子宫内膜息肉与胰岛素抵抗关系的研究

Study on correlation of endometrial polyp with insulin resistance

目的探讨子宫内膜息肉(EP)与胰岛素抵抗(IR)的关系。方法202例因异常子宫出血或(和)B超提示宫腔内异常回声或宫腔占位性病变拟行宫腔镜检查的患者,根据子宫内膜病理结果分为息肉组(子宫内膜息肉患者,118例)和对照组(正常子宫内膜组,84例)。比较两组临床资料及IR相关指标[空腹血糖(FPG)、空腹胰岛素(FIN)、胰岛素抵抗指数(HOMA-IR)、空腹血糖与空腹胰岛素的比值(G/I)],分析子宫内膜息肉发病的危险因素。结果两组年龄、孕次、产次、高血压、体质量指数(BMI)、臀围、腰臀比及子宫内膜分期比较,差异无统计学意义(P>0.05);息肉组月经不规则/闭经比例32.20%(38/118)高于对照组的19.05%(16/84),腰围(78.15±5.50)cm大于对照组的(71.43±6.61)cm,差异有统计学意义(P<0.05)。两组FPG、G/I比较,差异无统计学意义(P>0.05);息肉组FIN(8.61±0.80)mIU/L及HOMA-IR(2.08±1.56)均高于对照组的(7.40±0.39)mIU/L、(0.90±0.43),差异有统计学意义(P<0.05)。Logistic多元回归分析结果显示:FIN≥10 mIU/L、HOMA-IR≥2.14、腰围≥80 cm、月经周期不规则/闭经是子宫内膜息肉发病的危险因素(P<0.05)。结论子宫内膜息肉患者具备IR的部分特质,IR可能与子宫内膜息肉的发生发展相关,应引起患者足够重视,调整生活方式,关注月经情况,必要时加用胰岛素增敏剂。

Objective To discuss the correlation of endometrial polyp(EP)with insulin resistance(IR).Methods 202 patients who underwent hysteroscopy due to abnormal uterine bleeding or/and B-ultrasonography indicating abnormal uterine echo or uterine space-occupying lesion were divided into the polyp group(endometrial polyp patients,118 cases)and the control group(normal endometrial group,84 cases)according to the results of endometrial pathology.The clinical data and IR related indexes[fasting plasma glucose(FPG),fasting insulin(FIN),homeostasis model assessment of insulin resistance(HOMA-IR),glucose-to-insulin ratio(G/I)]of the two groups were compared to analyze the risk factors of endometrial polyps.Results There were no statistically significant differences in terms of age,gravidity,parity,hypertension,body mass index(BMI),hip circumference,waist-to-hip ratio and endometrial staging between the two groups(P>0.05).The proportion of irregular menstruation/amenorrhea in polyp group was 32.20%(38/118),which was higher than that of 19.05%(16/84)in control group;the waist circumference in polyp group was(78.15±5.50)cm was greater than that of(71.43±6.61)cm in control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in FPG and G/I between the two groups(P>0.05).FIN of(8.61±0.80)mIU/L and HOMA-IR of(2.08±1.56)in polyp group were higher than those of(7.40±0.39)mIU/L and(0.90±0.43)in control group,and the differences were statistically significant(P<0.05).Logistic multivariate regression analysis showed that FIN≥10 mIU/L,HOMA-IR≥2.14,waist circumference≥80 cm,irregular menstruation/amenorrhea were risk factors for endometrial polyps(P<0.05).Conclusion Patients with endometrial polyps have some characteristics of IR,and IR may be related to the occurrence and development of endometrial polyps.Patients should pay enough attention to it,adjust their lifestyle,pay attention to menstruation,and add insulin sensitizer when necessary.