不同分组多囊卵巢综合征患者糖代谢特征分析  

Features of glucose metabolism in different types of polycystic ovary syndrome.

作　　者：徐丽爽[1] 张艳芳[1] 张慧英[1] 薛凤霞[1] 韩玉崑[1] 

机构地区：[1]天津医科大学总医院妇产科,天津300052

出　　处：《现代妇产科进展》2010年第5期333-335,共3页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金资助项目(No:30772316)

摘　　要：目的:探讨不同分组的多囊卵巢综合征(PCOS)患者的糖代谢特征。方法:将256例PCOS患者按照雄激素水平、体重指数及青春期与育龄期分组,观察生殖激素、血糖及胰岛素水平,比较各组糖代谢异常发生率及糖代谢特征。结果:(1)256例PCOS患者糖耐量受损(IGT)发生率为18.36%,2型糖尿病(DM2)发生率为4.69%;(2)高雄组β细胞功能指数(HBCI)、胰岛素曲线下面积(IAUC)高于雄激素正常组(P<0.05);(3)肥胖组糖代谢各指标及代谢异常发生率均明显高于非肥胖组(P<0.01);(4)育龄期与青春期组比较胰岛素抵抗指数(HOMA-IR)、IAUC、HBCI及外周胰岛素敏感指数(ISI)差异均有统计学意义(P<0.05)。结论:(1)高雄激素血症可能加重高胰岛素血症,但不影响远期糖代谢;(2)肥胖的PCOS患者存在更严重的糖代谢异常;(3)青春期以胰岛素抵抗和高胰岛素血症为主要特点,随着年龄增长糖代谢异常的发生率逐渐增加。Objective:To investigate the features of abnormal glucose metabolism(AGM) in different types of polycystic ovary syndrome(PCOS).Methods:The total of 256 patients with PCOS were retrospectively analyzed according to testosterone level,body mass index,adolescents and fertility.Hormonal profiles,glucose and insulin levels were evaluated to compare the prevalence of abnormal glucose tolerance and features among groups.Results:(1)Among 256 PCOS patients 18.36% and 4.69% displayed impaired glucose tolerance and type 2 diabetes mellitus,respectively.(2)Hyperandrogenic women had higher HBCI,IAUC than non-hyperandrogenic PCOS women(P<0.05);(3)All glycometabolism parameters and prevalence were significantly higher in obesity PCOS group than in non-obesity PCOS group(P<0.01);(4)While HOMA index,IAUC,HBCI and ISI were statistically different in adolescents group and fertility group(P<0.05).Conclusions:(1)Hyperandrogenemia can aggravate hyperinsulinemia,but it doesn't affect glucose metabolism in long term.(2)Obesity PCOS patients show more severe AGM.(3)Adolescents PCOS patients are characterized by insulin resistant(IR) and hyperinsulinism,meanwhile the prevalence of AGM is increasing over years.

关 键 词：多囊卵巢综合征 葡萄糖耐受不良 高雄激素血症 肥胖症 年龄因素 

分 类 号：R711.75[医药卫生—妇产科学]