青春期多囊卵巢综合征患者胰岛素抵抗及糖代谢异常的分析  

Insulin resistance and abnormal glucose metabolism in adolescent polycystic ovary syndrome

作　　者：徐晶晶[1] 赵赟[1] 林金芳[1] 

机构地区：[1]复旦大学附属妇产科医院生殖内分泌诊疗中心,上海200011

出　　处：《中华内分泌代谢杂志》2010年第5期355-358,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市科委课题基金项目（08411952900）;国家“十一五”课题基金项目（2007BA104B04）

摘　　要：目的分析青春期多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）及糖代谢异常的发生情况。方法PCOS组为15—19岁诊断为PCOS的患者141例，对照组为年龄匹配、月经规则、无糖尿病家族史的女中学生266名。对照组测定空腹胰岛素（FINS）及空腹血糖（FPG），计算稳态模型评估的胰岛素抵抗指数（HOMA—IR），取对照组FINS及HOMA-IR75％位点值为生理高限值。将PCOS患者分为肥胖（OB—PCOS）及非肥胖（NOB—PCOS）组，均行口服葡萄糖耐量试验（OGTY）。结果FINS生理高限值为13．13mIU／L，HOMA—IR为2．69。PCOS组FINS[（17．68±16．13对10．40±5．33）mIU／L，P〈0．01]及HOMA—IR（2．64±2．01对2．01±1．61，P〈0．01）均高于对照组，其中OB—PCOS组FINS[（22．04±18．01对13．06±12．60）mIU／L，P〈0．01]及HOMA-IR（4．62±3．87对2．38±2．26，P〈0．01）高于NOB—PCOS组。PCOS组中FINS和HOMA．IR超过生理高限值的患者分别有75例（53．19％）和67例（47．52％），其中79例OB．PCOS患者中FINS和HOMA—IR超过生理高限值的患者有56（70．89％）和52（65．82％）例；62例NOB—PCOS患者中有19（30．65％）和15（24．19％）例。PCOS组发生糖尿病2例（1．42％），2例FINS及HOMA—IR均升高；糖耐量受损（IGT）患者12例（8．51％），11例患者FINS和HOMA—IR均升高。结论青春期PCOS患者普遍存在病理性IR，尤其在肥胖型PCOS患者中更严重、更常见，其中部分患者已发生糖代谢异常。Objective To analyze the occurrence of insulin resistance （ IR ） and abnormal glucose metabolism in adolescent polycystic ovary syndrome（PCOS）. Methods PCOS group included 141 patients aged 15-19 years old, who were diagnosed as PCOS according to criteria by reference to the European Society of Reproduction and Embryology/American Society for Reproductive Medicine proposed in 2003, at Rotterdam;and 266 age-matched female students, with regular menstrual cycles and no family history of diabetes, were enrolled in control group. Fasting insulin（FINS） ,fasting plasma glucose（FPG） ,and homeostasis model assessment for insulin resistance（HOMA-IR） were measured in control group. 75% percentile value of control group was set as physical upper limits of FINS and HOMA-IR. PCOS patients were divided into obese （ OB-PCOS ） and nonobese （NOB-PCOS） groups, and oral glucose tolerance test （OGTY） were performed. Results According to 75% percentile value of control group,the physical upper limits of FINS and HOMA-IR were 13.13 mlU/ L and 2.69, respectively. FINS and HOMA-IR values in PCOS group were higher than those in control group [ （17.68±16.13 vs 10.40±5.33） mlU/L,2. 64±2. 01 vs 2.01±1.61 ,both P〈0.01 ]. FINS and HOMA-IR values in OB-PCOS group were higher than those in the NOB-PCOS group [ （22.04±18.01 vs 13.06±12.60） mlU/L,4. 62±3. 87 vs 2.38±2.26, both P〈0.01]. In PCOS group, FINS of 75 cases（53.19% ）and HOMA-IR of 67 patients（47.52% ） exceeded the physical upper limits. In 79 OB-PCOS patients, FINS of 56 cases （70.89%） and HOMA-IR of 52 patients （65.82%）exceeded the physical upper limits while in 62 NOB-PCOS patients there were 19 （30.65 % ） and 15 （24.19%）patients. In PCOS group,2 （ 1.42% ） patients were diagnosed diabetes mellitus, and both FINS and HOMA-IR of these two cases increased. Meanwhile, 12 cases （ 8.51% ） were impaired glucose tolerance （IGT） , of whom 11 patients FINS and HOMA-IR increased. Conclusion Pathological IR is

关 键 词：多囊卵巢综合征 青春期 胰岛素抵抗 糖代谢异常 

分 类 号：R711.75[医药卫生—妇产科学]