高雄激素血症与多囊卵巢综合征中非酒精性脂肪性肝病的关系  

Hyperandrogenemia Relation to Nonalcoholic Fatty Liver Disease in Chinese Women with Polycystic Ovary Syndrome

作　　者：曲中玉[1] 石玉华[2] 陈子江[2] 

机构地区：[1]山东大学附属省立医院超声诊疗中心,济南250021 [2]山东大学附属省立医院生殖中心,济南250021

出　　处：《生殖与避孕》2011年第1期14-17,共4页Reproduction and Contraception

基　　金：国家自然科学基金项目;项目号:30611120524

摘　　要：目的:探讨高雄激素血症(HT)与多囊卵巢综合征(PCOS)患者非酒精性脂肪性肝病(NAFLD)发病的关系。方法:对306例PCOS患者进行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功能、血脂等检查,B超诊断脂肪肝。结果:306例PCOS患者中诊断出NAFLD94例,发病率为30.7%;其中NAFLD轻度56例(59.6%),中度34例(36.2%),重度4例(4.2%)。PCOS患者NAFLD的发病率与HA无明显相关性,与稳态模型评估胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)呈正相关。PCOS合并NAFLD组胰岛素抵抗(IR)发生率明显高于PCOS不合并NAFLD组,P<0.05;PCOS高雄激素血症(PCOS-HA)组IR发生率与PCOS非高雄激素血症(PCOS-NHA)组无明显差异,P>0.05。结论:PCOS患者NAFLD发病率较高,PCOS患者NAFLD的发生与IR、代谢异常密切相关,与HA无明显相关。Objective：To investigate the relationship between hyperandrogenemia（HA） and nonalcoholic fatty liver disease（NAFLD） in women with polycystic ovary syndrome（PCOS）.Methods：Patients data came from 306 women with PCOS by Rotterdam consensus criteria.Basal endocrine,oral glucose tolerance test（OGTT）,insulin release test,lipid profile,blood pressure and body mass index（BMI） were tested.Liver chemistries,B-hepatitis and C-hepatitis were performed,and alcoholic liver diseases were excluded.Fatty liver was diagnosed according to ultrasound.Results：The overall incidence of NAFLD in PCOS was 30.7%（94/306）,56 cases（59.6%） in mild degree,34 cases（36.2%） in moderate degree,4 cases（4.2%） in severe degree.Hyperandrogenemia was not associated with the development of NAFLD in women with PCOS.HOMA-IR and TG had positively correlation with NAFLD complicating PCOS.The presence of IR in PCOS women with NAFLD was significantly higher than that in the group without NAFLD（P0.05）.However,there was no significant difference in the presence of IR between PCOS women with hyperandrogenemia and those without hyperandrogenemia.Conlusion：These findings indicate that Chinese women with PCOS have a high prevalence of NAFLD.Insulin resistance and metabolic abnormalities are significantly associated with NAFLD in PCOS.It seemed that hyperandrogenemia doesn抰 play a role in the development of NAFLD in patients with PCOS.

关 键 词：多囊卵巢综合征(PCOS) 非酒精性脂肪性肝病(NAFLD) 胰岛素抵抗(IR) 高雄激素血症(HA) 

分 类 号：R711.75[医药卫生—妇产科学] R575.5[医药卫生—临床医学]