营养干预对肥胖型多囊卵巢综合征患者内分泌及妊娠成功率的影响

Effect of Nutritional Intervention on Endocrine Function and Pregnancy Rate in Patients with Obesity-Induced Polycystic Ovary Syndrome

目的探讨药物治疗基础上联合营养干预对肥胖型多囊卵巢综合征(PCOS)血糖、生殖激素及妊娠成功率的影响。方法选取2021年1月至2023年12月收治的有生育需求肥胖型PCOS患者118例。按照随机数字表法分为对照组与观察组,每组59例。观察组给予药物联合营养干预治疗,对照组给予单纯药物治疗。2组均连续治疗3个月经周期。观察并对比2组治疗前后体质量指数(BMI)、腰臀比、血糖水平、胰岛素抵抗指数、生殖激素水平及排卵和妊娠成功率。结果治疗后,2组空腹血糖、餐后2 h血糖、胰岛素水平、胰岛素抵抗指数、黄体生成素、睾酮水平均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后,2组BMI、腰臀比均较治疗前明显降低,观察组BMI较对照组明显降低(P<0.05,P<0.01),但腰臀比组间比较差异无统计学意义(P>0.05)。治疗后,2组促卵泡生成素高于治疗前,且观察组高于对照组(P<0.05,P<0.01)。2组排卵成功率比较差异无统计学意义(P>0.05);观察组妊娠成功率[49.15%(29/59)]高于对照组[32.20(19/59)],差异有统计学意义(P<0.05)。结论药物治疗基础上联合营养干预能够明显降低肥胖型PCOS患者的BMI,改善机体胰岛素抵抗的状态,缓解肥胖状态,能够正向改善生殖激素水平,从而提高肥胖型PCOS患者成功受孕率。

Objective To investigate the effects of drug therapy combined with nutritional intervention on blood glucose,reproductive hormone and pregnancy success rate in patients with obese polycystic ovary syndrome(PCOS).Methods A total of 118 obese PCOS patients with fertility needs were selected from January 2021 to December 2023.They were divided into control group and observation group,with 59 patients in each group.The observation group was given drug treatment combined with nutrition intervention,and the control group was given simple drug treatment.Both groups were treated for 3 consecutive menstrual cycles.The effects of body mass index(BMI),waist-to-hip ratio(WHR),blood glucose level,insulin resistance index,reproductive hormone index,ovulation and pregnancy success rate before and after treatment were observed and compared between the two groups.Results After treatment,fasting blood glucose,2 h postprandial blood glucose,insulin level,insulin resistance index,luteinizing hormone and testosterone levels in the two groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05).After treatment,BMI and WHR in the two groups were significantly lower than those before treatment,and BMI in observation group was significantly lower than that in control group(P<0.05,P<0.01),but there was no significant difference in WHR between the two groups(P>0.05).After treatment,follicle-stimulating hormone in the two groups was higher than that before treatment,and higher in the observation group than in the control group(P<0.05,P<0.01).There was no significant difference in the successful ovulation rate between the two groups(P>0.05).The pregnancy success rate in the observation group[49.15%(29/59)]was higher than that in the control group[32.20(19/59)],and the difference was statistically significant(P<0.05).Conclusion Drug therapy combined with nutritional intervention can significantly reduce the BMI of obese PCOS patients,improve the state of insulin resistance,alleviate obesity,and positively improve the level of reproductive hormone levels,so as to increase the success rate of conception in obese PCOS patients.