多囊卵巢综合征与高胰岛素血症的关系

目的　了解多囊卵巢综合征 (PCOS)与高胰岛素血症的关系。方法　检测记录 2 8例 PCOS患者年龄、身高、体重及体重指数 (BMI) ,放免法测定血雌 (E)、孕 (P)、雄激素 (T)、促卵泡生成素 (FSH )、促黄体生成素(L H)、泌乳素 (PRL )、游离三碘甲状腺原氨酸 (T3)、游离甲状腺素 (T4)、晨 8时及下午 4时皮质醇、空腹胰岛素及口服糖耐量试验 (OGTT)糖负荷后各时点胰岛素含量 ,用氧化酶法测定血浆葡萄糖。计算 L H/FSH比值 ,30分钟、12 0分钟、180分钟胰 /糖比 (I/G) ,胰岛素曲线下面积 (AUC)及胰岛素抵抗指数 (IRI) ,血糖水平 ,胰岛素敏感性指数 (ISI) ,胰岛β细胞功能及胰岛素抵抗指数。结果　 2 8人中有 16人 (5 7.1% )同时伴有高胰岛素血症 ,其中一人有糖尿病。高胰岛素与非高胰岛素血症患者的年龄 ,身高 ,体重 ,BMI,血 E、P、T,FSH、L H、PRL、T3、T4、晨 8时及下午 4时皮质醇等无差异。但高胰岛素血症组的 L H/FSH比值为 2 .4± 1.5 ,明显高于非高胰岛素血症组 (1.2± 0 .6 ,P=0 .0 12 5 )。其空腹胰岛素 ,OGTT糖负荷后各时点胰岛素 ,30分钟、12 0分钟、180分钟 I/G,AU C及 IRI亦均高于非高胰岛素血症组。而空腹及各时点的血糖水平与非高胰岛素血症的患者无差异。此外 ,高胰岛素血症组病人的空腹胰岛素水

Polycystic Ovaraian Syndrome and Hyperinsulinemia

Objective　To identify the relationship between polycystic ovarian syndrome and hyperinsulinemia. Methods　Age, body height, body weight, serum estradiol, progesterone, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin(PRL), triiodothyronine (T3), tetraiodothyronine (T4), insulin, oral glucose tolerance test (OGTT), and cortisol were measured in 28 patients with polycystic ovarian syndrome (PCOS).Results　Sxiteen patients (57.1% of total) had hyperinsulinemia. Among them one patient was found diabetic. No difference was noted in age, height, body weight, body mass index, serum estradiol, progesterone, testosterone, FSH, LH, PRL, T3, T4, cortisol, and glucose of OGTT between hyperinsulinemia and non-hyperinsulinemia patients. However the LH/FSH ratio(2.4±1.5) in hyperinsulinemia patients was significantly higher than 1.2±0.6 in non-hyperinsulinemia patients （P=0.0125）. In addition, the results showed that the fasting serum insulin, insulin after OGTT,the insulin/glucose ratio at 30, 120 minutes, 180 minutes, the area under curve of and the insulin, insulin resistant index (IRI) were higher in hyperinsulinemia pateints than in non-hyperinsulinemia patients respectively. Furthermore, the fasting insulin level, insulin/glucose ratio were found to be negatively related to insulin sensitivity index and positively related with β-cell functioning index. Conclusion　Hyperinsulinemia and insulin resistance accompany with some of the PCOS patients in China. Further investigations will be necessary to clarify the relevant mechanisms.