生活方式调整及药物治疗多囊卵巢综合征的临床研究

目的探讨生活方式调整、二甲双胍及罗格列酮治疗多囊卵巢综合征（PCOS）的临床疗效。方法将106例PCOS患者随机分为单纯生活方式调整（锻炼及饮食控制）、生活方式调整＋二甲双胍与生活方式调整＋罗格列酮治疗3组,分别为43、36、27例,共有60例（分别为22、21、17例）患者完成治疗,观察3组患者治疗前、后排卵情况,比较体重指数（BMI）、腰围、腰围与臀围比值（WHR）、血清睾酮、空腹真胰岛素水平、血脂、稳态模型法测定的胰岛素抵抗指数（HOMA-IR）、空腹血糖与胰岛素比值（GIR）、定量胰岛素敏感检测指数（QUICKI）的变化。结果治疗前3组患者年龄、BMI、腰围、WHR、睾酮水平、空腹真胰岛素水平、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白．胆固醇（HDL-C）、低密度脂蛋白-胆固醇（LDL-C）比较,差异均无统计学意义（P〉0．05）。单纯生活方式调整组的43例患者中22例完成治疗,23％（5／22）恢复排卵;生活方式调整＋二甲双胍组的36例患者中21例完成治疗,43％（9／21）恢复排卵;生活方式调整＋罗格列酮组的27例患者中17例完成治疗,59％（10／17）恢复排卵。3组患者的恢复排卵率比较,差异无统计学意义（P〉0．05）;但生活方式调整＋罗格列酮组较单纯生活方式调整组恢复排卵率高,且差异有统计学意义（P〈0．05）。治疗后3组患者的BMI、腰围、WHR、睾酮、TC、TG、LDL-C、HDL-C比较,差异均无统计学意义（P〉0．05）。结论生活方式调整、二甲双胍、罗格列酮对PCOS患者均有恢复排卵作用。     

吡格列酮治疗肥胖型多囊卵巢综合征前后血清抵抗素和脂联素的变化

目的:探讨胰岛素增敏剂吡格列酮治疗后肥胖型多囊卵巢综合征患者血清抵抗素和脂联素及其它临床指标的变化。方法:吡格列酮治疗肥胖型多囊卵巢综合征35例12周,监测治疗前后患者的临床指标,并用酶联免疫吸附法和放射免疫法检测治疗前后患者血清抵抗素、脂联素浓度,并检测空腹血糖、空腹血清胰岛素、黄体生成激素、卵泡刺激素和睾酮水平和血脂情况。结果:35例患者中31例(88.5%)月经和排卵功能改善,腰臀比和F-G评分比治疗前均下降,差异有统计学意义(P0.05),体重指数也有下降,但无统计学差异(P0.05);治疗后黄体生成激素和睾酮水平显著下降(P0.01),卵泡刺激素水平无明显变化(P0.05);空腹血清胰岛素和HOMA-IR较治疗前显著下降(P0.01),空腹血糖在治疗后略下降,但无显著差异(P0.05);治疗后总胆固醇、甘油三脂和低密度脂蛋白较前显著下降(P0.05),高密度脂蛋白较治疗前显著升高(P0.01);抵抗素较治疗前显著下降(P0.05),脂联素较治疗前显著升高(P0.05)。结论:吡格列酮可有效改善肥胖型多囊卵巢综合征的临床体征、胰岛素敏感性和糖、脂代谢状况;抵抗素和脂联素可能参与多囊卵巢综合征胰岛素抵抗的发生发展,吡格列酮可能通过改善血清抵抗素和脂联素而发挥治疗多囊卵巢综合征、改善其胰岛素抵抗的作用。     

