不同剂量二甲双胍对超重和肥胖多囊卵巢综合征患者体质指数和外周血炎性反应指标水平的影响

Effect of different doses of Metformin on body mass index and peripheral blood inflammatory response in patients with overweight or obese polycystic ovary syndrome

目的 观察不同剂量二甲双胍对超重和肥胖多囊卵巢综合征(PCOS)患者体质指数(BMI)和外周血炎性反应指标水平的影响。方法 选择2017年9月1日至2020年2月29日期间就诊于南通大学附属海安医院妇产科的超重和肥胖的PCOS患者,共127例。在首次接受治疗的6个月内接受日剂量1500 mg二甲双胍治疗,每日3次,治疗结束后对稳态模型评价(HOMA)指数进行评估,HOMA指数≥2.5的患者纳入高剂量组,接受日剂量2500 mg(早500 mg,中午和晚间各1000 mg)二甲双胍持续6个月治疗,常规剂量组则继续给予1500 mg日剂量二甲双胍。观察两组患者激素水平、空腹胰岛素和空腹血糖水平、HOMA指数、BMI、胆固醇以及外周血炎性反应指标水平。结果 在超重(25 kg/m2<BMI≤30 kg/m^(2))的PCOS患者中,常规剂量二甲双胍可显著改善胰岛素抵抗状态、BMI、外周血炎性指标、胆固醇水平及高雄激素血症,而对于肥胖(BMI>30 kg/m^(2))患者则需要服用高剂量二甲双胍;PCOS患者外周血炎性反应指标水平与BMI有显著相关性(P<0.05)。结论常规剂量二甲双胍可显著降低超重PCOS患者的BMI及外周血炎性反应指标水平,肥胖患者可能需要服用高剂量二甲双胍。

Objective To explore the effect of different doses of Metformin on body mass index(BMI)and peripheral blood inflammatory response in patients with overweight or obese polycystic ovary syndrome(PCOS).Methods We enrolled127 patients with overweight or obese PCOS from September 1,2017 to February 29,2020.All patients received Metformin1500 mg per day(3 times/day)within 6 months of the initial treatment,and the homeostasis model assessment(HOMA)index was performed after the end of the treatment.Patients with a HOMA index≥2.5 increased daily dose of Metformin to2500 mg in the following 6 months(high-dose group),and the remaining patients continued to receiving standard-dose Metformin(1500 mg/day).The hormone levels,fasting insulin and fasting blood glucose levels,HOMA index,BMI,cholesterol levels,and peripheral blood inflammation indicators were compared between the two groups.Results In PCOS patients with25 kg/m^(2)30 kg/m^(2)).The level of peripheral blood inflammatory response was significantly correlated with BMI(P<0.05)in patients with PCOS.Conclusion Standard-dose Metformin can significantly reduce BMI and peripheral blood inflammatory response levels in overweight PCOS patients,while obese patients may require high-dose Metformin.