多囊卵巢综合征患者肥胖与糖代谢异常关系的研究  

Relationship between obesity and abnormal glucose metabolism in patients with polycystic ovary syndrome

作　　者：刘靖芳[1] 汤旭磊[1] 成建国[1] 杨晓梅[1] 王岩[1] 

机构地区：[1]兰州大学第一医院内分泌科,甘肃兰州730000

出　　处：《中国现代医学杂志》2015年第18期73-76,共4页China Journal of Modern Medicine

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者胰岛素抵抗(IR)、糖代谢异常与体重指数(BMI)的关系。方法90例PCOS患者按BMI分为非肥胖组50例和肥胖组40例,比较两组患者BMI、腰臀比、口服葡萄糖耐量(OGTT)及胰岛素释放、稳态模式胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HOMA-B)、空腹胰岛素敏感指数(ISI)水平的差异。结果 1PCOS肥胖组患者BMI、腰围、臀围及腰臀比均显著高于非肥胖PCOS患者;2PCOS患者IR发生率为67.78%。糖代谢异常发生率为33.33%,其中空腹血糖受损(IFG)的发生率为15.56%;糖耐量受损(IGT)的发生率为10.00%;2型糖尿病(T2DM)的发生率为7.78%。PCOS肥胖组患者IR、IFG、IGT、T2DM的发生率显著高于非肥胖PCOS患者。3PCOS肥胖组患者0 min、30 min、1 h、2 h血糖及胰岛素水平均显著高于非肥胖PCOS患者。4PCOS肥胖组患者HOMA-IR和HOMA-B水平[(5.67±3.86)和(310.82±233.12)]高于非肥胖PCOS患者[(3.88±2.37),P=0.008]和[(194.31±119.90),P=0.003],而ISI水平(0.011±0.006)低于非肥胖PCOS患者[(0.018±0.014),P=0.01)]。结论肥胖可减低PCOS患者胰岛素的敏感性,加重胰岛素抵抗(IR),导致高胰岛素血症,促进PCOS患者糖代谢异常的发生。【Objective】 To investigate the relationship between insulin resistance（IR）, abnormal glucose metabolism and body mass index（BMI） in patients with polycystic ovary syndrome（PCOS）.【Methods】Ninety patients with PCOS at our hospital were divided into fatty group（40 cases） and non-fatty group（50 cases） according to BMI. BMI, waist-to-hip ratio, oral glucose tolerance test（OGTT）, insulin release, homeostasis model insulin resistance index（HOMA-IR）, β-cell function index（HOMA-B） and fasting insulin sensitivity index（ISI） were compared between the two groups.【Results】1 The BMI, waist circumference, hip circumference and waist-to-hip ratio levels in the fatty group of PCOS were significantly higher than those in the non-fatty group of PCOS. 2 In the PCOS patients, the incidence of IR was 67.78%, and that of abnormal glucose metabolism was 33.33%, in which the incidence of impaired fasting glucose（IFG） was 15.56%, that of impaired glucose tolerance（IGT） was 10.00% and that of type 2 diabetes mellitus（T2DM） was 7.78%. The incidences of IR, IFG, IGT and T2 DM in the fatty group of PCOS were significantly higher than those in the non-fatty group of PCOS. 3 Blood glucose and insulin levels at 0 min,30 min, 1 h and 2 h in the fatty group of PCOS were significantly higher than the corresponding ones in the non-fatty group of PCOS. 4 HOMA-IR and HOMA-B levels in the fatty group of PCOS [（5.67 ± 3.86） and（310.82± 233.12）] were significantly higher than those in the non-fatty group of PCOS [（3.88 ± 2.37）, P = 0.008, and（194.31 ± 119.90）, P = 0.003]. ISI level in the fatty group of PCOS was lower than that in the non-fatty group of PCOS [（0.011 ± 0.006） vs（0.018 ± 0.014）, P = 0.01）.【Conclusions】Obesity can reduce the sensitivity of insulin,aggravate IR and promote the occurrence of abnormal glucose metabolism in patients with PCOS.

关 键 词：多囊卵巢综合征 肥胖 糖代谢异常 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]