多囊卵巢综合征患者血清中一氧化氮水平及其相关因素的临床研究

目的探讨多囊卵巢综合征（PCOS）患者血清一氧化氮（NO）水平与其血管并发症的关系。方法采用硝酸还原酶法测定27例PCOS患者（PCOS组）,21例因男方因素或输卵管因素不孕患者（对照组）血清NO水平,测定并计算体重指数（BMI）、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、体脂含量、胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（IAI）、血清性激素、空腹血糖（FPG）和胰岛素（FINS）水平。结果非肥胖PCOS组的HOMA-IR高于非肥胖对照组,IAI、血清NO水平低于非肥胖对照组,差异均有显著性（P〈0.05）。非肥胖PCOS组IAI明显高于肥胖PCOS组,差异有显著性（P〈0.01）。血清NO水平在PCOS组和其对照组间差异无显著性（P〉0.05）。PCOS组中,血清NO水平与HOMA-IR（r=-0.317,P〈0.05）、体脂含量（r=-0.346,P〈0.05）呈负相关。结论PCOS患者血清NO水平降低,提示PCOS患者可能存在血管内皮功能受损。     

吡格列酮对多囊卵巢综合征伴胰岛素抵抗患者的疗效观察

目的了解吡格列酮对多囊卵巢综合征伴胰岛素抵抗的疗效。方法选择2003年1月～2005年10月于我院就诊的多囊卵巢综合征伴胰岛素抵抗的患者为研究对象，予吡格列酮口服12周。检测治疗前后BMI、血脂、外周胰岛素敏感度（SI）、FSH、LH、游离睾酮、硫酸脱氢表雄酮（DHEAs）、雄烯二酮、性激素结合球蛋白（sHBG）等指标。结果①BMI治疗前后差异无显著性（P〉0．05），血胆固醇、甘油三酯、低密度脂蛋白于治疗后均降低（P〈0．05），SI于治疗后升高（P〈0．05）；②FSH治疗前后差异无显著性（P〉0．05），LH、游离睾酮、DHEAS、雄烯二酮于治疗后均下降（P〈0．05），SHBG于治疗后升高（P〈0．05）。结论吡格列酮可改善多囊卵巢综合征患者的胰岛素抵抗，进而改善高雄激素症，恢复排卵月经。     

多囊卵巢综合征151例分析

目的：总结多囊卵巢综合征（PCOS）肥胖与非肥胖患者的临床特征及相关影响因素。方法：将151例PCOS患者分为二组，体重指数大于或等于25的PCOSI组；体重指数小于25的PCOSⅡ组。回顾分析两组的临床资料。用放射免疫法测定血清泌乳素、黄体生成素、卵泡刺激素、雌二醇、睾酮、雄烯二酮。结果：①PCOSI组的雄烯二酮、糖负荷后60、120min血糖、血糖曲线下面积、空腹胰岛素、糖负荷后60、120min胰岛素及胰岛素释放曲线下面积均显著高于PCOSⅡ组（P均＜0．05）；②PCOSI组中A、T与胰岛素曲线下面积呈正相关（P＜0．05）；PCOSⅡ组中LH与A呈正相关（P＜0．01）。结论：①肥胖的PCOS患者的临床内分泌紊乱更严重；②肥胖PCOS的高雄激素血症的形成可能是胰岛素抵抗所致，而非肥胖PCOS患者的高雄激素血症主要受LH的影响。     

二甲双胍联合吡格列酮治疗多囊卵巢综合征临床观察

目的观察联合应用二甲双胍和吡格列酮对多囊卵巢综合征(PCOS)的治疗效果.方法选择具有胰岛素抵抗的PCOS患者30例,给予二甲双胍500 mg,每日2次和吡格列酮15 nag,每日1次,治疗6个月.检测患者治疗前、后和停药6个月的血清性激素水平和胰岛素释放水平.结果15例多毛、痤疮症状均明显改善.22例(78.6%)恢复规律的排卵性月经.治疗后黄体生成激素(LH)、睾酮(T)、空腹胰岛素(F-Ins)、胰岛素曲线下面积(Ins-Auc)均分别下降,与治疗前相比,差异有非常显著性,P＜0.01.但在停药6个月内,15例已恢复排卵性月经的患者又相继停经,LH、T、F-Ins、Ins-Auc又有所上升,但与治疗前相比,差异无显著性(P＞0.05).结论二甲双胍联合吡格列酮对治疗PCOS具有协同作用,是一种安全且有效的的方法,但在停药后病情有一定程度的复发.     

