ω-3脂肪酸乙酯改善超重/肥胖型PCOS妊娠患者糖脂代谢异常的疗效研究  

Efficacy ofω-3 fatty acid ethyl ester on improving abnormal glucose and li-pid metabolism in overweight/obese PCOS pregnant patients

作　　者：闫霞 聂世书 汪海华[2] 桑敏 YAN Xia;NIE Shi-shu;WANG Hai-hua;SANG Min(Medical College of Yangtze University,Jingzhou 434023,China;Department of Obstetrics and Gynecology,Huanggang Maternal and Child Health Hospital;Department of Reproductive Medicine Center,Huanggang Central Hospital of Yangtze University,Huanggang 438000,China)

机构地区：[1]长江大学医学部,湖北荆州434023 [2]黄冈市妇幼保健院妇产科 [3]长江大学附属黄冈市中心医院生殖医学中心,湖北黄冈438000

出　　处：《哈尔滨医科大学学报》2024年第6期644-648,共5页Journal of Harbin Medical University

基　　金：2024年黄冈市科技创新专项一般项目(YBXM20240039);黑龙江省卫生健康委科研课题(2019-208)。

摘　　要：目的 探讨ω-3脂肪酸乙酯在改善超重/肥胖型多囊卵巢综合征(polycystic ovary syndrome, PCOS)妊娠早期患者的糖脂代谢异常的治疗效果,为临床治疗提供新的安全有效的治疗方案。方法 选择2022年10月~2023年10月期间黄冈市妇幼保健院收治的60例妊娠早期(7~12周)伴有高血脂症及胰岛素抵抗的超重/肥胖型PCOS患者,按随机数字法分为治疗组(n=30)和对照组(n=30),对照组患者给予合理膳食、适度体育锻炼等生活干预指导6周,治疗组患者在同样生活干预的同时从妊娠早期(7~12周)开始服用ω-3脂肪酸乙酯(4 g/d),使用6周后比较两组患者治疗前后空腹血清总胆固醇(total cholesterol, TC)、甘油三酯(triglycerides, TG)、高密度脂蛋白(high-density lipoprotein, HDL-C)、低密度脂蛋白(low-density lipoprotein cholesterol, LDL-C)、FBG、FINS、HOMA-IR、妊娠并发症及妊娠不良结局。结果 与对照组相比,治疗组患者空腹血清TG、TC、LDL-C、FINS、FBG、HOMA-IR下降,HDL-C上升,差异具有统计学意义(P<0.05);治疗组患者发生子痫前期、妊娠期糖尿病、胎儿生长发育迟缓低于对照组,差异具有统计学意义(P<0.05);治疗组患者发生早期流产、早产、难产及胎儿宫内窘迫均明显低于对照组,差异具有统计学意义(P<0.05)。结论 妊娠早期伴有高血脂症及胰岛素抵抗的超重/肥胖型PCOS妊娠患者在妊娠早期开始补充ω-3脂肪酸乙酯,能够显著纠正患者糖脂代谢,降低妊娠并发症发生率,改善妊娠不良结局。Objective To explore the therapeutic effect ofω-3 fatty acid ethyl ester in impro-ving the abnormal glucose and lipid metabolism in overweight/obese polycystic ovary syndrome(PCOS)patients,and to provide new safe and effective treatment options for clinical treat-ment.Methods Between October 2022 to October 2023,a total of 60 early pregnancy(7~12 weeks)patients with hyperlipidemia and insulin-resistant overweight/obese PCOS were en-rolled at Huanggang Maternal and Child Health Hospital.By using random number allocation method,the participants were divided into two groups:the treatment group(n=30)and the control group(n=30).The control group received lifestyle interventions including appropriate diet and moderate physical exercise for a duration of six weeks,while the treatment group re-ceived supplementation withω-3 fatty acid ethyl esters(4 g/d),starting from early pregnancy(7~12 weeks),in addition to the same lifestyle interventions.After six weeks,fasting serum levels of total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),fasting insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR)as well as pregnancy complica-tions and adverse outcomes were compared between the two groups.Results Compared to the control group,patients in the treatment group exhibited significant reductions in fasting serum levels of TG,TC,LDL-C,FINS,FBG,and HOMA-IR while experiencing an increase in high-density lipoprotein cholesterol HDL-C levels(P<0.05).The incidence of preeclampsia,ges-tational diabetes,and fetal growth restriction was significantly lower in the treatment group com-pared to the control group(P<0.05).Moreover,there were significantly fewer occurrences of early miscarriage,premature birth,difficult labor,and intrauterine fetal distress in the treat-ment group when compared to the control group(P<0.05).Conclusion In early pregnan-cy,ω-3 fatty acid ethyl ester supplementation in overweight/obese PCOS pregnant patie

关 键 词：ω-3脂肪酸乙酯 超重/肥胖型PCOS妊娠患者 糖脂代谢异常 妊娠并发症 妊娠不良结局 

分 类 号：R711.75[医药卫生—妇产科学]