青春期多囊卵巢综合征患者糖代谢的临床研究

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、内分泌特点,探讨糖代谢异常与胰岛素抵抗、体重的关系.方法 44例青春期PCOS患者, 按糖耐量低减诊断标准分为糖耐量正常组（37例）与糖耐量低减组（7例）;于卵泡早期取患者空腹静脉血行生殖激素检查后,口服75g葡萄糖, 行糖耐量及胰岛素测定,用稳态模型胰岛素抵抗指数（HOMAIR）评价胰岛素抵抗.结果 （1）糖耐量低减患者的体重指数（BMI）、空腹血糖、空腹胰岛素（FINS）及服糖后120min的血糖值、HOMAIR均高于糖耐量正常患者, 差异有统计学意义（P＜0.01）;（2） BMI、HOMAIR与服糖后120min血糖值均呈正相关,分别（r=0.671,r=0.871,P＜0.001）,BMI和FINS水平呈正相关（r=0.745,P＜0.001）;（3）糖耐量低减（IGT）发生率为15.9%.结论 （1）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异常的重要因素;（2）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.

Abnormal Glucose Tolerance in Adolescents with Polycystic Ovary Syndrome

Objective To study the prevalence of impaired glucose tolerance(IGT), to understand the relationship among abnormalities of glucometabolism and weight and insulin resistance in adolescents with polycystic ovary syndrome(PCOS). Methods Fourty and four PCOS patients were divided into normal glucose tolerance group(37 cases) and impaired glucose tolerance group(7 cases) according to diagnosis criteria.Blood tests for genito-hormone were done in early stage of follicle.And then 75 g glucose was administered orally,glucose tolerance test and insulin were measured.Insulin resistance was evaluated by homeostasis model assessment of insulin resistance(HOMAIR).Results 1.Body mass index(BMI),fasting glucose and insulin,120 min glucose,HOMAIR were significantly higher in patients with IGT(P<0.05) than that in patients with normal glucose tolerance.2.BMI and HOMAIR were positively correlated to the level of 120min plasma glucose (r=0.671,r=0.871,P<0.001).BMI was positively correlated to the level of FINS (r=0.745,P<0.001).3.The prevalence of IGT was 15.9%.Conclusion 1.Adolescents with PCOS are at increased risk for abnormal glucose metabolism,fat and insulin resistance can play an important role in abnormal glucose tolerance in adolescents with PCOS.2.Oral glucose tolerance test could be used for the routine screening of abnormal glucose tolerance in adolescents with PCOS.