伴有黑棘皮病多囊卵巢综合征患者相关实验室指标的特点

目的总结多囊卵巢综合征（PCOS）伴有黑棘皮病（AN）和不伴有该病的实验室检查指标的特点。方法将2002-09—2003-11在北京大学医学部第三医院妇科内分泌门诊就诊的163例多囊卵巢综合征患者根据是否伴有黑棘皮病分为两组，回顾性分析两组的临床资料，用放射免疫法测定卵泡刺激素、黄体生成素、血清泌乳素、雌二醇、睾酮、雄烯二酮。测定空腹血糖以及餐后30min、餐后60min的血糖值和胰岛素各个时点的值，计算葡萄糖和胰岛素的曲线下面积，计算胰岛素敏感系数、胰岛素抵抗指数。结果在性激素中只有血睾酮，伴AN组的患者高于不伴AN组的患者（P〈0，05），其他两组间差异均无显著意义（P〉0，05）。反映血糖及胰岛素水平的各项指标，两组间的差别均有显著意义（P〈0，05），且伴AN组的水平均高于不伴AN组。结论伴有黑棘皮病的PCOS患者雄激素的改变以睾酮增高为主，而且伴有该病的患者更容易伴有糖代谢异常。     

二甲双胍对多囊卵巢综合征患者胰岛素样生长因子-1的影响

目的探讨二甲双胍对多囊卵巢综合征（PCOS）患者血清胰岛素样生长因子-1（IGF-1）及胰岛素样生长因子结合蛋白-1（IGFBP-1）水平的影响及其作用机制，明确二甲双胍治疗的临床效果。方法2002年1—11月对山西医科大学第二医院24例PCOS患者给予二甲双胍500mg，一日3次，8～24周治疗，比较治疗前后血清IGF-1、IGFBP-1、空腹胰岛素及睾酮水平，并对月经恢复、排卵、妊娠情况进行分析。结果二甲双胍可降低血清空腹胰岛素及睾酮水平，能显著升高IGFBP-1水平，治疗前后血清IGF—1水平差异无显著性。单纯二甲双胍治疗后月经恢复率为41．67％（10／24）；自然排卵率为25．00％（6／24），自然妊娠率为12．50％（3／24）。二甲双胍加促排卵治疗共18个周期，排卵周期率66．67％（12／18），妊娠周期率为11．11％（2／18）。结论二甲双胍可以降低血清空腹胰岛素及睾酮水平，增高IGFBP-1水平，可以改善卵泡微环境，有助于月经恢复，提高促排卵和妊娠率．是治疗PCOS的重要手段。     

盐酸二甲双胍和马来酸罗格列酮治疗多囊卵巢综合征的临床研究

目的:探讨应用胰岛素增敏剂盐酸二甲双胍和马来酸罗格列酮治疗多囊卵巢综合征(PCOS)的临床效果.方法:选择在我院就诊的PCOS患者55例,随机分成盐酸二甲双胍组30例和马来酸罗格列酮组25例,治疗疗程12周.观察两组患者用药前后体重、血糖及胰岛素水平、生殖激素水平变化及排卵、月经改善和不良反应情况.结果:①盐酸二甲双胍治疗后患者的体重降低(P＜0.05),两组治疗后体重比较,差异有统计学意义(P＜0.05);②两药治疗后基础胰岛素值、胰岛素曲线下面积及胰岛素抵抗指数均降低,且马来酸罗格列酮组治疗后数值低于盐酸二甲双胍组(P＜0.05);③两药治疗后雄烯二酮、睾酮水平明显下降,与治疗前相比,差异有高度统计学意义(P＜0.01).④两药治疗后两组排卵率比较差异无统计学意义(P＞0.05).⑤盐酸二甲双胍组的不良反应有稀便、恶心,马来酸罗格列酮组有体重增加、水肿.结论:盐酸二甲双胍、马来酸罗格列酮均能改善PCOS患者的胰岛素抵抗.盐酸二甲双胍有轻微降低体重的作用,价格便宜;马来酸罗格列酮减轻胰岛素抵抗效果优于盐酸二甲双胍.     

