肥胖与多囊卵巢综合征患者胰岛素抵抗的临床特征与意义(英文)

Insulin resistance in polycystic ovary syndrome associated with obesity

目的:探讨多囊卵巢综合征(polycysticovarysyndrome,PCOS)患者胰岛素抵抗特点。方法:对62例PCOS患者行葡萄糖耐量试验、胰岛素释放试验,测定五个时点血糖、胰岛素以及C-肽浓度;测定空腹血瘦素、总睾酮浓度以及体重指数(BMI)和腰臀比例(WHR)。结果:PCOS患者糖负荷后血糖、胰岛素以及C-P浓度峰值均在服糖后30～60min。服糖后3h血糖、胰岛素以及C-P浓度显著高于空腹值(t=3.3723～5.0412,P<0.05)。肥胖组的胰岛素曲线下面积显著高于消瘦组(t=2.1263,P<0.05);两组的血糖及C-肽浓度曲线下面积无显著差异(t=0.9949～1.0692,P>0.05)。空腹、60min以及120min胰岛素浓度与肥胖有关指标(瘦素,BMI,WHR)均呈显著正相关(r>0.40,P<0.05)。结论:PCOS患者同时存在胰岛素抵抗和代谢异常。对于PCOS患者常规进行糖耐量及胰岛素释放试验是必要的。肥胖能加重PCOS患者胰岛素抵抗的程度。

AIM:To explore the characteris ti cs of in sulin resistance in patients with polycystic ovary syndrome (PCOS ). METHODS:Blood glucose,insulin,and C-Pepti de(C-P)levels,along with the f asting leptin and sexy horm ones concentrations were measured i n62PCOS patien ts during oral glucose tolerance test(OGTT),and insulin release test was perf ormed at 5diffe rent time points.The body mass index(BMI )and waist-to-hip ratio(WHR)were also measured.RESULTS:The peak levels of blood glucose,insu lin and C-P occurred 30to60minutes after oral glucose admini stration ,and remained significant ly higher at 3hours than those at empty s tomach(t=3. 3723-5.0412respec-tively,P<0.05).The area under the curve(A UC)of serum insulin was significantly larger in obese group than in the lean gr oup(t=2.1263,P<0.05),while the AUC of glucose and C-P searcely differed(t=0.9949-1.0692,P>0.05).The insulin concentratio ns at fasting,60and120min after glucose stimulation we re positively corre lated with leptin lev-els,BMI and WHR(r>0.40,P<0.05).CONCLUSION :Insulin resistance and insulin meta bolic abnormality may coexist in PCOS pati ents.Glucose an d insulin concentrations after glucose stimulation are more ind icative of t he degree of insulin resistant.Obesity may exacerbate insulin resi stance.