非肥胖型PCOS不孕患者超声测量肥胖指标的临床研究

目的:探讨体重指数(BMI)正常的不孕症患者中,多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)即非肥胖型PCOS(NOB-PCOS)与非PCOS(对照组)患者之间内脏脂肪厚度(visceral fat thicknes,VFT)及判断肥胖相关的人体测量值的差异,为更好地治疗NOB-PCOS不孕症提供依据。方法:检测不孕症患者中BMI正常的140例PCOS及81例非P-COS患者的基础性激素,用超声检测腹部皮下脂肪、内脏脂肪、肝前脂肪、肝前皮下脂肪厚度,测量身高、体重、腹围、腰围、臀围等,对两组间上述指标进行分析。结果:NOB-PCOS组血清促黄体生成素(LH)、睾酮(T)明显高于非PCOS组(P<0.05);NOB-PCOS组腹围、腹部皮下脂肪厚度及内脏脂肪厚度明显高于非PCOS组(P<0.05)。结论:NOB-PCOS不孕症患者腹围、腹部皮下脂肪及内脏脂肪厚度等判断肥胖的指标大于非PCOS患者,治疗时应引起重视。     

肥胖型与非肥胖型多囊卵巢综合征患者超声参数与内分泌指标特征比较

目的探讨肥胖型与非肥胖型多囊卵巢综合征(PCOS)患者超声参数及内分泌指标方面的差异性。方法选取2015年1月-2016年12月十堰市妇幼保健院收治的120例PCOS患者为研究对象,根据WHO标准,将BMI≥25 kg/m2者归为肥胖组,将BMI25 kg/m2者归为非肥胖组,对两组患者二维、三维超声参数、内分泌指标及血脂血糖代谢指标进行比较。结果肥胖组PCOS患者卵巢平均直径、最大切面卵泡个数均大于非肥胖组PCOS患者,促卵泡生成激素(FSH)低于非肥胖组(P0.05)。肥胖组PCOS患者卵巢体积、间质体积及卵泡体积均高于非肥胖组,血流指数及血管化-血流指数均高于非肥胖组(P0.05),肥胖组PCOS患者TC、空腹血胰岛素、胰岛素抵抗指数均高于非肥胖组(P0.05),肥胖组PCOS患者性激素结合球蛋白(SHBG)、游离雄激素指数(FAI)均高于非肥胖组(P0.05)。肥胖组PCOS患者最大切面卵泡个数与FSH呈正相关(r=0.862,P0.05),卵巢体积、间质体积、血流指数及血管化-血流指数均与胰岛素抵抗指数呈正相关(r=0.721、0.682、0.712、0.673,P0.05)。结论肥胖型与非肥胖型PCOS患者其超声参数及内分泌指标特征存在一定的差异性,肥胖型PCOS患者其体内胰岛素抵抗水平高于非肥胖组,肥胖型PCOS患者其超声参数与内分泌指标有一定的相关性。     

