非肥胖型多囊卵巢综合征胰岛素抵抗与糖、脂代谢及脂肪分布的关系

发布时间：2018-04-27 03:35

本文选题：多囊卵巢综合征 + 胰岛素抵抗　；参考：《广东医学》2017年18期

【摘要】：目的探讨非肥胖型多囊卵巢综合征(Nob-PCOS)胰岛素抵抗(IR)与糖、脂代谢及脂肪分布的关系。方法选取60例非肥胖(体质指数28 kg/m2)PCOS患者,根据是否存在IR分为IR(+)组(n=40)和IR(-)组(n=20)。比较IR(+)组和IR(-)组患者的生化指标、各项性激素水平结果及脂肪分布情况。结果(1)两组年龄、体重、体质指数、腰围、臀围、腰臀比、三酰甘油、总胆固醇、低密度脂蛋白、高密度脂蛋白差异无统计学意义。IR(+)组收缩压、舒张压、空腹血糖、空腹胰岛素、游离睾酮指数均高于IR(-)组,IR(+)组性激素结合球蛋白低于IR(-)组,差异有统计学意义(P0.05);(2)两组总脂肪量、全身脂肪含量百分比、肌肉量差异无统计学意义。IR(+)组的躯干脂肪百分比、腹区脂肪百分比、躯干脂肪/大腿脂肪、腹区脂肪/臀区脂肪均高于IR(-)组,差异有统计学意义(P0.05);(3)HMOA-IR与躯干脂肪/大腿脂肪(r=0.430,P0.01)、腹区脂肪/臀区脂肪(r=0.399,P0.05)、肌肉量(r=0.366,P0.05)呈正相关;(4)多元回归分析显示:躯干脂肪/大腿脂肪、肌肉量是Nob-PCOS患者IR的独立影响因素。结论中心型脂肪分布在Nob-PCOS患者IR发生中起重要作用,对Nob-PCOS患者不仅要重视对IR的治疗,也要重视减少内脏脂肪的治疗。
[Abstract]:Objective to investigate the relationship between insulin resistance (IRR) and glucose, lipid metabolism and fat distribution in non obese polycystic ovary syndrome (PCOS). Methods 60 patients with non-obesity (BMI 28 kg/m2)PCOS) were divided into two groups according to the existence of IR. The biochemical indexes, sex hormone levels and fat distribution were compared between IR- () and IR- (-) groups. Results there were no significant differences in age, body weight, body mass index, waist circumference, hip circumference, waist-to-hip ratio, triacylglycerol, total cholesterol, low density lipoprotein and high density lipoprotein between the two groups. Fasting insulin and free testosterone index were higher than those in IR-) group (P < 0.05). The sex hormone binding globulin was lower in IR-group than that in IR-group, and the difference was statistically significant (P < 0.05). There was no significant difference in muscle mass. The percentage of trunk fat, abdominal fat, trunk fat / thigh fat, abdominal fat / gluteal area fat in IRN () group were higher than those in IR-) group. There was a significant difference between HMOA-IR and trunk fat / thigh fat, abdominal fat / hip fat 0.399m P0.05a, muscle volume 0.366P0.05). Multiple regression analysis showed that trunk fat / thigh fat and muscle volume were independent factors of IR in Nob-PCOS patients. The results of multiple regression analysis showed that there was a positive correlation between HMOA-IR and trunk fat / thigh fat, and muscle volume was an independent factor of IR in patients with Nob-PCOS. The results showed that there was a positive correlation between HMOA-IR and trunk fat / thigh fat, and muscle volume was an independent factor of IR in patients with Nob-PCOS. Conclusion the distribution of central fat plays an important role in the occurrence of IR in patients with Nob-PCOS. The treatment of IR and the reduction of visceral fat should be emphasized in the patients with Nob-PCOS.
【作者单位】：广州医科大学附属第三医院内分泌科;
【基金】：国家自然科学基金资助项目(编号:81200607) 广东省产科重大疾病重点实验室自主课题(编号:2012Z05)
【分类号】：R711.75

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