高雄激素不同类型多囊卵巢综合征患者糖脂代谢和胰岛功能特征

目的:分析高雄激素不同类型多囊卵巢综合征(PCOS)患者糖脂代谢特征及胰岛功能差异。方法:选择2017年1月-2019年10月本院就诊的PCOS患者,根据血清睾酮(T)及雄烯二酮(AND)检测结果分为T和AND正常组、单纯高T组、单纯高AND组、高T伴高AND组。分析组间性激素、糖脂代谢及胰岛功能指标差异。结果:单纯高T组、单纯高AND组、高T伴高AND组的mF-G评分及多毛发生率无差异但均高于T和AND正常组(P<0.05),年龄、排卵障碍、体质指数及腰围各组无差异(P>0.05);促黄体生成素(LH)水平、LH/卵泡刺激素(FSH),单纯高T组、单纯高AND组、高T伴高AND组均高于T和AND正常组,单纯高AND组、高T伴高AND组高于单纯高T组(均P<0.05),单纯高AND组与高T伴高AND组无差异(P>0.05),雌二醇(E 2)、泌乳素(PRL)、FSH水平各组无差异(P>0.05);FINS、TC、LDL水平,单纯高T组、单纯高AND组、高T伴高AND组均高于T和AND正常组,单纯高AND组、高T伴高AND组高于单纯高T组(均P<0.05),单纯高AND组与高T伴高AND组无差异(均P>0.05),空腹血糖(FPG)、总胆固醇(TG)、高密度酯蛋白(HDL)各组无差异(P>0.05);单纯高T组、单纯高AND组、高T伴高AND组胰岛素抵抗指数(HOMA-IR)均高于T和AND正常组,胰岛素β细胞功能指数(HOMA-β)低于T和AND正常组,单纯高AND组、高T伴高AND组HOMA-IR高于单纯高T组,HOMA-β低于单纯高T组(均P<0.05),单纯高AND组与高T伴高AND组HOMA-IR、HOMA-β无差异(P>0.05),胰岛素敏感系数(ISI)、葡萄糖曲线下面积(GLU-AUC)、胰岛素曲线下面积(INS-AUC)各组无差异(P>0.05)。结论:伴有高AND的PCOS患者糖脂代谢异常和胰岛素抵抗更严重。

The characteristic of glycolipid metabolism and islet function of women with different types of polycystic ovary syndrome and high hyperandrogenism

Objective:To analyze the characteristic of different types of high hyperandrogenism and glycolipid metabolism of women with polycystic ovary syndrome(PCOS),and to study their islet function situation.Methods:The women with PCOS were selected in this study from January 2017 to October 2019.And according to the levels of serum testosterone(T)and androstenidone(AND),these women were divided into group A(women with normal levels of T and AND),group B(women with high level of T),group C(women with high level of AND),and group D(women with high levels of T and AND).The differences of sex hormone level,glycolipid metabolism,and islet function of women in these groups were analyzed.Results:There were no significant differences in mF-G score and incidence of hirsutism of women among group B,group C,and group D(P<0.05),but those of women in group B,group C,and group D were significant higher than those of women in group A(P<0.05).There were no significant differences in age,ovulation disorder rate,BMI,and WHR of women among these four groups(P>0.05).LH level and LH/FSHB value of women in group B,group C,and group D were significant higher than those of women in group A,and those of women in group C and D were significant higher than those of women in group B(all P<0.05),but those of women in group C had no significant different from those of women in group D(P>0.05).There were no significant differences in levels of E2,PRL,and FSH of women among these four groups(P>0.05).The levels of FINS,TC,and LDL of women in group B,group C,and group D were significant higher than those of women in group A,and those of women in group C and D were significant higher than those of women in group B(all P<0.05),but those of women in group C had no significant different from those of women in group D(P>0.05).There were no significant differences in levels of FPG,TG,and HDL of women among these four groups(P>0.05).The HOMA-IR value of women in group B,group C,or group D was significant higher than that of women in group A,and that of women in group C or D was significant higher than that of women in group B,but the HOMA-βvalue of women in group C or D was significant lower than that of women in group B(all P<0.05).The values of HOMA-IR and HOMA-βof women in group B had no significant different from those of women in group D(P>0.05).There were no significant differences in values of ISI,GLU-AUC,and INS-AUC of women among these four groups(P>0.05).Conclusion:The women with PCOS and high AND has more serious abnormal glucose lipid metabolism and insulin resistance.