糖耐量异常对PCOS患者雄激素、脂代谢及血管内皮相关因子的影响

Effects of impaired glucose tolerance on androgen,lipid metabolism and vascular endothelial related factors in patients with PCOS

目的探讨糖耐量异常(IGT)对多囊卵巢综合征(PCOS)患者雄激素、脂代谢及血管内皮相关因子的影响。方法回顾性分析2019年1月至2021年1月确诊并治疗的PCOS患者98例,根据是否存在IGT分组为IGT组(糖耐量受损组,n=36)和NGT组(糖耐量正常组,n=62)。比较两组年龄、体质量指数(BMI)、腰臀比(WHR)和文化程度等一般资料;比较两组雄激素、脂代谢及血管内皮相关因子水平,Pearson分析雄激素、脂代谢及血管内皮相关因子水平与IGT的关系。结果两组年龄、BMI、WHR、文化程度、存在多毛、痤疮、黑棘皮和溢脂所占比例无显著差异(P>0.05);IGT组脱氢表雄酮(DHEA)、睾酮(T)、雄烯二酮(A)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血管内皮生长因子(VEGF)和内皮抑素(ES)水平显著高于NGT组(P<0.05);IGT组高密度脂蛋白胆固醇(HDL-C)水平显著低于NGT组(P<0.05)。PCOS患者DHEA、T、A、TC、TG、LDL-C、VEGF和ES水平与IGT水平呈正相关(P<0.05),HDL-C与IGT水平呈负相关(P<0.05)。结论PCOS伴IGT患者血糖水平与雄激素和血管内皮因子均呈正相关关系,且与脂代谢水平中TC、TG、LDL-C呈正相关,HDL-C呈负相关。

Objective To explore the effects of impaired glucose tolerance(IGT)on androgen,lipid metabolism and vascular endothelial-related factors in patients with polycystic ovary syndrome(PCOS).Methods A retrospective analysis was performed on the 98 patients with PCOS confirmed and treated between January 2019 and January 2021.According to presence or absence of IGT,they were divided into IGT group(impaired glucose tolerance group,n=36)and NGT group(normal glucose tolerance group,n=62).The general data[age,body mass index(BMI),waist-to-hip ratio(WHR),education level],levels of androgen,lipid metabolism and vascular endothelium-related factors between the two groups were compared.The relationship between androgen,lipid metabolism,vascular endothelium-related factors and IGT was analyzed by Pearson analysis.Results There was no significant difference between the two groups in age,BMI,WHR,educational level,proportions of cases with hirsutism,acne,acanthosis and seborrheic dermatitis(P>0.05).The levels of dehydroepiandrosterone(DHEA),testosterone(T),androstenedione(A),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),vascular endothelial growth factor(VEGF)and endostatin(ES)in IGT group were significantly higher than those in NGT group(P<0.05),while HDL-C level was significantly lower than that in NGT group(P<0.05).In PCOS patients,levels of DHEA,T,A,TC,TG,LDL-C,VEGF and ES were positively correlated with IGT level(P<0.05),while HDL-C level was negatively correlated with it(P<0.05).Conclusion The level of blood glucose is positively correlated with level of androgens and vascular endothelial factors in patients with PCOS and IGT,which is positively correlated with TC,TG and LDL-C,while negatively correlated with HDL-C.