不同血脂水平多囊卵巢综合征患者血糖和血清胰岛素的影响

Effects of blood glucose and serum insulin on blood lipid levels in patients with polycystic ovary syndrome

目的探讨不同血脂水平多囊卵巢综合征(PCOS)患者血糖和血清胰岛素变化的意义及评价血脂对PCOS患者胰岛素抵抗的诊断价值。方法选取2018年1月至2019年1月该院收治137例PCOS患者作为研究对象,PCOS患者中三酰甘油(TG)>1.69mmol/L患者59例作为高血脂组,TG≤1.69mmol/L患者78例作为血脂正常组;PCOS患者中以稳态模型评估的胰岛素抵抗指数(HOMA-IR)≥2.5患者61例作为胰岛素抵抗组,HOMA-IR<2.5患者76例作为非胰岛素抵抗组。另选取同期正常孕前保健妇女74例作为对照组,分别行口服葡萄糖耐量试验、胰岛素释放实验检测血糖、胰岛素水平,以及空腹状态下的血脂指标TG、总胆固醇(CHOL)、低密度脂蛋白(LDL)水平。比较各组胰岛素、血糖水平和HOMA-IR及评价血脂对PCOS患者胰岛素抵抗的诊断价值。结果高血脂组和血脂正常组血糖、血清胰岛素水平均高于对照组,高血脂组血糖、血清胰岛素水平高于血脂正常组,差异均有统计学意义(P<0.05)。血脂各指标中,TG对PCOS胰岛素抵抗诊断效能较高。结论 PCOS患者的血脂异常与其糖代谢紊乱和胰岛素抵抗之间存在一定的相关性,当患者TG>1.36mmol/L时,应注意其发生胰岛素抵抗的风险,酌情检测血糖和胰岛素水平。

Objective To explore the role of the alteration of blood glucose and serum insulin in polycystic ovary syndrome(PCOS)patients with different lipid levels.To detect the diagnostic value of blood lipid in PCOS patients with insulin resistance.Methods 137 PCOS patients admitted to the hospital from January 2018 to January 2019 were selected as the research objects.Among the PCOS patients,59 patients with triglyceride(TG)> 1.69 mmol/L were selected as the hyperlipidemia group,and 78 patients with TG≤1.69 mmol/L were selected as the normal lipid group.Among the PCOS patients,61 patients with homeostasis model assessment-insulin resistance(HOMA-IR)≥2.5 were selected as the insulin resistance group,and 76 patients with HOMA-IR<2.5 were selected as the non-insulin resistance group.In addition,74 normal pre-pregnancy health care women in the same period were selected as the control group.Oral glucose tolerance test and insulin release test were performed respectively to detect blood glucose and insulin levels as well as fasting TG,total cholesterol(CHOL)and low-density lipoprotein(LDL)levels.Insulin,blood glucose levels and HOMA-IR were compared in each group,and the diagnostic value of blood lipids in insulin resistance of PCOS patients was evaluated.Results The blood glucose and serum insulin levels of the hyperlipidemia group and the normal blood lipid group were higher than those of the control group.The blood glucose and serum insulin levels of the hyperlipidemia group were higher than those of the normal blood lipid group,and the differences were statistically significant(P<0.05).Among the blood lipid indexes,TG had a higher diagnostic efficiency for PCOS insulin resistance.Conclusion There is a certain correlation between dyslipidemia,glucose metabolism disorder and insulin resistance in PCOS patients.When TG>1.36 mmol/L,attention should be paid to the risk of insulin resistance,and blood glucose and insulin levels should be measured as appropriate.