伴或不伴胰岛素抵抗的多囊卵巢综合征的超声特征及其与内分泌指标的相关性

目的 比较伴或不伴胰岛素抵抗（IR）的多囊卵巢综合征（PCOS）患者的超声特征及其内分泌指标的相关性。方法 根据胰岛素抵抗指数（HOMA-IR）将126例PCOS患者分为PCOS伴胰岛素抵抗组（IR-PCOS组，67例）和PCOS不伴胰岛素抵抗组（NIR-PCOS组，59例）。经腔内超声测量并比较两组卵巢和子宫灰阶及彩色多普勒超声参数；检测并比较两组性激素及血脂等相关内分泌指标；分析超声参数与内分泌指标间的相关性。结果 IR-PCOS组卵巢卵泡数（FN）、卵巢间质面积与总面积之比明显增高（P<0.05），卵巢体积、子宫动脉阻力指数（RI）显著增高（P<0.01），卵巢间质动脉RI降低（P<0.01），体质量指数（BMI）、游离睾酮增高（P<0.01），性激素结合球蛋白降低（P<0.05），甘油三酯、HOMA-IR、餐后2 h血糖（2hPG）、空腹血浆胰岛素（FINS）、餐后2 h血浆胰岛素显著增高（P<0.01），FPG增高（P<0.05），高密度脂蛋白降低（P<0.01）。IR-PCOS组FN与黄体生成素与卵泡刺激素比值呈正相关（P<0.01）；卵巢体积与BMI、糖化血红蛋白、HOMA-IR、FPG、2hPG呈正相关（P<0.01）；卵巢体积与FINS呈正相关（P<0.05）。结论 IR-PCOS与NIR-PCOS患者超声特征及内分泌指标有一定差异，且其间有一定相关性。

Ultrasonic features and correlation with endocrine profiles in polycystic ovary syndrome patients with or without insulin resistance

Objective To observe ultrasonic features and differences of endocrine indicators in polycystic ovary syndrome (PCOS) patients with or without insulin resistance (IR), and to investigate their correlation. Methods One hundred and twenty-six patients with PCOS were recruited. Patients were divided into PCOS with IR group (IR-PCOS group, n=67) and without IR group (NIR-PCOS group, n=59) according to homeostasis model assessment for IR index (HOMA-IR). Ultrasonic parameters and hormonal factors were obtained and compared, and their correlation was observed. Results Compared with NIR-PCOS group, follicle number (FN) and the ratio of stromal area/ovarian total area was significantly higher (P<0.05), the ovarian volume and uterine artery resistance index (RI) were also significantly higher (P<0.01), while RI of ovarian interstitial reduced (P<0.01), the levels of body mass index (BMI) and free testosterone were significantly higher (P<0.01), and sex hormone binding globulin was lower (P<0.05), triglyceride, HOMA-IR, plasma glucose-2H (2hPG), fasting plasma insulin (FINS), plasma insulin-2 h were significantly higher (P<0.01), fasting plasma glucose (FPG) was also higher (P<0.05), high density lipoprotein was significantly lower in IR-PCOS group (P<0.01). In IR-PCOS group, FN was significantly associated with luteinizing hormone/follicle stimulating hormone (P<0.01), the ovarian volume was significantly associated with BMI, glycosylated hemoglobin (Hb1AC), HOMA-IR, FPG and 2hPG (P<0.01), the ovarian volume was also significantly associated with FINS (P<0.05). Conclusion There are differences in ultrasonic and endocrine parameters between IR-PCOS and NIR-PCOS patients, and correlation exist among them.