体质量指数对多囊卵巢综合征患者肠道菌群和内分泌代谢及胰岛素抵抗的影响  

Effects of body mass index on intestinal floras,endocrine metabolism and insulin resistance in patients with polycystic ovary syndrome

作　　者：李婷[1] 张莉莉 张颂婕 崔彬彬[1] 林倩如 LI Ting;ZHANG Lili;ZHANG Songjie;CUI Binbin;LIN Qianru(Department of Obstetrics and Gynecology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361003,China;不详)

机构地区：[1]厦门大学附属中山医院妇产科,福建厦门361003

出　　处：《中国微生态学杂志》2024年第8期955-961,共7页Chinese Journal of Microecology

摘　　要：目的探讨体质量指数(BMI)对多囊卵巢综合征(PCOS)患者肠道菌群、内分泌代谢及胰岛素抵抗(IR)的影响,为该类患者的治疗提供参考。方法选取2021年1月至2023年6月厦门大学附属中山医院妇产科收治的64例PCOS患者,根据2021年版肥胖症多学科诊疗共识的标准分为正常体质量组(30例)和超重/肥胖组(34例)。比较不同BMI的PCOS患者年龄、初潮年龄、病程、BMI、腰臀比(WHR)、月经周期、多毛发生率、黑棘皮发生率和肠道拟杆菌门、厚壁菌门、变形菌门、拟杆菌属、埃希-志贺菌属、布劳特菌属、粪杆菌属相对丰度;采用Pearson相关性分析PCOS患者BMI与属水平肠道菌群构成的关系;比较不同BMI的PCOS患者雌二醇(E2)、睾酮(T)、黄体生成素(LH)、促甲状腺激素(TSH)和空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平;采用Pearson相关性分析PCOS患者BMI与内分泌代谢、IR指标的关系。结果超重/肥胖组患者BMI、WHR和多毛、黑棘皮发生率均高于正常体质量组,月经周期长于正常体质量组(均P<0.05)。超重/肥胖组患者肠道拟杆菌门相对丰度显著低于正常体质量组,厚壁菌门相对丰度显著高于正常体质量组(均P<0.05)。超重/肥胖组患者肠道拟杆菌属、埃希-志贺菌属相对丰度均显著高于正常体质量组,而布劳特菌属和粪杆菌属相对丰度均显著低于正常体质量组(均P<0.05)。Pearson相关性分析显示,PCOS患者肠道拟杆菌属、埃希-志贺菌属相对丰度与BMI均呈正相关,而布劳特菌属、粪杆菌属相对丰度与BMI均呈负相关(均P<0.05)。超重/肥胖组患者T、TSH、FPG、2hPG、FINS和HOMA-IR水平均显著高于正常体质量组,LH水平显著低于正常体质量组(均P<0.05)。Pearson相关性分析显示,PCOS患者TSH与BMI呈弱负相关,T与BMI呈强负相关,LH、FPG、2hPG与BMI呈中等程度正相关,FINS、HOMA-IR与BMI呈强正相关(均P<0.05)。�Objective To observe the effects of body mass index(BMI)on intestinal floras,endocrine metabolism and insulin resistance(IR)in patients with polycystic ovary syndrome(PCOS)so as to provide reference for the treatment of such patients.Methods A total of 64 patients with PCOS admitted to Obstetrics and Gynecology Department of Zhongshan Hospital Affiliated to Xiamen University were enrolled between January 2021 and June 2023.According to the criteria of multidisciplinary diagnosis and treatment consensus of obesity in 2021,they were divided into normal weight group(30 cases)and overweight/obesity group(34 cases).The age,menophania age,course of disease,BMI,waist-to-hip ratio(WHR),menstrual cycle,incidence of crinosity and acanthosis,relative abundances of Bacteroides,Firmicutes,Proteobacteria,Bacteroidetes,Escherichia−Shigella,Blautia and Faecalibacterium were compared among PCOS patients with different BMI.The relationship between BMI and intestinal floras at genus level was analyzed with Pearson correlation analysis.The levels of estradiol(E2),testosterone(T),luteinizing hormone(LH),thyroid stimulating hormone(TSH),fasting plasma glucose(FPG),2h postprandial glucose(2hPG),fasting insulin(FINS)and homeostasis model assessment insulin resistance(HOMA-IR)were compared among the PCOS patients with different BMI.The relationship between BMI and endocrine metabolism,IR in PCOS patients were analyzed by Pearson correlation analysis.Results BMI,WHR,incidence of crinosity and acanthosis in overweight/obesity group were higher,and menstrual cycle was longer than that in normal weight group(all P<0.05).The relative abundance of Bacteroidetes in overweight/obesity group was significantly lower,while relative abundance of Firmicutes was significantly higher than in normal weight group(all P<0.05).The relative abundances of Bacteroides and Escherichia-Shigella in overweight/obesity group were significantly higher,while relative abundances of Blautia and Faecalibacterium were significantly lower than those in normal weight gr

关 键 词：体质量指数 多囊卵巢综合征 肠道菌群 内分泌代谢 胰岛素抵抗 

分 类 号：R711.7[医药卫生—妇产科学]