多囊卵巢综合征患者脂代谢的研究  

Lipoprotein Lipids in Polycystic Ovarian Syndrome: Independent Associations with Androgen Excess and Insulin Resistance

作　　者：吴效科[1] 张祖暄[1] 苏延华[1] 

机构地区：[1]南京军区南京总医院妇产科

出　　处：《中华妇产科杂志》1998年第1期25-27,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨多囊卵巢综合征（ＰＣＯＳ）患者雄激素过多和胰岛素抵抗与脂代谢的关系。方法对黄体生成素（ＬＨ）／卵泡刺激素（ＦＳＨ）≥３的１５例Ⅰ型组患者、ＬＨ／ＦＳＨ＜３的１５例Ⅱ型组患者和２０例对照组妇女，行黄体生成素释放激素（ＬＲＨ，１００μｇ）兴奋垂体－卵巢轴功能试验，观察试验前后３组睾酮（Ｔ）、甘油三酯（ＴＧ）、高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ）及其载脂蛋白（Ａ１）（ａｐｏＡ１）的变化。结果基础状态下，ＴＧ浓度高低顺序是对照组＜Ⅰ型组＜Ⅱ型组，ＨＤＬ－Ｃ的情况正好相反；ＬＲＨ试验后，两个患者组Ｔ和ＴＧ均呈上升曲线，ＨＤＬ－Ｃ呈下降曲线，尤其以Ⅱ型组的变化更加明显。结论Ⅱ型组患者的脂代谢异常比Ⅰ型组更加严重。雄激素过多和胰岛素抵抗是ＰＣＯＳ患者脂代谢异常的两个基本因素。Objective To investigate the relationship between androgen excess, insulin resistance and altered lipoprotein lipids in polycystic ovarian syndrome (PCOS). Methods Both basal and luternizing hormone releasing hormone (LHRH, 100 μg) induced responses of circulating testosterone (T), triglycerides (TG), high density lipoprotein cholesterol (HDL C) and apoprotein A1 (apo A1) were measured in two PCOS groups with similar T levels (LH/FSH≥3, Group 1, n =15; LH/FSH<3, Group 2, n =15) and the control ( n =20) of matched body mass index with Group 1. Insulin resistance was assessed by fasting insulin levels. Results In basal state, the mean TG levels in women of three groups were as follows: Group 2>Group 1>control, while HDL C showed the opposite. After LHRH test, mean T and TG concentrations increased and HDL C decreased in all PCOS subjects, especially Group 2 whereas the indices remained unchanged in the controls. Conclusion Our data suggest that altered lipid profiles in women with PCOS may result from the independent effects of androgen excess and insulin resistance.

关 键 词：多囊卵巢综合征 雄激素 胰岛素抵抗 脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]