伴或不伴非酒精性脂肪肝对多囊卵巢综合征患者代谢指标的影响

目的:分析伴或不伴非酒精性脂肪肝(NAFLD)对多囊卵巢综合征(PCOS)患者代谢指标的影响?方法:测定PCOS伴NAFLD组(PCOS1组27例)和PCOS不伴NAFLD组(PCOS2组23例)的体质指数(BMI)?腰臀比(WHR)?血压(BP)?尿酸(UA)?丙氨酸氨基转移酶(ALT)?皮质醇(F)?黄体生成素(LH)?卵泡刺激素(FSH)?催乳素(PRL)?睾酮(T)?雌二醇(E2)?总胆固醇(TC)?甘油三酯(TG)?低密度脂蛋白-胆固醇(LDL-C)?高密度脂蛋白-胆固醇(HDL-C)?脂蛋白aLP(a)]?空腹血糖(FBG)?空腹胰岛素(FINS)和瘦素(LEP)水平,计算胰岛素抵抗指数(HOMA-IR)?结果:PCOS2组ALT?BMI和WHR低于PCOS1组(P < 0.01)?PCOS2组TG?Lp(a)?FINS?LEP水平低于PCOS1组(P < 0.05)?PCOS2组F?HDL-C高于PCOS1组(P < 0.05)?PCOS1组HOMA-IR与LEP?BMI?Lp(a)呈正相关趋势?PCOS2组HOMA-IR与T呈正相关趋势?结论:PCOS伴NAFLD患者代谢异常以胰岛素抵抗?血脂异常为主要特征;PCOS不伴NAFLD患者以T升高为主要特征?PCOS?NAFLD两种疾病在临床上存在相关性,对伴或不伴NAFLD的PCOS患者在干预和治疗上应采用不同手段?

Effect of polycystic ovary syndrome with or without nonalcoholic fatty liver disease on the metabolism parameters

Objective: To investigate the endocrine and metabolic differences between polycystic ovary syndrome(PCOS) with nonalcoholic fatty liver disease(NAFLD) and without NAFLD. Methods: Body mass index(BMI), waist-to-hip ratio(WHR), blood pressure(BP), uric acid(UA), alanine transaminase(ALT), cortiso1(F), follicle stimulating hormone(FSH), prolactin (PRL), testosterone(T), estradiol(E2), luteinizing hormone(LH), total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), high density lipoprotein-cholesterol(HDL-C), lipoprotein aLP(a)], fasting blood glucose(FBG), fasting serum insulin(FINS) and leptin(LEP) levels were measured in PCOS with NAFLD group(PCOS1 group,total number is 27) and PCOS without NAFLD(PCOS2 group,total number is 23). The HOMA-IR was measured too. Results: BMI,WHR,ALT,TG,LP(a),FINS,LEP were lower while HDL-C, F were higher in PCOS2 group than those in PCOS1 group(P < 0.05). HOMA-IR was positively correlated to LEP,BMI,Lp(a) in PCOS1 group, whereas HOMA-IR was positively correlated to T in PCOS2 group. Conclusion: Insulin resistance and dyslipidemia were more frequently observed in PCOS with NAFLD, while PCOS without NAFLD was demonstrated with higher T level. It is definitely that there are a clinical association between PCOS and NAFLD. The intervention and treatment of PCOS should be adopted differently between PCOS with NAFLD and PCOS without NAFLD patients.