二甲双胍治疗肥胖及非肥胖PCOS患者的临床评价

目的:探讨二甲双胍治疗对肥胖及非肥胖PCOS患者的临床症状、内分泌、代谢指标的影响,为PCOS患者提供合理的治疗方案。方法:47例肥胖PCOS患者、37例非肥胖PCOS患者应用二甲双胍500 mg/次,3次/d,连续3个月。比较治疗前后临床症状、内分泌、代谢指标的改变。结果:二甲双胍治疗前,肥胖组患者体重指数(BMI)、空腹胰岛素(FINS)、胰岛素曲线下面积(IAUC)、甘油三酯(TG)明显高于非肥胖组患者(P<0.01),而非肥胖组患者促黄体生成素(LH)、胰岛素敏感指数(ISI)、高密度脂蛋白(HDL-c)高于肥胖组患者(P<0.05、P<0.01)。二甲双胍治疗后,肥胖组中24例患者恢复了月经,非肥胖组中19例患者恢复了月经,两组患者治疗后月经恢复情况比较差异无统计学意义(P>0.05)。二甲双胍治疗后,肥胖组患者BMI、腰臀比(WHR)、LH、雄激素(T)、FINS、IAUC明显降低(P<0.05、P<0.01),ISI明显提高(P<0.05);非肥胖组患者WHR、LH、T、FINS、IAUC明显降低(P<0.05、P<0.01),ISI明显提高(P<0.05)。肥胖组患者治疗后,总胆固醇(TCH)、甘油三酯(TG)、低密度脂蛋白(LDL-c)、载脂蛋白-B(ApoB)均明显下降(P<0.05、P<0.01);非肥胖组中,只有ApoB下降(P<0.01),余无明显改变。结论:肥胖与非肥胖PCOS患者内分泌特征不同,二甲双胍可改善肥胖及非肥胖PCOS患者的临床症状,降低LH、T水平,提高胰岛素的敏感性,对肥胖及非肥胖PCOS患者均有效,尤其适用于肥胖患者。     

肥胖与非肥胖型多囊卵巢综合征患者血清C反应蛋白水平及意义

[目的]探讨肥胖与非肥胖型多囊卵巢综合征(PCOS)患者血清中C反应蛋白(CRP)的变化及与胰岛素抵抗的关系。[方法]将56例PCOS患者按体重指数(BMI)分为非肥胖PCOS组(22例)和肥胖PCOS组(34例),46例正常妇女分为非肥胖对照组(19例)和肥胖对照组(27例)。测定血清卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、雌二醇(E2)、睾酮(T)、空腹血糖(FPG)、空腹胰岛素(FINS)、CRP浓度。[结果]PCOS组LH、LH/FSH、T、FINS显著高于对照组,胰岛素敏感指数(ISI)显著低于对照组,两组CRP水平无统计学差异。肥胖PCOS组和肥胖对照组血清CRP水平均显著高于各自的非肥胖组。血清CRP水平与BMI、FINS呈正相关,与ISI呈负相关。[结论]PCOS患者不存在慢性亚临床炎症,心血病风险仅限于合并肥胖或胰岛素抵抗的PCOS患者。     

血清瘦素 脂联素水平与肥胖型多囊卵巢综合征不孕患者体外受精-胚胎移植助孕结局的关系

目的探究血清瘦素(Leptin)、脂联素水平与肥胖型多囊卵巢综合征(PCOS)不孕患者体外受精-胚胎移植(IVF-ET)助孕结局的关系。方法选取2017年1月-2019年3月该院诊治的126例肥胖型PCOS不孕患者为肥胖型PCOS组,132例非肥胖型PCOS不孕患者为非肥胖型PCOS组,130例因输卵管因素于该院行IVF-ET治疗的继发不孕患者为对照组。比较各组一般资料;采用酶联免疫吸附法(ELISA)检测各组受试者血清Leptin、脂联素水平; Pearson法分析肥胖型PCOS患者血清Leptin、脂联素水平与空腹胰岛素(FINS)及稳定型评价胰岛素抵抗(HOMA-IR)指数相关性;比较各组IVF-ET结局; Logistic回归分析PCOS不孕患者IVF-ET妊娠结局的影响因素。结果肥胖型PCOS组体质指数(BMI)、睾酮(T)、FINS、HOMAIR及血清Leptin水平均明显高于非肥胖型PCOS组、对照组(P0.05),血清脂联素水平、临床妊娠率、着床率均明显低于非肥胖型PCOS组、对照组(P0.05),非肥胖型PCOS组雄激素(T)、促黄体生成素、FINS、HOMA-IR及血清Leptin水平均明显高于对照组(P0.05),血清脂联素水平、临床妊娠率及着床率均明显低于对照组(P0.05);肥胖型PCOS患者血清Leptin水平与FINS、HOMA-IR呈正相关,脂联素水平与FINS、HOMA-IR呈负相关(P0.05); BMI、FINS、HOMA-IR及Leptin为PCOS患者IVF-ET妊娠结局的危险因素(P0.05),脂联素是PCOS患者IVF-ET妊娠结局的保护因素(P0.05)。结论肥胖型PCOS不孕患者血清Leptin呈高水平,脂联素呈低水平,Leptin、脂联素可能在PCOS不孕疾病进展中发挥一定作用,两者均可能与IVF-ET不良妊娠结局密切相关。     

