脂质蓄积指数较腰围更好反映多囊卵巢综合征患者的胰岛素抵抗  

Lipid Accumulation Product is Better than Waist Circumference in Identifying Insulin Resistance in Wowen with Polycystic Ovary Syndrome

作　　者：罗梅[1] 杨淑敏[1] 夏伟[1] 梅玫[1] 程庆丰[1] 宋颖[1] 田波[1] 李启富[1] 

机构地区：[1]重庆医科大学附属第一医院内分泌科,重庆400016

出　　处：《生殖与避孕》2011年第12期811-816,共6页Reproduction and Contraception

基　　金：重庆市科委自然科学基金资助项目;项目号:CSTC2008BB5206

摘　　要：目的:比较多囊卵巢综合征(PCOS)人群脂质蓄积指数(LAP)和腰围(WC)与胰岛素抵抗(IR)的相关性。方法:纳入121例PCOS患者和115例正常对照,测量人体参数及血液代谢指标,行75 g口服葡萄糖耐量试验,对其中20例对照及90例PCOS患者行高胰岛素-正葡萄糖钳夹术,并计算HOMA2-IR及LAP。结果:PCOS组LAP、WC等较对照组明显增高(P<0.05),胰岛素敏感性明显降低(P<0.05);匹配WC和年龄后,PCOS组LAP仍明显高于对照组(P<0.01),胰岛素敏感性明显低于对照组(P<0.05);与WC相比,LAP与M值(r=-0.66 vs r=-0.68,P<0.01)及HOMA2-IR(r=0.49 vs r=0.55,P<0.01)间关系更密切,校正WC后,LAP仍与M值(r=-0.37,P<0.01)及HOMA2-IR(r=0.26,P<0.01)相关;二项Logistic回归显示,高LAP患者发生IR的风险是正常LAP患者的6.05倍(OR=6.05,95%CI:1.67,21.90,P<0.05)。结论:在PCOS人群中,LAP与胰岛素敏感性相关,较WC更好地反映IR。Objective： To compare association of lipid accumulation product（LAP） and waist circumference（WC） with insulin resistance（IR） in women with polycystic ovary syndrome（PCOS）.Methods： A total of 121 PCOS patients and 115 age-matched controls were enrolled.Anthropometric index and fasting serum metabolic parameters were determined.An oral glucose tolerance test with 75 g glucose was performed on all subjects.Ninty PCOS subjects and 20 controls underwent euglycaemic-hyperinsulinaemic clamp to assess their insulin sensitivity,which was expressed as M value.The HOMA2-IR and LAP[（WC-58）×TG] were then calculated.Results： Compared with control subjects,PCOS women had significantly higher LAP and WC levels and decreased insulin sensitivity（P0.05）.Subgroup analysis showed that compared with age-and WC-matched controls,PCOS women still had decreased insulin sensitivity and increased LAP levels（P0.05）.Both LAP and WC were correlated with M value（r=-0.68 vs r=-0.66,P0.01） and HOMA2-IR（r=0.55 vs r=0.49,P0.01）,and after adjusted for WC LAP still correlated with M value（r=-0.37,P0.01） and HOMA2-IR（r=0.26,P 0.01）.Binary Logistic regression analysis revealed that the risk of IR in high LAP group was 6.05 times of that in the normal LAP group（OR=6.05,95%CI： 1.67,21.90,P0.05）.Conclusion： In women with PCOS,LAP is associated with insulin sensitivity and it has a better correlation with IR than WC.

关 键 词：多囊卵巢综合征(PCOS) 胰岛素抵抗(IR) 脂质蓄积指数(LAP) 腰围(WC) 

分 类 号：R711.75[医药卫生—妇产科学]