各型多囊卵巢综合征患者内分泌及代谢特点分析

目的:探讨各型多囊卵巢综合征(PCOS)患者内分泌及代谢特征,为PCOS的合理治疗及并发症防治提供依据。方法:将54例PCOS患者,根据体重指数(BMI)将其分为肥胖PCOS组30例、非肥胖PCOS组24例,同时选择肥胖对照组20例和非肥胖对照组22例。测定并计算所有研究对象的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(ISI),抽血检测血清黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、泌乳素(PRL)、睾酮(T)、空腹血糖(FPG)和胰岛素(FINS)、低密度脂蛋白(TC)、甘油三酯(TG)水平。结果:两PCOS组的LH水平及T水平均显著高于其相应的对照组(P0.01);肥胖PCOS组的TG水平高于非肥胖PCOS组,而TC水平高于其对照组(P均0.05);肥胖PCOS组的FINS,HOMA-IR均显著高于非肥胖PCOS组(P0.01),且两PCOS组的HOMA-IR均显著高于其对照组(P0.05);肥胖PCOS组的ISI显著低于非肥胖PCOS组(P0.01),且非肥胖PCOS组的ISI显著低于其对照组(P0.05)。PCOS组血清T与LH和TC呈正相关,PCOS组HOMA-IR与BMI、WHR、体脂含量、收缩压、舒张压、FPG、FINS均呈正相关。结论:高雄激素血症(hyperandrogenemia,HA)、胰岛素抵抗(insulin resistance,IR)和高胰岛素血症(hyperinsulinemia,HI)为PCOS的基本特征,肥胖的PCOS患者更易出现IR,要重视PCOS的远期并发症。

Analysis on endocrine and metabolizable characteristics of patients with different type of polycystic ovary syndrome

Objective:To explore the endocrine and metabolizable characteristics of patients with different type of polycystic ovary syndrome(PCOS),provide a basis for rational therapy of PCOS and prevention and treatment of complications.Methods:54 cases with PCOS were divided into obese PCOS group(30 cases) and non-obese PCOS group(24 cases) according to body mass index(BMI),at the same time,obese control group(20 cases) and non-obese control group(22 cases) were selected,the levels of BMI,waist-to-hip ratio(WHR),systolic blood pressure(SBP),diastolic blood pressure(DBP),body fat contents,HOMA-IR,insulin sensitivity index(ISI),serum luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2),prolactin(PRL),testosterone(T),fasting plasma glucose(FPG),fasting insulin(FINS),TC and triglyceride(TG) of all the cases were detected and calculated.Results:The serum levels of LH and T in obese PCOS group and non-obese PCOS group were significantly higher than those in obese control group and non-obese control group(P<0.01).The serum level of TG in obese PCOS group was significantly higher than that in non-obese PCOS group,but the serum level of TC was significantly higher than those in control group(P<0.05).The levels of FINS and HOMA-IR in obese PCOS group were significantly higher than those in non-obese PCOS group(P<0.01),and the levels of HOMA-IR in obese PCOS group and non-obese PCOS group were significantly higher than those in obese control group and non-obese control group(P<0.05).The level of ISI in obese PCOS group was significantly lower than that in non-obese PCOS group(P<0.01),and the level of ISI in non-obese PCOS group was significantly lower than that in non-obese control group(P<0.05).In PCOS group,there was positive correlation between serum T and LH,TC;HOMA-IR was positively correlated with BMI,WHR,body fat contents,SBP,DBP,FPG and FINS.Conclusion:Hyperandrogenemia,insulin resistance and hyperinsulinemia are basic characteristics of PCOS,the obese PCOS patients are easier to present insulin resistance,the long term complications of PCOS should be paid more attention to.