初诊多囊卵巢综合征与胰岛素抵抗、肥胖和性激素的关联性研究

目的探讨初诊多囊卵巢综合征(PCOS)患者胰岛素抵抗、肥胖指标和性激素的关联性。方法选取2014年3月-2016年3月就诊于佛山市三水区人民医院初诊的PCOS患者60例设为阳性组,并招募月经正常的健康女性30例设为阴性组。计算体质量指数(BMI)和腰臀比(WHR),并收集血清检测促黄体生成素(LH)、卵泡刺激素(FSH)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。通过进行葡萄糖耐量试验,检测血糖、胰岛素水平,评估胰岛素抵抗的指标。采用双抗体夹心酶联免疫吸附法(ELISA)测定血清Orexin A及Nesfatin-1,并进行相关性分析。结果两组BMI和WHR相比差异有统计学意义(P0.05),LH、FSH、T、LDL-C、TG水平相比差异有统计学意义(P0.05),且阳性组LH/FSH3。两组各胰岛素抵抗指标相比差异有统计学意义(P0.05)。与阴性组相比,阳性组血清OXA及Nesfatin-1水平均明显降低(P0.01)。阳性组和阴性组的肥胖亚组OXA及Nesfatin-1水平均明显低于对应的非肥胖亚组(P0.05)。相关性分析显示,PCOS组空腹血清OXA水平与HOMA-IR、LH、LH/FSH、FBG和P2h BG关联性最为密切。此外,Nesfatin-1水平与HOMA-IR、FINS和FBG相关性最为显著。结论 PCOS患者体内的胰岛素抵抗、性激素和肥胖指标发生了显著性变化,对判断和纠正PCOS患者代谢综合征的发生有临床意义。     

二甲双胍用于改善非肥胖型多囊卵巢综合征患者糖、脂代谢的临床观察

目的:观察二甲双胍改善非肥胖型多囊卵巢综合征(PCOS)患者糖、脂代谢的临床效果。方法:选取诊断为PCOS的非肥胖患者,随机分为观察组和对照组,观察组243例,其中有胰岛素抵抗(IR)74例(30.45%),均采用二甲双胍联合达因-35治疗3个月;对照组214例,其中有胰岛素抵抗(IR)70例(32.71%),均采用达因-35治疗3个月,比较两组治疗前后的糖、脂代谢相关指标。结果:①观察组治疗前后空腹胰岛素(FPG)、总胆固醇(TC)及低密度脂蛋白(LDL-C)水平比较,差异均有统计学意义(P0.05);②对照组治疗前后糖脂代谢相关指标比较均无统计学意义(P0.05)。结论:对于非肥胖型PCOS患者,无论是否存在IR,二甲双胍对于改善其胰岛素敏感性及脂代谢均有一定的临床效果。     

