多囊卵巢综合征的胰岛素抵抗特征及相关因素研究

目的探讨多囊卵巢综合征患者的胰岛素抵抗特点及与体重指数的关系。方法对2005年7月至2008年7月46例多囊卵巢综合征患者与26例健康女性进行比较研究。按体重指数分为非肥胖组和肥胖组。观察内分泌激素水平、体重指数、OGTT试验及胰岛素释放、稳态模式胰岛素抵抗指数（homeostasis model assessment of insulin resistance,HOMA IR等情况。结果肥胖与非肥胖PCOS组在内分泌激素FSH、PRL及E2等方面无明显差异,肥胖PCOS组LH水平（14.12±0.13）较非肥胖PCOS组（15.34±0.56）低（P〈0.01）,而T水平（4.21±0.87）较非肥胖PCOS组（3.61±0.78）高（P〈0.01）。PCOS组空腹及OGTT2h后血糖及胰岛素水平均较对照组高（P〈0.01）,肥胖组较非肥胖组高（P〈0.01）。PCOS组BMI与HOMA IR之间呈正相关,相关系数为r=0.67（P〈0.01）。结论胰岛紊抵抗是多囊卵巢综合征患者代谢异常的基本特征,肥胖是引起胰岛素抵抗、多囊卵巢综合征的危险因素之一。

Research of Insulin resistance and Its Relative Factors of Polycystic Ovarian Syndrome(PCOS)

Objective To explore the characteristics of insulin resistance（IR）and its relationship with body mass index（BMI）in PCOS.Methods 46 patients with PCOS at our hospital between Jun,2005 and Jun,2008 were compared with 26 healthy women. According to body mass index（BMI）,they were divided into fatty group and non-fatty group.Comparisons were conducted in the endocrinic hormone,BMI,OGTT test,insulin release and homeostasis model assessment of insulin resistance（HOMA IR）.Results No significant differences were observed between fatty group and non-fatty group in aspects of serum follicle-stimulating hormone,prolactin and estradiol.The serum level of luteotrophic hormone in fatty group of PCOS was lower than that of non-fatty group of PCOS,but the serum level of testicular hormone was higher than that of non-fatty group.The levels of plasma glucose and insulin at empty stomach and OGTT 2hour in PCOS were higher than those of normal group.The relationship between BMI and HOMA IR in PCOS was positive correlative,and coefficient correlation was 0.67（P〈0.01）.Conclusion Insulin resistance is a characteristics of abnormal metabolism of polycystic ovarian syndrome,and obesity is one of risk factors causing insulin resistance and polycystic ovarian syndrome.