多囊卵巢综合征患者不同表型之间代谢异常的特点分析

发布时间：2018-04-30 10:48

本文选题：多囊卵巢综合征 + 表型　；参考：《中国糖尿病杂志》2017年01期

【摘要】：目的分析多囊卵巢综合征(PCOS)患者不同表型间代谢异常的特点。方法选取因不孕症在我院门诊就诊并拟诊为PCOS的患者251例,行OGTT、血脂谱、卵泡期的性腺轴激素水平测定等,并行经阴道卵巢和子宫超声波检查。选取34名月经规律的正常育龄期女性作为健康对照组(NC)。结果 (1)根据鹿特丹诊断标准,234例确诊为PCOS,其中,同时符合全部3条诊断标准的患者129例(55.1%),为符合3条标准组;符合2条诊断标准者105例(44.9%),为符合2条标准组;单纯的卵巢多囊化(PCO)患者17例,为单纯PCO组。与NC组比较,PCOS患者雄激素水平、IR和代谢异常比例升高(P0.05);与单纯PCO组比较,符合2条标准组的血清雄激素、TC水平及肥胖比例升高(P0.05);符合3条标准组的BMI、肥胖比例、TC、LDL-C、雄激素水平、LH/FSH比值升高,且HOMA-IR升高,而Matsuda指数降低(P0.05)。与符合2条标准组比较,符合3条标准组的BMI、肥胖比例、TC、LDL-C、雄激素水平、LH/FSH比值升高,且FPG和HOMA-IR升高,而Matsuda指数则降低(P0.05)。(2)在234例PCOS患者中,有高雄激素血症(HA)者占69.2%。与非HA组比较,HA组的FPG、FIns及胰岛素抵抗指数(HOMA-IR)升高,而Matsuda指数降低(P0.05)。(3)在234例PCOS患者中,超重或肥胖者占53.8%。与体重正常组比较,超重或肥胖组的雄激素水平、糖代谢异常和血脂异常的比例升高(P0.05)。结论在PCOS患者中,同时符合3条诊断标准的患者有更严重的IR和代谢异常;HA可能加重PCOS患者的IR;超重或肥胖可加重PCOS女性生殖内分泌和代谢异常。
[Abstract]:Objective to analyze the characteristics of metabolic abnormalities among different phenotypes in patients with polycystic ovary syndrome (PCOS). Methods 251 patients who were diagnosed as PCOS in our outpatient clinic because of infertility were selected and examined by transvaginal ovarian and uterine ultrasound, including OGTT, blood lipid profile, gonadal hormone level in follicular phase and so on. 34 women with regular menstruation were selected as healthy control group. Results according to the Rotterdam diagnostic criteria, 234 patients were diagnosed as PCOS. among them, 129 patients who met all 3 diagnostic criteria were found to be in accordance with 3 criteria, 105 patients with 2 diagnostic criteria were in accordance with 2 criteria. There were 17 patients with simple ovarian polycystic PCO group. Compared with NC group, the levels of androgen and the proportion of abnormal metabolism in PCOS patients were higher than those in NC group, and those in PCO group were higher than those in simple PCO group. The serum androgen TC level and obesity ratio in the two standard groups were higher than those in the control group (P 0.05), and the obesity ratio in the three standard groups was higher than that in the control group (P < 0.05), and the ratio of androgen and the ratio of HOMA-IR and HOMA-IR were increased, while the Matsuda index was lower than that of the control group (P 0.05). Compared with the two standard groups, the obesity ratio and the ratio of androgen, FPG and HOMA-IR in the three standard groups were increased, while the Matsuda index was decreased (P 0.05). In 234 PCOS patients, hyperandrogenemia was found in 69.2% of the 234 PCOS patients. Compared with the non-HA group, the FINs and the insulin resistance index (HOMA-IRR) of the HA group were increased, while the Matsuda index decreased (P 0.05). Among the 234 patients with PCOS, the overweight or obese group accounted for 53.8% of the total. Compared with normal body weight group, the levels of androgen, abnormal glucose metabolism and abnormal blood lipids increased in overweight or obese group (P 0.05). Conclusion in patients with PCOS, more severe IR and abnormal metabolism may be found in those who meet the three diagnostic criteria, and overweight or obesity may aggravate the abnormality of reproductive endocrine and metabolism in women with PCOS.
【作者单位】：北京大学第三医院内分泌科;北京大学第三医院生殖医学中心;
【基金】：国家973计划资助项目(2012CB517502) 国家自然科学基金资助项目(81500626)
【分类号】：R711.75

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