吡格列酮联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗的疗效观察

目的观察吡格列酮联合二甲双胍治疗多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)的疗效。方法选取2012年3月~2014年9月我院收治的PCOS伴IR患者72例,将其随机分成观察组与对照组,各36例。观察组给予吡格列酮联合二甲双胍片治疗,对照组给予二甲双胍治疗。3月后,观察两组患者的疗效。结果观察组患者接受治疗后空腹胰岛素(F-INS)、黄体生成素(LH)、睾酮(T)等指标均明显低于治疗前,且均明显高于观察组,月经不规律人数减少,恢复排卵人数增加,差异有统计学意义(P0.05)。结论吡格列酮联合二甲双胍片治疗PCOS具有良好的疗效,能更好地改善机体激素水平,增加胰岛素敏感性,恢复排卵,值得临床推广。     

二甲双胍对多囊卵巢综合征患者纤溶系统、内分泌、代谢的影响及对耐氯米芬的作用

目的：评估二甲双胍对多囊卵巢综合征（PCOS）与耐氯米芬患者的治疗作用。方法：31例PCOS患者（8例为耐氯米芬者）,用二甲双胍375mg/次、3次／d,治疗12－16周,观察服药前后血纤溶酶原激活物抑制物－1（PAI－1）及组织型纤溶酶原激活物（tPA）水平,月经、生殖内分泌激素,糖、脂代谢,卵巢体积的变化及副反应。服用二甲双胍未恢复正常月经、耐氯米芬的患者,再加用氯米芬促排卵,观察排卵情况。非耐氯米芬未恢复正常月经的患者,二甲双胍加量至500mg／次、3次／d,至少8周,观察月经情况。结果：二甲双胍治疗后,PAI－1、黄体生成素／促卵泡激素（LH／FSH）、睾酮、雄烯二酮、低密度脂蛋白胆固醇、总胆固醇、胰岛素、胰岛素曲线下面积、舒张压明显下降,下降幅度分别为3％、41％、25％、34％、28％、14％、27％、23％、7％;左侧卵巢体积缩小59％,右侧卵巢体积缩小41％;雌二醇和FSH水平分别上或42％、58％（P＜0．05－0．01）。二甲双胍375mg/次、3次／d治疗后,61％（19／31）的患者恢复正常月经,2例妊娠;12例恢复正常月经周期,其中6例伴耐氯米芬者再用氯米芬,5例（12／18周期）排卵,2例妊娠,余6例二甲双胍加量至500mg／次、3次／d,1例恢复月经并妊娠。结论：二甲双胍可改善PCOS患者的纤溶系统,生殖内分泌激素,糖、脂代谢,月经失调等,增强耐氯米芬患者对氯米芬的敏感性。     

Effects of the Insulin Sensitizer Pioglitazone on Menstrual Irregularity,Insulin Resistance and Hyperandrogenism in Young Women with Polycystic Ovary Syndrome

BackgroundPolycystic ovary syndrome (PCOS) is the most common endocrine cause of menstrual irregularities, hirsutism and acne. Women with PCOS present elevated plasma insulin levels, both fasting and after a glucose load, as an indirect evidence of insulin resistance. PCOS women may also present hypertension, low levels of HDL cholesterol, hypertriglyceridemia, visceral obesity and a higher level of CRP and fibrinogen that can predict an atherosclerotic risk.MethodsThis study was carried out on 15 young women with PCOS selected according to the 2003 diagnostic criteria of The Rotterdam Consensus Statement and 15 Control women. PCOS women were treated with pioglitazone 30 mg/day and at the beginning and after 6 months of treatment were evaluated: menstrual cycle trend, hirsutism and acne, total cholesterolemia and HDL, triglyceridemia, fibrinogenemia, C-reactive protein, oral glucose tolerance test, glycated hemoglobin, FSH, LH, 17OH-progesterone, 17β-estradiol, free and total testosterone, SHBG, DHEA-S, Δ4-androstenedione and adiponectin.Results and DiscussionTreatment with pioglitazone improves the irregularities of menses and hirsutism. Six months of treatment modify other parameters linked with a higher risk of type 2 diabetes mellitus and cardiovascular diseases: adiponectin increased with reduction of insulin resistance while fibrinogen and CRP levels decreased.     

