多囊卵巢综合征胰岛素抵抗及与代谢综合征的相关性  

The occurrence of insulin resistance and metabolic syndrome in polycystic ovary syndrome

作　　者：黄佳[1] 倪仁敏[1] 陈晓丽[1] 莫亚勤[1] 杨冬梓[1] 

机构地区：[1]广州中山大学孙逸仙纪念医院,510120

出　　处：《中国妇产科临床杂志》2011年第2期125-129,共5页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：中山大学优秀研究生导师逸仙创新人才培养计划(81000-3126204);2010年国家自然科学基金(81070466);2010年教育部博士点基金(20100171110085);2010年广东省科技计划项目(2010B31600058)资助

摘　　要：目的分析中国南方多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者中胰岛素抵抗的发生情况及其与代谢综合征(metabolic syndrome,MetS)发生的相关性。方法回顾性分析中山大学孙逸仙纪念医院2004年1月至2008年10月初诊的578例PCOS患者各表征胰岛素抵抗指标的发生率,及其与代谢综合征发生的关系。结果 PCOS患者中,332例(57.4%)稳态模型测定(HOMA-IR)>75th,133例(23.0%)空腹胰岛素(FIN)>95th,73例(12.6%)胰岛素释放实验2h胰岛素(2h-INS)>150mU/L,49例(8.5%)FIN和2h-INS同时超标,157例(27.2%)发生高胰岛素血症(HIN),FIN和/或2h-INS超标。FIN升高、2h-INS升高、HIN和HOMA-IR超标者,代谢综合征发生率分别为40.6%、41.1%、39.5%和26.8%。与指标正常者比较,其发生代谢综合征的风险明显增加(P<0.001)。结论应用不同表征胰岛素抵抗的指标得到的PCOS患者胰岛素抵抗的发生率存在差异,但是存在任一胰岛素抵抗指标异常的患者合并代谢综合征的风险显著高于无高胰岛素血症及HOMA-IR正常者。因此,判断和纠正PCOS患者的胰岛素抵抗对于预防代谢综合征的发生有临床意义。Objective To investigate the occurrence of insulin resistance in Chinese women with polycystic ovary syndrome（PCOS）,and the relationship between insulin resistance and metabolic syndrome（MetS）.MethodsTotal of 578 PCOS patients were included in this study.Data were collected to analyze the prevalence of insulin resistance and the risk for metabolic syndrome.ResultsThe prevalence of Homeostasis model assessment of（HOMA-IR）75th,fasting insulin（FIN）95th,2h-insulin（2h-INS）150 U/L,raised both FIN and 2h-INS,and hyperinsulinemia（HIN,raised FIN and/or 2h-INS）were 57.4%,23.0%,12.6%,8.5% and 27.2%,respectively in these PCOS patients.There were 40.6% patients with raised FIN suffered from MetS;41.1%with raised 2h-INS;39.5% with hyperinsulinemia（HIN,raised FIN and/or 2h-INS）;26.8% with raised HOMA-IR.Compared to the patients with normal HOMA-IR,FIN or 2h-FIN,the risk for suffering from MetS was higher（P0.001）.ConclusionsThe prevalence of insulin resistance varied from different criteria.Patients met any criteria for insulin resistance had a greater risk of developing of metabolic syndrome.It is worthy to find out and treat the insulin resistance in PCOS patients.

关 键 词：多囊卵巢综合征 胰岛素抵抗 代谢综合征 

分 类 号：R711.75[医药卫生—妇产科学]