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。

Clinical efficacy of Metformin therapy on obese and non-obese women with Polycystic ovary syndrome

Objective:To assess the effects of Metformin therapy on obese and non-obese with Polycystic ovary syndrome(PCOS) women in clinical and biochemical parameters.Methods:Forty-seven obese PCOS patients and thirty-seven non-obese PCOS patients were oral Metfomin 500mg three times daily for three months.The clibical symptoms,endocrine and metabolic index were determined before and after treatment characteristics were assessed initially and three months after Metfomin therapy: body mass index(BMI),waist hip ratio(WHR),serum follicule stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),fasting insulin(FINS),fasting serum glucose(FSG),insulin sensitivity index(ISI),the area under the curve for insulin(IAUC),triglyceride(TG),total cholesterol(TCH),high density liproprotein-cholesterol(HDL-c),low density liproprotein-cholesterol(LDL-c),apoliproteinA(ApoA),apoliprotein B(ApoB) Clinical and biochemical parameters were compared in obese and non-obese patients.Results:Before the treatment,the levels of BMI,FINS,IAUC and TG in obese group were significantly higher than that in non-obese group(P<0.01),while the levels of LH,ISI,HDL-c in non-obese group were higher than that in obese group(P<0.05,P<0.01).After the treatment,24 patients in obese group and 19 patients in non-obese group achieved regular menstrual periods.The levels of BMI,WHR,LH,T,FINS,IAUC in obese group and WHR,LH,T,FINS,IAUC in non-obese group were significant reduced(P<0.05,P<0.01 and P<0.05,P<0.01),but the levels of ISI in both groups were significant increased(P<0.05).The levels of TCH,TG,LDL-c,ApoB in obese group were significant reduced(P<0.05,P<0.01),but only ApoB in non-obese group was reduced(P<0.01).Conclusion:Endocritic profiles of obese PCOS patients were different from those of non-obese PCOS patients Three months of Metformin therapy may be clinically useful in obese and non-obese with PCOS,especially applicable to obese PCOS patients.