Pioglitazone for treating polycystic ovary syndrome in non-obese women of reproductive age with different clinical presentations

Aims. To evaluate the effects of pioglitazone on menstruation and the metabolic parameters of non-obese women of reproductive age with polycystic ovary syndrome (PCOS) and compare the effects among different subgroups of PCOS patients with different clinical presentations.

Methods. Twenty-eight women of reproductive age with PCOS were recruited; 20 women finished the study. The women were divided into three groups according to clinical presentations: group A (n = 4) had chronic oligo- or anovulation with polycystic ovaries; group B (n = 5) had chronic oligo- or anovulation with hyperandrogenism; and group C (n = 11) had chronic oligo- or anovulation, hyperandrogenism and polycystic ovaries. Pioglitazone (15 mg/day) was given for 6 months and the therapeutic effects were evaluated. Menstrual cycle regularity and hormone levels (plasma luteinizing hormone (LH), follicle-stimulating hormone, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, insulin, C-peptide, free testosterone, homeostatic model assessment (HOMA)) were evaluated during and after pioglitazone treatment.

Results. Thirty percent and 45.5% of the patients showed improvement of menstrual cycle regularity immediately after completion of treatment and at 6 months after completion of pioglitazone treatment, respectively, although there were no statistical differences among the subgroups. There was a significant difference in the change of body mass index (BMI) throughout the study period among the subgroups (p = 0.008). The decrease in BMI was significantly higher in group B than in groups A and C at 3 months (p = 0.0381) and 6 months of treatment (p = 0.0054), as well as at 6 months after completion of treatment (p = 0.003). HDL-C concentrations increased throughout the period (p = 0.001) without a difference among the subgroups. LH levels decreased at 6 months of treatment and throughout the follow-up period (p = 0.0045), but this did not differ among subgroups. The free testosterone level decreased, but without significance. There was no statistical improvement in any of the parameters of insulin resistance, but baseline free testosterone levels were related to the improvement of the HOMA insulin sensitivity score (p = 0.0009). Patients with more than a 50% decrease of their HOMA insulin resistance (HOMA-IR) score showed higher baseline free testosterone levels (hyperandrogenic groups B and C) than did the patients with less than 50% HOMA-IR score improvement or those patients with an increased HOMA-IR score.

Conclusions. These preliminary results suggest that pioglitazone treatment for non-obese PCOS women of reproductive age may be effective to help the resumption of the menstrual cycle, and the patients showed a different response pattern according to their baseline free testosterone levels.     

Management of polycystic ovarian syndrome with Diane-35 or Diane-35 plus metformin

In this study, we assessed the efficacy and safe usage of the oral contraceptive, Diane-35, in the treatment of polycystic ovary syndrome (PCOS) when combined with the drug metformin. Eighty-two patients with PCOS were randomly divided into two equal groups: Diane-35 treatment group and Diane-35 plus metformin group. Three treatment cycles were administered. Patients’ biomedical data such as height, weight, waist circumference, hip circumference, body fat percentage, acne score, hirsutism score and serum hormone levels were selected, which were tested between the second and the fifth day of the menstrual cycle and follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), blood glucose, blood lipids and insulin levels(IR) were analyzed. Significant reduction in body mass index (BMI), acne score, LH and T levels were observed in both groups after three months of treatment; on the other hand, high-density lipoprotein cholesterol (HDL) concentration elevated (p?p?相似文献   

Endocrine-metabolic effects of the treatment with pioglitazone in obese patients with polycystic ovary syndrome.