非肥胖型多囊卵巢综合征患者饮食运动行为研究与分析

目的探讨非肥胖型多囊卵巢综合征(PCOS)患者的饮食结构以及运动行为。方法选取2009年1月-2015年12月该院收治的PCOS患者80例为病例组,根据患者体质量指数(BMI)分为肥胖组和非肥胖组,另选取同期在该院健康体检年龄匹配的健康妇女40例为对照组。检测所有受试者睾酮(T)、空腹血糖(FBG)和空腹胰岛素(FINS)水平,并计算胰岛素抵抗指数(HOMA-IR)。使用该科室研发的糖尿病/肥胖综合评估与康复处方系统调查分析受试者饮食构成以及运动行为。结果非肥胖型PCOS患者表现出显著的高雄激素血症。饮食摄入构成方面,非肥胖型PCOS组早餐的比例以及碳水化合物的摄入显著低于对照组,而脂肪的摄入高于对照组。运动行为方面,非肥胖组PCOS较肥胖组有较高的运动能量消耗,而在日常活动以及职业活动方面,3组无显著差异。结论非肥胖型PCOS患者与肥胖型PCOS患者同样存在显著的饮食不规律以及营养不合理的情况,但在运动方面并无显著的异常。     

多囊卵巢综合征患者血清Ghrelin水平与胰岛素抵抗关系的研究

目的 探讨多囊卵巢综合征(PCOS)患者血清Ghrehin水平与胰岛素抵抗的关系.方法 选择我院2010年3月到2011年3月期间60例PCOS患者,根据体重指数(BMI)随机分为两组:肥胖组(A组,BMI ≥25 kg/m2)和非肥胖组(B组,BMI ＜25 kg/m2),每组30例.并选取60例健康受试者作为对照组,其中肥胖组(C组,BMI≥25 kg/m2)和非肥胖组(D组,BMI ＜25 kg/m2)各30例.采集以上四组患者空腹静脉血,测定空腹血糖(FBG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR);采用酶联免疫吸附法(ELISA)测定血清Ghrelin水平.结果 ①与健康受试者比较,PCOS患者的FINS、HOMA-IR均明显增高(P＜0.05),血清Ghrelin明显降低(P＜0.05),FBG无明显差异(P＞0.05);②在PCOS患者和健康受试者中:与非肥胖组比较,肥胖组的FINS、HOMA-IR均明显增高(P＜0.05),血清Ghrelin明显降低(P＜0.05),FBG无明显差异(P＞0.05);③PCOS患者血清Ghrelin水平与BMI呈显著负相关(r=-0.59,P=0.006),与WHR呈显著负相关(r=-0.24,P =0.021),与HOMA-IR呈显著负相关(r=-0.40,P=0.003).结论 PCOS患者Ghrelin水平降低,并以PCOS肥胖组降低尤为明显;PCOS患者Ghrelin水平与胰岛素抵抗相关.     

广东地区455例多囊卵巢综合征患者糖脂代谢特征

目的研究多囊卵巢综合征(PCOS)患者内分泌及糖脂代谢特征,以指导临床治疗。方法依据2003年鹿特丹诊断标准纳入PCOS患者455例,按照体重指数和胰岛素抵抗指数分组,比较不同分类患者的性激素、血糖、胰岛素及血脂水平。结果 (1)肥胖组和非肥胖组分别为152例和303例,肥胖组PCOS患者T、FPG、FINS、2 h-PG、2 h-INS、HOMA-IR、TG、LDL、Apo-B高于非肥胖组,FSH、LH、HDL低于非肥胖组,差异有统计学意义(P0.05);(2)胰岛素抵抗组217例(IR组)和非胰岛素抵抗组238例(NIR组),IR组PCOS患者BMI、FPG、FINS、2h-PG、2h-INS、HOMA-IR、TG高于NIR组,LH、HDL低于NIR组,差异有统计学意义(P0.05)。结论 (1)非肥胖的PCOS患者表现为下丘脑-垂体-卵巢轴功能紊乱,肥胖的PCOS患者更容易出现胰岛素抵抗;(2)PCOS患者存在脂代谢异常,以肥胖型PCOS患者和胰岛素抵抗型PCOS患者血脂紊乱更为明显。     

Abdominal fat distribution measured by ultrasound and aerobic fitness in young Danish men born with low and normal birth weight

