多囊卵巢综合征患者胰岛素抵抗与雄激素和糖代谢变化的关系

The correlation between insulin resistance, androgen levels and carbohydrate metabolism in women with polycystic ovary syndrome

目的 探讨多囊卵巢综合征 (PCOS)患者胰岛素抵抗 (IR)与雄激素和糖代谢的关系。方法 2 5例正常生育期妇女为对照组。 15 9例PCOS患者分为三组 :非胰岛素抵抗 (NIR)组 5 6例 ;高胰岛素血症 (HI)组 81例 ;异常糖代谢 (AGM )组 2 2例。分别比较四组LH FSH比值、雄激素水平、血糖和胰岛素水平、糖曲线下面积 (GAUC)、胰岛素曲线下面积 (IAUC)和胰岛素敏感指数 (ISI)。结果 LH FSH比值和血雄激素水平 :AGM组 >HI组 >NIR组 >对照组 ;GAUC和IAUC :对照组≈NIR组 <HI组 <AGM组 ;ISI :对照组≈NIR组 >HI组 >AGM组。结论 PCOS部分患者可能经历了NIR→IR→HI→IGT→DM的渐进性病理生理过程 ;胰岛素抵抗是PCOS患者高雄激素血导致持续性无排卵的重要因素之一 。

Objective To investigate the relationship between insulin resistance (IR), serum androgen levels and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). Methods Twenty five normal reproductive age matched individuals were regarded as control group, while 159 PCOS women as 3 groups, non insulin resistance (NIR) group of 56 individuals, hyperinsulinemia (HI) group of 81 individuals, and abnormal glucose metabolism (AGM) group of 22 patients. All of the women in the 4 groups were reviewed regarding a LH/FSH ratio, serum glucose and insulin, glucose area under curve (GAUC), insulin area under curve (IAUC), and insulin sensitivity index (ISI). Results Serum androgen levels and LH/FSH ratio shown: AGM>HI>NIR>control. GAUC and IAUC were: control≈NIR<HI<AGM. ISI indicated: control≈NIR>HI>AGM. Conclusion A part of women with PCOS may undergo a pathophysiologic process:NIR→IR→HI→IGT→DM. Insulin resistance is one of the important factors in hyperandrogenic chronic anovulation, and is a factor inducing PCOS glucose metabolism abnormality.