多囊卵巢综合征胰岛素抵抗亚型:临床指标与发病机制  

The insulin resistant subphenotype of polycystic ovary syndrome: Clinical parameters and pathogenesis

作　　者：Mor E. Zograbyan A. Saadat P. E. Mor 白符 

机构地区：[1]Univ.S. California Keck Sch. Med., Los Angeles, CA, United States Dr.

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2005年第1期13-14,共2页Core Journal in Obstetrics/Gynecology

摘　　要：Objective This study was undertaken to compare clinical and biochemic al charac teristics of the insulin resistant (IR) and non-IR subphenotypes of polycystic ovary syndrome (PCOS). Study design Infertile PCOS women were classified as IR ( n=32) or non-IR(n=46) on the basis of fasting glucose and insulin levels. The i ncidence of acanthosis nigricans (AN), hirsutism, and ovulation in response to c lomiphene citrate (CC) was compared between the 2 groups, along with serum level s of gonadotropins, and sex steroids. Blood samples from 28 PCOS patients and 8 controls were analyzed by enzymatic immunoassay for autophosphorylated insulin r eceptor (APIR) and total insulin receptor (TIR) content. Results Insulin resista nce was associated with obesity (odds ratio <OR]=3.5, P < .05), AN (OR=6.0, P < .05), hirsutism (OR=3.1, P < .05), and resistance to CC (OR=5.0, P < .05). Mean levels of LH, LH/FSH ratios, and testosterone were lower in women with IR (11.5 ±6.8mIU/mL, 2.0 ±1.0, and 56.6 ±29.0 ng/dL, respectively) compared with women without IR (15.0 ±13.4 mIU/mL, 2.4 ±1.5, and 72.5 ±29.8 ng/dL, respectively) (P < .05). Mean APIR/TIR ratios in IR women were lower than in non-IR women (P < .05 at 100 nmol/L of insulin) and controls (P < .01 at 1, 10 and 100 nmol/L i nsulin). Conclusion Patients with IR are more likely to be obese and have AN, hi rsutism, resistance to CC, and lower LH, LH/FSH ratios, and testosterone levels. Furthermore, IR patients appear to have defective autophosphorylation of the in sulin receptor, a key element in insulin action, and a possible mechanism for IR in PCOS.Objective This study was undertaken to compare clinical and biochemic al charac teristics of the insulin resistant (IR) and non-IR subphenotypes of polycystic ovary syndrome (PCOS). Study design Infertile PCOS women were classified as IR ( n=32) or non-IR(n=46) on the basis of fasting glucose and insulin levels. The i ncidence of acanthosis nigricans (AN), hirsutism, and ovulation in response to c lomiphene citrate (CC) was compared between the 2 groups, along with serum level s of gonadotropins, and sex steroids. Blood samples from 28 PCOS patients and 8 controls were analyzed by enzymatic immunoassay for autophosphorylated insulin r eceptor (APIR) and total insulin receptor (TIR) content. Results Insulin resista nce was associated with obesity (odds ratio <OR]=3.5, P < .05), AN (OR=6.0, P < .05), hirsutism (OR=3.1, P < .05), and resistance to CC (OR=5.0, P < .05). Mean levels of LH, LH/FSH ratios, and testosterone were lower in women with IR (11.5 ±6.8mIU/mL, 2.0 ±1.0, and 56.6 ±29.0 ng/dL, respectively) compared with women without IR (15.0 ±13.4 mIU/mL, 2.4 ±1.5, and 72.5 ±29.8 ng/dL, respectively) (P < .05). Mean APIR/TIR ratios in IR women were lower than in non-IR women (P < .05 at 100 nmol/L of insulin) and controls (P < .01 at 1, 10 and 100 nmol/L i nsulin). Conclusion Patients with IR are more likely to be obese and have AN, hi rsutism, resistance to CC, and lower LH, LH/FSH ratios, and testosterone levels. Furthermore, IR patients appear to have defective autophosphorylation of the in sulin receptor, a key element in insulin action, and a possible mechanism for IR in PCOS.

关 键 词：多囊卵巢综合征 胰岛素抵抗 发病机制 自身磷酸化 黑棘皮症 克罗米酚 睾酮水平 空腹血糖 促性腺激素 酶免疫分析法 

分 类 号：R711.75[医药卫生—妇产科学]