Abdominal subcutaneous and visceral adipose tissue thickness was examined by ultrasound in 17 men with low birth weight (LBW) and 26 with normal BW control individuals to determine if abdominal obesity in LBW individuals is due to increased visceral or subcutaneous fat mass/thickness, or both. Men born with LBW had an increased waist-to-hip ratio (P = 0.04), greater abdominal fat thickness (P = 0.05) and increased visceral (VAT) and subcutaneous adipose tissue (SAT) thickness compared with controls, however the latter not statistically significant (P = 0.08, P = 0.10). A significant difference between birth weight groups in both SAT (P = 0.04) and VAT (P = 0.03) was found after adjustment for weight, whereas no significant difference in either SAT (P = 0.93) or VAT (P = 0.30) was found after adjustment for BMI. Increased waist-to-hip ratio in LBW individuals is due to increased total abdominal fat including both subcutaneous and visceral fat.     

用能谱CT的方法评估成年人腹部脂肪分布特点及其影响因素分析

目的 用能谱CT的方法评估成年人腹部脂肪分布的特点,并分析其影响因素。方法 对105例成年人进行身高、体重、腰围、臀围的测量,并用能谱CT扫描评估腹部脂肪分布特点。结果 与非肥胖者相比,肥胖症患者的腹部皮下脂肪、腹腔和肝脏异位脂肪含量均较高（P<0.05）,而肌肉内脂肪（IMAT）含量并不随BMI而增加;中年组的腰围、腰臀比、腹腔面积和IMAT均较青年组高,且中年组的肌肉含量较青年组低,两组间的差异有统计学意义（P<0.05）;男性的腹腔面积和肌肉含量高于女性,而女性的皮下脂肪面积、腹部皮下脂肪厚度和竖脊肌内脂肪含量高于男性,两组间差异有统计学意义（P<0.05）。结论 不同BMI、年龄和性别的受试者的腹部脂肪分布的特点不同,因此,应重视对肥胖症患者的异位脂肪分布的个体性评估。能谱CT可作为异位脂肪评估的重要手段,为制定个体化的减重方案提供依据。     

Upper trunk fat assessment and its relationship with metabolic and biochemical variables and body fat in polycystic ovary syndrome

Background: Fat accumulation in the upper region of the body is common in polycystic ovary syndrome (PCOS) and is associated with metabolic complications. The present study aimed to assess the relationship between trunk circumference, metabolic indicators, and abdominal and visceral fat in obese PCOS women. Methods: The weight, fat mass, and subcutaneous arm fat (SAF) of 30 obese PCOS women and 15 healthy controls matched for age and body mass index were evaluated by bioelectrical impedance analysis. Trunk (TrC), neck (NC) and hip circumferences were measured, and the trunk/hip (Tr/H) ratio was determined. Total abdominal fat (TAF), visceral fat (VF) and trunk fat (TrF) were determined by computed tomography. Biochemical evaluation included glycaemia, insulinaemia, testosterone and lipid profile, insulin resistance (IR) was assessed by the QUICKI index. Results: In the PCOS group, there were positive correlations between NC and TAF (r = 0.49, P < 0.0006), TrC and VF (r = 0.62, P = 0.01), and NC and VF (r = 0.70, P < 0.0002). There was good correlation between TrC and TrF (r = 0.69, P = 0.003). TrF correlated with triglycerides levels positively (r = 0.44, P = 0.02). Women with PCOS and IR had a larger quantity of VF and TrF, but a smaller amount of SAF. Within the PCOS group, women with Tr/H ratio above the median had higher basal insulin levels and lower QUICKI indices compared to women presenting a Tr/H ratio below the median. Conclusions: TrC is associated with important metabolic variables in PCOS, proving to be a valuable and innovative tool for assessment of body adiposity distribution in obese PCOS women.     

