多囊卵巢综合征代谢特征及其与非酒精性脂肪肝的关系

目的:探讨育龄期与青春期多囊卵巢综合征(PCOS)患者的临床表现、内分泌与代谢特点以及与非酒精性脂肪肝的相关性,分析伴和不伴非酒精性脂肪肝对多囊卵巢综合征患者代谢指标的影响。方法:总结分析2008~2009年就诊于南京医科大学第一附属医院内分泌科的50例PCOS患者和非P-COS患者50例的临床资料,描述其临床表现、内分泌与代谢特点。比较两组患者NAFLD、胰岛素抵抗(IR)、丙氨酸氨基转移酶(ALT)升高发生情况及一般临床参数。结果:50例PCOS患者中育龄期与青春期患者分别有34例和16例,主诉有月经稀发、无排卵、不育,高雄激素表现包括多毛、痤疮、脂溢性脱发和高雄激素血症,代谢紊乱表现包括肥胖或超重、高胰岛素血症,糖尿病或糖耐量异常,高血压,非酒精性脂肪肝和血脂紊乱。育龄期患者中按不同方法计算IR者占25.6%~41.2%。青春期患者中按不同方法计算的IR者占40.8%~50.6%。PCOS组NAFLDI、R、ALT升高的发生率与非PCOS对照组比较显著增高,差异有统计学意义(P<0.01)。结论:PCOS是涉及多系统的疾病,要重视PCOS患者,特别是青春期患者的代谢综合征的筛查与诊治。NAFLD在PCOS患者中患病率高。PCOS、NAFLD两种疾病在临床上存在相关性。

Metabolic characteristics of polycystic ovary syndrome and its correlation with non-alcoholic fatty liver

Objective：To investigate the clinical manifestations,endocrinological and metabolic characteristics of polycysfic ovary syndrome（PCOS） in women of childbearing women age（or in puberty） and its correlation with nonalcoholic fatty liver disease（NAFLD）,especially pay attention to analyze differences in metabolic characters when PCOS was accompanied by alcoholic fatty liver or not.Methods：Clinical manifestations,endocrinological and metabolic characteristics of 50 PCOS patients and 50 non PCOS patients that visited the Endocrinological Department of the First Affiliated Hospital of Nanjing Medical University from 2008 to 2009 were analyzed.Clinic anthropometric variables including prevalence of NAFLD,insulin resistance（IR）,ALT levels were compared between the two groups.Results：Among the 50 cases of PCOS patients,34 were of childbearing age and 14 were in puberty.Their chief complains are oligomenorrhea,armovulation,infertility and clinical manifestations linked to hyperandrogen including hirsutism,acne,alopecia.The metabolic disorders include fat or overweight,diabetes or impaired glucose tolerance,hypertension,nonalcoholic fatty liver and lipid disturbance.IR was presented in 25.6%～41.2% of the 34 patients of childbearing age,and 40.8%～50.6%of those in puberty according to different calculating formulas.Prevalence of NAFLD,IR and ALT was significant higher in PCOS patients compared with non-PCOS patients（P0.05）.Conclusions：PCOS is a complicated disease involved with multiple organs,which also shows correlation with the prevalence of NAFLD.Thus it′s very important to screen metabolic disorders in PCOS patients.