高雄激素血症与胰岛素抵抗对PCOS患者脂代谢的影响

Effects of Hyperandrogenemia and Insulin Resistance on Lipid Metabolism in Patients with PCOS

目的:探究多囊卵巢综合征患者高雄激素血症与胰岛素抵抗因素对血脂代谢的影响及相关性分析。方法:回顾分析2016年3月至2018年6月确诊为PCOS的病例593例,选取健康女性83例作为对照组,根据睾酮及高雄烯二酮值将PCOS组分为HA组和NHA组,根据胰岛素抵抗指数(HOMA-IR)将PCOS组分为IR组和NIR组,检测各组患者血脂水平,分析脂代谢水平与激素和胰岛素抵抗的关系。结果:①PCOS组TC、TG、HDL、LDL、Apo-A、Apo-B、Apo-B/Apo-A值均大于对照组;②HA组TC、TG、LDL、Apo-A、Apo-B、Apo-B/Apo-A值均大于NHA组,HA组HDL值小于NHA组;③IR组TC、TG、LDL、Apo-A及Apo-B值均大于NIR组;④T与TC、TG、LDL、Apo-B、Apo-B/Apo-A呈正相关,与Apo-A、HDL呈负相关;AND与TC、TG、HDL、LDL、Apo-A及Apo-B呈正相关,与Apo-B/Apo-A呈负相关;HOMA-IR与TC、TG、LDL、Apo-A、Apo-B及Apo-B/Apo-A呈正相关,与HDL呈负相关。结论:PCOS患者存在严重的脂代谢异常,PCOS伴HA/IR患者脂代谢异常加重;PCOS患者的T、AND及HOMA-IR与TC、TG、HDL、LDL、Apo-A、Apo-B、Apo-B/Apo-A各指标存在相关性。

Objective: To investigate the effects of hyperandrogenemia and insulin resistance on lipid metabolism in patients with polycystic ovary syndrome. Methods: 593 cases of PCOS diagnosed from March 2016 to June 2018 were retrospectively analyzed. 83 healthy women were selected as control group. PCOS was divided into HA group and NHA group according to testosterone and hyperandrostenedione values. PCOS was divided into IR group and NIR group according to HOMA-IR. Blood lipid levels of each group were measured and the relationship between lipid metabolism and hormone and insulin resistance was analyzed. Results: TC,TG,HDL,LDL,Apo-A,Apo-B,Apo-B/Apo-A values in PCOS group were higher than those in control group. TC,TG,LDL,Apo-A,Apo-B,Apo-B/Apo-A values in HA group were higher than those in NHA group,and HDL values in HA group were lower than those in NHA group. TC,TG,LDL,Apo-A and Apo-B values in IR group were higher than those in NIR group. T and TC,TG,LDL,Apo,Apo,Apo-B,Apo-A/Apo-A showed positive phase. Guan was negatively correlated with Apo-A and HDL;AND was positively correlated with TC,TG,HDL,LDL,Apo-A and Apo-B,and negatively correlated with Apo-B/Apo-A;HOMA-IR was positively correlated with TC,TG,LDL,Apo-A,Apo-B and Apo-B/Apo-A,and negatively correlated with HDL. Conclusion: PCOS patients had severe abnormal lipid metabolism,and PCOS patients with HA/IR had more abnormal lipid metabolism. T,AND and HOMA-IR in PCOS patients were correlated with TC,TG,HDL,LDL,Apo-A,Apo-B,Apo-A.