三酰甘油作为评估胰岛素抵抗的替代指标在中国多囊卵巢综合征患者中应用的可行性分析  

Feasibility analysis of triglyceride as a surrogate marker for insulin resistance in Chinese women with polycystic ovary syndrome

作　　者：周莉[1] 高婧[1] 陈晨[1] ZHOU Li;GAO Jing;CHEN Chen(Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China)

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025

出　　处：《上海交通大学学报（医学版）》2017年第1期60-63,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海浦江人才计划(11PJ1406600)~~

摘　　要：目的·探讨三酰甘油(TAG)作为胰岛素抵抗替代指标在中国多囊卵巢综合征(PCOS)患者中应用的可行性。方法·选择2012年5月—2015年6月在上海交通大学医学院附属瑞金医院妇产科就诊的PCOS患者171例,均符合鹿特丹标准且未经过药物治疗。分别检测其身高,体质量,血清TAG、总胆固醇(TC)、高密度脂蛋白(HDL)等指标,行口服葡萄糖耐量试验(OGTT)和胰岛素释放试验(IRT),计算体质量指数(BMI)、胰岛素抵抗稳态指数模型(HOMA-IR)等参数。按BMI将患者分为肥胖组和非肥胖组,分析探讨在2组患者中TAG作为评估胰岛素抵抗替代指标的可行性。结果·肥胖组PCOS患者的TAG、HDL、TC、各时相血糖和胰岛素水平均显著高于非肥胖组(均P<0.05);肥胖组患者发生胰岛素抵抗的比例显著高于非肥胖组(P=0.000)。ROC曲线分析显示在肥胖组PCOS患者中,TAG不具有预测胰岛素抵抗的价值;在非肥胖组中受试者工作特征(ROC)曲线下面积为0.791,最佳切点为1.585 mmol/L,敏感度和特异度分别为0.484和0.979。结论·TAG可以考虑作为中国PCOS非肥胖患者胰岛素抵抗的替代指标。Objective·To analyze the feasibility of triacylglycerol(TAG)as a surrogate marker for insulin resistance in Chinese women with polycysticovary syndrome(PCOS).Methods·Height,weight,TAG,total cholesterol(TC),high density lipoprotein(HDL),OGTT,insulin release test weremeasured in171women with PCOS according to Rotterdam consensus,who went to Department of Obstetrics and Gynecology of Ruijin Hospital fromMay,2012to June,2015.Body mass index(BMI)and HOMA-IR were calculated.PCOS patients were divided into obese and non-obese group by BMIto analyze the feasibility of TAG as a surrogate marker for insulin resistance in two groups.Results·TAG,HDL,TC,plasma glucose and insulin levels inobese group were significantly higher than those in non-obese group(P<0.05).The proportion of patients with insulin resistance was also higher in obesegroup(P=0.000).The ROC curve analysis demonstrated that TAG could not predict insulin resistance in obese group.But in non-obese group the areasunder the ROC curve was0.791.The optimal cut-off point was1.585mmol/L with sensitivity of0.484and specificity of0.979.Conclusion·TAG can beused as a surrogate marker for insulin resistance in non-obese Chinese women with PCOS.

关 键 词：多囊卵巢综合征 三酰甘油 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]