不同体重指数的多囊卵巢综合征患者的临床特征差异性分析

Difference analysis of clinical characteristics of polycystic ovary syndrome patients with different body mass index

目的研究不同体重指数的多囊卵巢综合征(PCOS)患者的临床特征、性激素及糖脂代谢指标水平,探讨肥胖对PCOS的影响。方法收集2015年1月—2018年8月于黑龙江中医药大学附属第一医院妇科门诊临床科研信息一体化系统的病例,选择确诊为PCOS患者,共660例。根据不同体重指数将患者分为正常组243例(体重指数18.5~<23.0 kg/m^2)、超重组100例(体重指数23.0~<25.0 kg/m^2)、肥胖组317例(体重指数≥25 kg/m^2),比较三组临床特征、性激素及糖脂代谢指标水平。结果三组年龄、多毛比较,差异无统计学意义(P>0.05)。三组收缩压、舒张压、腰围、臀围、腰臀比、痤疮、黑棘皮比较,差异均有统计学意义(P<0.05)。三组促卵泡生成素、促黄体生成素、促卵泡生成素/促黄体生成素、睾酮、雄烯二酮及性激素结合球蛋白水平比较,差异均有统计学意义(P<0.05)。三组雌二醇和硫酸脱氢表雄酮比较,差异无统计学意义(P>0.05)。三组空腹血糖、空腹胰岛素及稳态模式胰岛素抵抗指数比较,差异均有统计学意义(P<0.05)。三组三酰甘油、总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇水平比较,差异均有统计学意义(P<0.05)。结论肥胖型PCOS患者,脂肪分布多表现为腹型肥胖,雄激素水平较高,糖脂代谢紊乱更加明显。

Objective To study clinical characteristics,sex hormone level,glucose metabolism level and lipid metabolism level of polycystic ovary syndrome(PCOS)patients with different body mass index(BMI),and to explore the effect of obesity on PCOS.Methods From January 2015 to August 2018,660 patients with PCOS were selected from Gynecology Clinic in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine.According to different BMI,the patients were divided into normal group(BMI 18.5-<23.0 kg/m^2)of 243 cases,overweight group(BMI 23.0-<25.0 kg/m^2)of 100 cases,obesity group(BMI≥25 kg/m^2)of 317 cases.Clinical characteristics,sex hormone,glucose and lipid metabolism were compared among three groups.Results There were no significant differences in age and hirsutism among three groups(P>0.05).There were significant differences in systolic blood pressure,diastolic blood pressure,waist circumference,hip circumference,waist hip ratio,acne and black acanthosis among three groups(P<0.05).The levels of follicle stimulating hormone,luteinizing hormone,follicle stimulating hormone/luteinizing hormone,testosterone,rostenedione and sex hormone binding globulin were significantly different among three groups(P<0.05).There were no significant differences in estradiol and dehydroepiandrosterone sulfate among three groups(P>0.05).There were significant differences in fasting blood glucose,fasting insulin and insulin resistance index among three groups(P<0.05).There were significant differences in triglyceride,total cholesterol,high density lipoprotein cholesterol and low density lipoprotein cholesterol among three groups(P<0.05).Conclusion In obese PCOS patients,fat distribution is abdominal obesity,androgen level is higher,glucose and lipid metabolism disorder is more obvious.