main influencing factors of postprandial lipid metabolism disorder in women with polycystic ovary syndrome

目的:探讨PCOS患者餐后脂代谢紊乱主要影响因素,为临床治疗提供指导。方法:纳入符合鹿特丹标准PCOS患者68例,非PCOS患者68例,比较PCOS组与对照组餐后脂代谢指标甘油三酯(TG)、高密度脂蛋白(HDL-C)、载脂蛋白A(Apo A)、载脂蛋白B(Apo B)、性激素结合球蛋白(SHBG)的差异,并做相关性分析。结果 PCOS组与对照组餐后2h TG、AUC-TG、餐后4h血糖、AUC-血糖、胰岛素、AUC-胰岛素、i AUC-胰岛素有显著差异(P<0.05);PCOS组0、2、4、6 h的HDL-C及AUC-HDL-C水平明显低于对照组(P<0.05);两组间载脂蛋白无显著差异(P>0.05)。结论:胰岛素抵抗是导致PCOS患者血脂异常和心血管疾病风险增加的重要因素,在治疗肥胖的PCOS患者时,应该优先改善患者的胰岛素抵抗。

Objectives： To investigate the main influencing factors of postprandial lipid metabolism disorder in women with polycystic ovary syndrome（ PCOS） so as to provide guidance for its clinical treatment. Methods： 68 PCOS patients meeting Rotterdam standard and 68 non-PCOS patients were selected. Levels of triglyceride（ TG）,high density lipoprotein（ HDL-C）,load apolipoprotein A（ Apo A）,load of apolipoprotein B（ Apo B）,sex hormone binding globulin（ SHBG） after meal in PCOS group and control group were compared. Results： The TG andAUC-TG 2 hours after meal,blood glucose 4 hours after meal,AUC-blood glucose,insulin,AUC-insulin,i AUC-insulin of PCOS group and control group had significant differences（ P〈0. 05）. HDL-C and AUC-HDL-C levels of PCOS group 0,2,4 and 6 hours after meal in PCOS group were significantly lower than these in control group（ P〈0. 05）. The apolipoprotein level of two groups had no significant difference（ P〉0. 05）. Conclusion： Insulin resistance is an important factor leading to dyslipidemia and cardiovascular disease in PCOS women. During treatment,overweight PCOS patients should be given priority in improving insulin resistance.