自身免疫性甲状腺炎对多囊卵巢综合征(痰湿证)患者糖脂代谢的影响

目的:探讨自身免疫性甲状腺炎(AIT)对痰湿证多囊卵巢综合征患者糖脂代谢的影响。方法:筛选2017年8月至2019年8月黑龙江中医药大学附属第一医院妇科科研门诊首次诊断为多囊卵巢综合征(PCOS)的患者551例,其中非痰湿证312例,痰湿证239例,并根据自身免疫性甲状腺炎(AIT)诊断标准将痰湿证PCOS患者分为Ⅰ组(痰湿证PCOS合并AIT组,n=60)、Ⅱ组(痰湿证PCOS非AIT组,n=179),比较各组之间糖脂代谢水平的差异。结果:(1)痰湿证组及非痰湿证组PCOS患者比较:痰湿组患者WHR、FPG、FINS、FT3高于非痰湿证组,差异有统计学意义(P<0.05);其中痰湿证组患者BMI、IR、TG、ApoA、ApoB、FT4、TPOAb显著高于非痰湿证组(P<0.01);非痰湿证组TC、LDL、脂蛋白a、TSH显著高于痰湿证组(P<0.01);两组患者年龄、HDL及TgAb比较,差异无统计学意义(P>0.05)。(2)Ⅰ组及Ⅱ组比较:Ⅰ组患者IR、TG高于Ⅱ组,差异有统计学意义(P<0.05);其中Ⅰ组患者FINS、120min胰岛素水平、TC、LDL、脂蛋白a、TSH、TPOAb、TgAb显著高于Ⅱ组(P<0.01);Ⅱ组患者HDL、ApoA、ApoB、FT4显著高于Ⅰ组(P<0.01);两组年龄、BMI、WHR、FPG、120 min血糖水平、FT3差异无统计学意义(P>0.05)。结论:痰湿证PCOS患者相比于其他证型的PCOS患者,在糖脂代谢和甲状腺功能方面表现出相对紊乱的状态;而合并AIT的痰湿证PCOS患者腹型肥胖、糖脂代谢紊乱及甲状腺功能紊乱现象更加严重,需给予高度的重视和及时的药物干预,以预防疾病的进一步发展。

Influence of Autoimmune Thyroiditis on Glycolipid Metabolism in Patients with Iolycystic Ovary Syndrome(Phlegm-Dampness Syndrome)

Objective:To investigate the influence of autoimmune thyroiditis(AIT)on glucose and lipid metabolism in patients with polycystic ovary syndrome(PCOS)of phlegm dampness syndrome.Methods:Totally 551 cases of polycystic ovary syndrome(PCOS)were selected from August 2017 to August 2019 in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,including 312 cases of non phlegm dampness syndrome and 239 cases of phlegm dampness syndrome.According to the diagnostic criteria of autoimmune autoimmune thyroiditis(AIT),PCOS patients of phlegm dampness syndrome were divided into GroupⅠ(PCOS with phlegm dampness syndrome combined with AIT,n=60)and groupⅡ(PCOS without phlegm dampness syndrome combined with AIT,n=179).The glycolipid metabolism level was compared among the groups.Results:(1)Comparison between PCOS patients in phlegm dampness syndrome group and non phlegm dampness syndrome group:phlegm dampness syndrome group showed higher WHR,FPG,FINS and FT3 than non phlegm dampness syndrome group(P<0.05).Phlegm dampness syndrome group showed higher BMI,IR,TG,Apo A,Apo B,FT4 and TPOAb than non phlegm dampness syndrome group(P<0.01).Non phlegm dampness syndrome group showed higher TC,LDL,lipoprotein-a and TSH than phlegm dampness syndrome group(P<0.01).There was no statistical significance on age,HDL and Tg Ab between the two groups(P>0.05).(2)Comparison between GroupⅠand GroupⅡ:GroupⅠshowed higher IR and TG than groupⅡ(P<0.05);GroupⅠshowed higher FINS,120 min FINS,TC,LDL,lipoprotein-a,TSH,TPOAb and Tg Ab than groupⅡ(P<0.01).GroupⅡshowed higher HDL,Apo A,Apo B and FT4 than groupⅠ(P<0.01).There was no statistical significance on age,BMI,WHR,FPG,120 min FPG and FT3 between the two groups(P>0.05).Conclusion:Compared with other PCOS patients,PCOS patients with phlegm dampness syndrome showed relatively disorder in glycolipid metabolism and thyroid function.However,the abdominal obesity,glycolipid metabolism disorder and thyroid function of PCOS patients with AIT are more serious.Therefore,high attention and timely drug intervention are needed to prevent the further development of the disease.