某医院职工人体成分与脂肪肝检出情况研究

目的了解医院职工健康状况,研究体成分与脂肪肝的相关性,更好地预防慢性疾病的发生。方法 2014年2~5月职工体检期间有322名在职及离退休人员参加了体成分测试,结合同期体检腹部彩超结果,分为脂肪肝组与非脂肪肝组,对两组人员的体成分参数进行分析。结果参检者体质量指数(BMI)、体脂百分比、腹围、腰臀比等均值高于正常范围,不同性别参检者BMI、矿物质含量、骨骼肌肉量、蛋白质、身体水分、体脂百分比等有性别差异,P0.01;年龄、内脏脂肪面积、肥胖程度、健康评分等无性别差异,P0.05;男性脂肪肝检出率高于女性,P0.05;脂肪肝组与非脂肪肝组的BMI、矿物质含量、骨骼肌肉量、蛋白质、体脂肪、体脂百分比、内脏脂肪面积、腹围、臀围、腰臀比、健康评分有高度统计学差异,P0.01,内脏脂肪面积分段与脂肪肝检出率有统计学意义,P0.01。结论本组职工超重肥胖率较高,脂肪肝检出率高于近年事业单位体检报道[1-3],慢性疾病潜在危险性较高,脂肪肝组与非脂肪肝组体成分有高度统计学差异,对BMI、腰臀比超标及内脏脂肪面积80cm2的职工进行个体化饮食及运动方式指导,跟踪效果,利于脂肪肝等慢性疾病的预防。     

The relationship between anthropometry and body composition from computed tomography: The Mediators of Atherosclerosis in South Asians Living in America Study

Objective: Few studies examine the relationships between anthropometry and the body composition measures they approximate, or whether they differ by sex, and no studies have examined these relationships in South Asians living in the US.

Design: We conducted a cross-sectional study of 871 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study who had BMI?2 and underwent abdominal CT scans for measurement of visceral and subcutaneous fat. Linear regression was used to model the associations between anthropometric measures and naturally log-transformed body composition measures.

Results: All measures of anthropometry, except height, were significantly associated with visceral fat and had a significant non-linear component (p?p?=?.007 for interaction) and waist-to-hip ratio (women 25.9, men 717.4, p?2): 10.3, 14.0; waist circumference (cm): 1.51, 3.36; hip circumference (cm): 2.53, 4.50) with p?Conclusions: In MASALA participants, the relationships of anthropometric measures with visceral and subcutaneous fat appear similar to other race/ethnic groups, but with weaker non-linearity and heterogeneity by sex. Given these results, researchers should consider separate models by sex for US South Asians when approximating subcutaneous fat or when using waist circumference to approximate visceral fat.     

A 360-degree overview of body composition in healthy people: Relationships among anthropometry,ultrasonography, and dual-energy x-ray absorptiometry

ObjectiveThe aim of this study was to test the relationship between anthropometry, ultrasonography, and dual-energy x-ray absorptiometry (DXA) for the assessment of body composition in clinical practice.MethodsThe study was carried out in Italian blood donor volunteers belonging to five different age groups (18–70 y old; 25 men and 25 women per group; N = 250 participants; n = 125 men, n = 125 women). A complete history was collected and routine blood analyses were performed to confirm healthy status. All participants were submitted to whole-body DXA (tricompartmental analysis, regional, and total body), ultrasonography (abdominal adiposity evaluation), and anthropometric measurements. DXA was used as gold standard and its biomarkers were taken as reference for fat–lean mass balance, central–peripheral fat distribution, central or visceral fat, and subcutaneous fat.ResultsAnthropometric and ultrasound parameters were closely associated with most of DXA parameters. Composite markers representative of central and abdominal visceral fat compartments were significantly correlated with waist circumference, waist-to-hip ratio, and intra-abdominal fat thickness by ultrasound, in both men and women (P < 0.025). As expected, subcutaneous depots were significantly correlated with maximum subcutaneous fat thickness measured by ultrasonography (P < 0.025).ConclusionsBoth anthropometry and ultrasonography provide a reliable estimate of visceral adipose tissue in a non-obese population compared with DXA, whereas anthropometry prediction of subcutaneous adiposity is weak. Physicians should be aware of the limits of these techniques for the assessment of body composition.     

