初诊多囊卵巢综合征患者胰岛素抵抗与雄激素水平的相关性分析  

The Association Between Insulin Resistance and Androgen in Participants with Newly Diagnosed Polycystic Ovary Syndrome

作　　者：薛丽萍[1] 胡红琳[1] XUE Li-ping;HU Hong-lin(Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第一附属医院内分泌科

出　　处：《标记免疫分析与临床》2019年第11期1895-1897,1902,共4页Labeled Immunoassays and Clinical Medicine

基　　金：安徽省科技厅公益性联动基金(编号:1704F0804026)

摘　　要：目的观察腹型肥胖的初诊多囊卵巢综合征(PCOS)患者与非腹型肥胖的初诊PCOS患者的糖代谢水平、血脂水平及雄激素水平的差异,并分析PCOS患者游离睾酮指数(FAI)水平与胰岛素抵抗的相关性。方法选取初诊的PCOS患者123例,根据腰围分为腹型肥胖组41例,非腹型肥胖组82例。测定受试者身高、体重,计算体质指数(BMI),测定三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平以及睾酮(T)、性激素结合球蛋白(SHBG),计算游离睾酮指数(FAI);测定禁食后的空腹血糖(FBG)、空腹胰岛素(FINS),计算稳态模型评估的胰岛素抵抗指数(HOMA-IR),比较两组间各指标的差异。结果①两组年龄无统计学差异;腹型肥胖组BMI、腰围大于非腹型肥胖组,差异有统计学意义(P<0.05);腹型肥胖组FBG、FINS、HOMA-IR、TC、TG水平较非腹型肥胖组高(P<0.05),两组HDL-C、LDL-C水平无差异。②腹型肥胖组SHBG较非腹型肥胖组低,FAI较非腹型肥胖组高,差异有统计学意义(P<0.05),而两组T水平无差异。③直线回归分析,可发现FAI与BMI、HOMA-IR呈正相关性,与腰围、FBG、FINS、TC、TG无明显相关性。结论腹型肥胖的PCOS患者更易发生糖脂代谢异常及胰岛素抵抗,PCOS患者胰岛素抵抗与FAI水平相关。Objective To analyse the glucose metabolism,lipid concentrations and androgen in abdominal obese and non-abdominal obese participants with newly diagnosed polycystic ovary syndrome(PCOS)and to analysis the association between insulin resistance and free androgen index(FAI)in PCOS.Methods There were 41 abdominal obese and 82 non-abdominal obese PCOS participants included in this study.The information of height,weight,waist circumference(WC)and body mass index(BMI)was collected.Serum levels of fasting glucose(FBG),fasting insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR)scores,triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-L),testosterone(T),sex hormone binding globulin(SHBG)and FAI were measured or calculated.T-test was used to compare these variables within two groups.Linear regression was used to assess the association of FAI with other glucose and lipid metabolism variables.Results Abdominal obese PCOS participants had higher BMI,WC,FBG,FINS,HOMA-IR,TC,TG,FAI and lower SHBG than non-abdominal obese participants(all P<0.05).However,age,HDL-C,LDL-C,T were similar in these two groups.In univariable linear regression,FAI had positive association with BMI and HOMA-IR,but no association with WC and FBG,FINS,TC,TG.Conclusion Participants with abdominal obesity and PCOS may have high prevalence of insulin resistance and dyslipidaemia.The androgen excess indicated by high FAI levels in participants with PCOS may associated with insulin resistance.

关 键 词：多囊卵巢综合征 腹型肥胖 胰岛素抵抗 雄激素 

分 类 号：R58[医药卫生—内分泌]