青春期多囊卵巢综合征患者糖代谢评估

目的　研究青春期多囊卵巢综合征 (PCOS)患者糖耐量异常的发生率 ,探讨糖代谢异常与胰岛素抵抗、体重的关系以及早期评估方法。　方法　 4 3例青春期PCOS患者 ,口服 75 g葡萄糖 ,行糖耐量及胰岛素释放实验。用稳态模型胰岛素抵抗指数 (HOMAIR)评价胰岛素抵抗。　结果　 (1)糖耐量低减发生率为 11 6 % (5 /43) ;(2 )糖耐量低减患者的体重指数、空腹血糖、空腹胰岛素及服糖后 6 0、 12 0min的血糖值、胰岛素值、HOMAIR均高于糖耐量正常患者 ,差异有显著性 (P <0 0 5 )。 (3)体重指数与服糖后 12 0min血糖值成正相关 (r =0 35 5 ,P <0 0 5 )。HOMAIR与服糖后 12 0min血糖值成正相关 (r=0 5 78,P <0 0 5 )。　结论　青春期PCOS患者存在糖代谢异常 ,肥胖和胰岛素抵抗是影响其糖耐量的重要因素 ,口服糖耐量试验是用于监测青春期PCOS患者糖代谢的较好指标。

Study on abnormal glucose tolerance in adolescents with polycystic ovary syndrome

ObjectiveTo study the prevalence of impaired glucose tolerance (IGT),type diabetes mellitus in adolescents with polycystic ovary syndrome (PCOS) and assess suitable screening tests to predict these abnormalities within this population.MethodsPlasma glucose and insulin(INS) response to the tolerance test with 75 g oral glucose load were tested in 43 PCOS patients.Homeostasis model assessment of insulin resistance(HOMA IR) was used to assessed the insulin resistant.The 120min plasma glucose level after an oral glucose challenge was used to classify subjects with IGT.Results1 Five of 43 patients with PCOS had IGT,and the prevalence of IGT was 11 6 %.Thirty eight of 43 patients had normal glucose tolerance;2 Compared to patients with normal glucose tolerance,there were higher levels of fasting glucose and insulin,60min plasma glucose and insulin,120min plasma glucose and insulin,HOMA IR in the patients with IGT;3 BMI was positivly correlated with the level of 120min plasma glucose(r=0 355,P<0 05),and HOMA IR was positively correlated with the level of 120min plasma glucose (r=0 578,P<0 05).ConclusionAdolescents with PCOS are at increased risks for abnormal glucose metabolism.BMI and insulin resistance can play an important role in abnormal glucose tolerance of adolescents with PCOS.Oral glucose tolerance tests could be used for the routine screening of adolescents with PCOS for abnormal glucose tolerance.