胰岛素增敏剂干预对多囊卵巢综合征患者血清和肽素、胰岛素抵抗及BMI的影响

Effects of insulin sensitizer intervention on serum copeptin,insulin resistance and BMI in patients with polycystic ovary syndrome

目的对比研究胰岛素增敏剂干预对多囊卵巢综合征患者血清和肽素、胰岛素抵抗及体重指数(BMI)的影响。方法收集秦皇岛市第一医院生殖医学科收治的100例多囊卵巢综合征(PCOS)患者及秦皇岛市第一医院体检健康的80例育龄期女性的临床资料与随访资料,进行回顾性分析,将80例体检健康者作为健康组(n=80),100例PCOS患者作为PCOS组(n=100),PCOS组再根据治疗方法的不同分为观察组(n=50)和对照组(n=50),对照组采用吡格列酮治疗,观察组采用吡格列酮联合二甲双胍治疗。分别比较两组患者治疗前后肥胖相关指标(BMI、腰围/臀围比值、瘦素),胰岛素抵抗[胰岛素、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、定量胰岛素敏感性指数(QUICKI)]及血清和肽素水平变化。结果 PCOS组肥胖相关指标、血清和肽素、胰岛素、HOMA-IR、HOMA-β均高于健康组,QUICKI指数低于健康组,差异具有统计学意义(P<0.05)。治疗前,两组PCOS患者肥胖相关指标、胰岛素、HOMA-IR、HOMA-β、血清和肽素及QUICKI比较差异无统计学意义(P>0.05);治疗后,两组PCOS患者肥胖相关指标、胰岛素、HOMA-IR、HOMA-β及血清和肽素均有所下降,QUICKI有所升高,差异具有统计学意义(P<0.05);且观察组肥胖相关指标、胰岛素、HOMA-IR、HOMA-β及血清和肽素下降幅度均大于对照组,QUICKI升高幅度大于对照组,差异具有统计学意义(P<0.05)。结论采用胰岛素增敏剂干预多囊卵巢综合征患者,能够有效改善胰岛β细胞功能与内分泌,调节代谢紊乱,降低血清和肽素水平,减轻体重,值得临床进一步推广。

Objective To compare the ffects of insulin sensitizer intervention on serum copeptin,insulin resistance and body mass index(BMI)in patients with polycystic ovary syndrome(PCOS).Methods The clinical data and fllow-up data of 100 patients with polyceystic ovary syndrome(PCOS)and.80 healthy women of childbearing age in the First Hospital of Qinhuangdao were collected and analyzed retrospectively.80 healthy people were divided into healthy group(n=80)and 100 PCOS patients were divided into PCOS group(n=100).PCOS group was divided into observation group(n=50)and control group(n=50)according to different treatment methods.The control group was treated with pioglitazone,and the observation group was treated with pioglitazone combined with metformin.The changes of obesity related indexes(BMI,waisthip ratio,leptin),insulin resistance[insulin,insulin resistance index(HOMA-IR),insulin secretion index(HOMA-Bβ),quantiative insulin sensitivity index(QUICKI)]and senm copeptin level were compared hotwoen the lwn grmupe hofore and after treatment.Results The obrsity related indexes,copeptin,insulin,HOMA-IR and HOMA-βin PCOS group were significant higher than those in healthy group,while QUICKI index was lower than that in healthy group(P<0.05);before treatment,there were no significant difference in obesity related indexes,insulin,HOMA-IR,HOMA-B,copeptin and QUICKI between the two PCOS groups(P>0.05).After treatment,the obesity related indexes,insulin,HOMA-IR,HOMA-βand serum copeptin of PCOS group in the two groups were decreased,and the QUICKI was increased,with statistically significant difference(P<0.05);the decrease of obesity related indexes,insulin,HOMA-IR,HOMA-βand serum copeptin in the observation group were greater than those in the control group,and the increase of QUICKI was greater than that in the control group,with statistically sig-nificant dfference(P<0.05).Conclusions Insulin sensitizer intervention in the treatment of polyeystic ovary syndrome can efectively improve isletβcell function and endocrine,regulate metabolic disorder,reduce serum copeptin level,and reduce body weight,which is worthy of further clinical promotion.