体脂分布对减肥效果的影响

目的探讨体脂分布对减肥效果的影响。方法研究对象为471名单纯肥胖者。采用InBody720人体成分测定仪进行内脏脂肪测定。根据内脏脂肪正常与否分为内脏脂肪超标组和正常组。经过1个月的饮食控制、适量运动,分别于实验前后进行体重测量。结果经过减肥治疗,内脏脂肪超标组减重分数(0.067±0.022)明显高于内脏脂肪正常组(0.057±0.023),有统计学意义(P<0.01)。男性中内脏脂肪超标组减重分数和女性中内脏脂肪超标组减重分数均明显高于相对应的内脏脂肪正常组的减重分数,且均有明显的统计学差异(男性P<0.05,女性P<0.01)。而内脏脂肪超标组和正常组组内的男女之间的减重分数没有统计学差异(P>0.05)。随体重指数(BMI)的增大,减重效果越明显,年龄小于45岁者较年龄大者减重效果并没有统计学差异(P>0.05)。结论内脏脂肪超标者其减脂效果好于正常者,体重指数(BMI)越高者减脂效果越好,但其减肥效果与性别、年龄无关。     

生活方式综合管理超重肥胖多囊卵巢综合征患者体质量下降与成功妊娠的关系

目的综合管理不孕超重肥胖多囊卵巢综合征(PCOS)女性,以期更有效地控制体质量(BW)、改善胰岛素抵抗(IR)及不孕,并明确体质量下降程度与妊娠的关系。方法健康管理中心开设体质量管理门诊,针对不孕超重肥胖的PCOS女性进行生活方式综合管理,观察干预后妊娠率,并分析体质量下降程度与成功妊娠的关系。结果52例不孕不育超重肥胖PCOS女性随访管理时长平均8个月,其中30例妊娠(4例自然受孕,26例该院生殖中心辅助受孕;在总人群中自然受孕率为7.69%)。基线时两组BW、体质指数(BMI)、内脏脂肪面积(VFA)及三酰甘油(TG)差异无统计学意义(P>0.05)。干预后两组BW、BMI、VFA、体脂肪(BF)及稳态模型评估胰岛素抵抗指数(HOMA-IR)、TG均明显下降(P<0.05);干预后未妊娠组TG及HOMA-IR显著高于妊娠组(P<0.05);干预前后妊娠组体质量下降百分比(△BW%)高于未妊娠组(P=0.019);能够成功受孕的△BW%临界值为10.45%。结论对于超重肥胖不孕PCOS患者生活方式综合管理后,体质量、BMI、BF及HOMA-IR、血脂均取得良好改善;为成功妊娠,体质量下降需达原始体质量的10.45%。     

The relationship between visceral adiposity and cardiometabolic risk in Chinese women with polycystic ovary syndrome

ObjectiveTo compare the extent to which visceral adiposity, as measured by mesenteric fat thickness, contribute to cardiometabolic risk, especially insulin resistance, in women with PCOS and healthy control.MethodsThis is a cross-sectional study with a total of 190 women with PCOS fulfilling the Rotterdam diagnostic criteria. Women without PCOS were recruited from a previous study, which comprised 416 healthy women controls with normal glucose tolerance. All subjects underwent OGTT, biochemical assessment, and sonographic assessment with measurements of mesenteric, preperitoneal and subcutaneous fat thickness.ResultsMesenteric fat thickness was strongly correlated to cardiometabolic traits including blood pressure, fasting and 2-h glucose, triglycerides, HOMA-IR; and was negatively correlated to HDL-C in both cohorts (all p < 0.01). In PCOS, positive correlation was observed between mesenteric fat thickness and free androgen index (p < 0.01). Compared with controls, the regression line between mesenteric fat and HOMA-IR is much steeper in PCOS (p < 0.01).ConclusionWomen with PCOS remain more insulin resistant compared to controls at any given degree of visceral adiposity.