The hyperandrogenism found in polycystic ovary syndrome (PCOS) can be a consequence of hyperinsulinemia as a result of peripheral insulin resistance. Metformin and insulin sensitizers have become a potential therapeutic tool for treating these patients; however, there are few studies with pioglitazone in PCOS. Elevated luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratios and LH hyper-responsivity to stimulation with gonadotropin-releasing hormone (GnRH) are common findings in PCOS. The reason why hyperinsulinemia produces hyperandrogenism and whether insulin action on the pituitary alters gonadotropin liberation remain unknown. In the present study, we evaluated the effect of pioglitazone (30 mg/day for 2 months) on insulin response to an oral glucose tolerance test (OGTT), serum levels of androgens and sex hormone-binding globulin (SHBG), and pituitary gonadotropin response to GnRH stimulation in 15 obese PCOS women. We found a significant decrease in insulin response to the OGTT and also in total and free testosterone levels, an increase in SHBG and a reduction in the LH response to GnRH stimulation after pioglitazone treatment. In conclusion, this short-term treatment with pioglitazone decreased hyperinsulinemia and hyperandrogenemia in obese PCOS patients, and there was a significant reduction in LH response to GnRH stimulation. Further research should be carried out to establish the risks and benefits of pioglitazone, which would assist in the physiopathologic comprehension of PCOS.     

Sibutramine has a positive effect on clinical and metabolic parameters in obese patients with polycystic ovary syndrome

OBJECTIVE: To evaluate the effectiveness of sibutramine therapy alone and in combination with ethinyl estradiol-cyproterone acetate (EE-CPA) on the clinical and metabolic parameters of obese women with polycystic ovary syndrome (PCOS). DESIGN: Prospective randomized, controlled study. SETTING: Endocrinology and gynecology clinics. PATIENT(S): Forty obese women with PCOS. INTERVENTION(S): Group 1 was treated with oral EE-CPA (35 microg-2 mg/day), group 2 with oral sibutramine (10 mg/day), and group 3 with a combination of EE-CPA plus sibutramine for 6 months. All groups were advised to consume a diet of 1200 kcal/day. MAIN OUTCOME MEASUREMENT(S): Measurements were performed before and 6 months after treatment of body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, Ferriman-Gallwey hirsutism score, total testosterone, free testosterone, sex hormone-binding globulin, dihydroepiandrosterone sulfate (DHEAS), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, glucose and insulin during oral glucose tolerance test, and insulin sensitivity index; area under the curve for glucose and insulin were obtained from OGTT. RESULT(S): Body mass index, Ferriman-Gallwey hirsutism score, serum total testosterone, free testosterone, and DHEAS levels were significantly decreased and SHBG was significantly increased in all groups at the end of the study. WHR, diastolic blood pressure, and serum triglyceride level were significantly reduced only in the sibutramine group. CONCLUSION(S): Sibutramine might have a positive effect on hyperandrogenemia, and clinical and metabolic risk factors for cardiovascular disease in obese women with PCOS.     

Effects of metformin on clinical and biochemical parameters in polycystic ovary syndrome

