多囊卵巢综合征患者并发代谢综合征的影响因素及其预测价值

Influencing factors of metabolic syndrome in patients with polycystic ovary syndrome and its predictive value

目的探讨多囊卵巢综合征(PCOS)患者并发代谢综合征(MS)的影响因素及其预测价值。方法以2019年5月至2022年5月作为病例收集周期,纳入十堰市妇幼保健院收治的231例PCOS患者作为研究对象,采用十堰市妇幼保健院自制资料调查表收集患者临床资料。治疗期间所有患者均定期随访3个月,根据随访结果,将患者分为MS组和未发生MS组,比较两组患者的临床资料;采用多因素Logistic回归分析PCOS患者治疗3个月内发生MS的影响因素;绘制受试者工作特征(ROC)曲线评估相关指标对MS发生的预测价值。结果231例PCOS患者中,共有99例发生MS(MS组),MS发生率为42.86%,其余132例患者纳入未发生MS组。MS组治疗前血清雌二醇(E2)、睾酮(T)及分泌型卷曲相关蛋白5(SFRP5)水平较未发生MS组低,而血清黄体生成素(LH)水平较未发生MS组高,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PCOS患者治疗前血清E2、T、SFRP5水平升高是PCOS患者治疗3个月内发生MS的保护因素(P<0.05),血清LH水平升高是治疗3个月内发生MS的危险因素(P<0.05)。ROC曲线结果显示,PCOS患者治疗前血清E2、LH、T及SFRP5水平预测MS发生的曲线下面积分别为0.790、0.800、0.781、0.825,最佳截断值分别为167.645 pmol/L、10.970 IU/L、2.355 nmol/dL、10.515 ng/L。结论PCOS患者并发MS可能与血清性激素水平及SFRP5水平异常有关,建议临床医生在治疗前密切监测PCOS患者血清性激素、SFRP5水平,早期预防MS的发生。

Objective To explore the influencing factors of complicated metabolic syndrome(MS)in patients with polycystic ovary syndrome(PCOS)and its predictive value.Methods A total of 231 PCOS patients admitted to Shiyan Maternal and Child Health Hospital from May 2019 to May 2022 were included as study objects,and the clinical data of the patients were collected by homemade data questionnaire of Shiyan Maternal and Child Health Hospital.All patients were regularly followed up for 3 months during the treatment period,patients were divided into MS group and non-MS group according to the follow-up results,and clinical data of the two groups were compared;multivariate Logistic regression was applied to analyze the influencing factors for the occurrence of MS within 3 months of treatment in PCOS patients;and receiver operating characteristic(ROC)curve was plotted to assess the predictive value of the relevant indexes for the occurrence of MS.Results Among 231 patients with PCOS,99 cases had MS(MS group),with MS incidence rate of 42.86%,and the remaining 132 patients were in the non-MS group.The levels of serum estradiol(E 2),testosterone(T)and secreted frizzled-related protein 5(SFRP5)of PCOS patients before treatment in the MS group were lower than those in the non-MS group,and the serum luteinizing hormone(LH)was higher than that in the non-MS group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis results showed that increased levels of serum E2,T and SFRP5 in PCOS patients before treatment were protective factors for the occurrence of MS within 3 months after treatment(P<0.05),and increased level of serum LH was an risk factor for the occurrence of MS within 3 months after treatment(P<0.05).ROC results showed that the areas under the curves of serum E 2,LH,T and SFRP5 for the prediction of the occurrence of MS in PCOS patients before treatment were 0.790,0.800,0.781 and 0.825,respectively,and the optimal cut-off values were 167.645 pmol/L,10.970 IU/L,2.355 nmol/dL and 10.515 ng/L,respectively.Conclusion PCOS patients complicated with MS may be related to the abnormality of serum sex hormone levels and SFRP5 level,and it is recommended that clinicians should closely monitor serum sex hormone and SFRP5 levels in PCOS patients before treatment for early prevention of MS.