OBJECTIVE: To assess the effects of 6 months of metformin therapy on clinical and biochemical parameters in polycystic ovary syndrome (PCOS) and to evaluate those parameters in responders and nonresponders to identify the subjects who respond to an insulin sensitizer in PCOS. STUDY DESIGN: Sixty-six diagnosed PCOS patients were recruited. Baseline characteristics (menstrual history, hirsutism scoring, acne grading, body mass index [BMI], serum luteinizing hormone and follicule-stimulating hormone [LH/FSH] ratio, testosterone,fasting insulin and glucose/insulin index) were assessed initially and 6 months after metformin therapy. Three groups were constructed on the basis of menstrual symptoms: oligomenorrhea (group I), amenorrhea (group II) and hypomenorrhea (group III). Responders were those who had improvements in menstrual pattern or conceived. Response was compared in 3 groups, and biochemical parameters were compared in responders and nonresponders. RESULTS: There were 44 (66.6%) oligomenorrheic, 17 (25.7%) amenorrheic and 5 (7.5%) hypomenorrheic cases and 31 (46.5%) infertile women. In total, 85.7% responded to treatment; the rest (14.3%) were nonresponders. Among responders, 62.29% achieved regular periods, 22.95% experienced improvements in their menstrual abnormalities, and 13% conceived. Overall, a significant reduction occurred in BMI (P =.04), mean testosterone (P = .03) and mean fasting insulin levels (P = .01), but no significant improvement was observed in hirsutism, acne, LH/FSH ratio or glucose/insulin index. A total of 9.75%, 18.75% and 30% did not respond in the oligomenorrheic, amenorrheic and hypomenorrheic groups, respectively (P = .04). Testosterone and insulin were reduced significantly in responders (P = .05 and .01, respectively) but not in nonresponders (P = .26 and .73). An initial high LH/FSH ratio and lower testosterone levels were associated with a better response. CONCLUSION: Six months of metformin therapy improved menstrual cyclicity and fertility in women with PCOS. It resulted in a decline in testosterone and insulin levels. Oligomenorrheic patients with an increased LH/FSH ratio and lower testosterone levels responded better.     

High-sensitivity C-reactive protein (hs-CRP) levels and its relationship with components of polycystic ovary syndrome in Indian adolescent women with polycystic ovary syndrome (PCOS)

C-reactive protein (CRP) is a risk marker for type 2 diabetes mellitus and cardiovascular diseases. In polycystic ovary syndrome (PCOS), limited data are available on high-sensitivity C-reactive protein (hs-CRP) levels and its relationship with components of PCOS especially in Indian women. The objective was to determine serum hs-CRP concentration in adolescent women with and without PCOS and to assess possible correlations of serum hs-CRP levels with components of PCOS in Indian women. One hundred and sixty women with PCOS and sixty non-PCOS women having normal menstrual cycles were included. Clinical assessment included anthropometry, Ferriman–Gallwey (FG) score and blood pressure (BP) measurement. Laboratory evaluation included estimation of T4, TSH, LH, FSH, total testosterone, prolactin, cortisol, 17OHP, hs-CRP, lipid profile, and insulin, and glucose after 2-h oral glucose tolerance test. Homeostasis Model Assessment Insulin resistance index (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) and glucose intolerance was calculated. FG score, LH, FSH, total Testosterone, HOMA-IR and QUICKI were significantly different among women with or without PCOS (p?p?>?0.05). A significant and positive correlation was found between hs-CRP and body mass index (BMI) (r?=?0.308, p?per se be associated with PCOS, rather can be related to fat mass in this subset of subjects.     

多囊卵巢综合征与糖,脂代谢关系的探讨

对多囊卵巢综合征（ＰＣＯＳ）３０例患者，按体重指数（ＢＭＩ）＞２７或＜２４，分为肥胖ＰＣＯＳ组（１７例）及非肥胖ＰＣＯＳ组（１３例）进行糖耐量试验。测定血糖、胰岛素及血脂水平；另选择正常育龄妇女３０例，也按ＢＭＩ分为肥胖对照组（１４例）及非肥胖对照组（１６例）进行对照。结果显示：ＰＣＯＳ患者空腹胰岛素及给糖负荷后的胰岛素水平均较对照组明显升高；且空腹胰岛素水平与睾酮呈显著正相关，说明高胰岛素血症可能是ＰＣＯＳ病因之一。血脂水平，肥胖ＰＣＯＳ及对照组的甘油三脂明显高于非肥胖ＰＣＯＳ及对照组；且甘油三脂与ＢＭＩ呈显著正相关。提示：肥胖ＰＣＯＳ组患者脂代谢改变，可能是肥胖的原因，与ＰＣＯＳ无关。