多囊卵巢综合征患者肥胖与高胰岛素、高雄激素血症的关系

【Abstract】 Objective To explore the relationship between obesity and hyperinsulinemia, hyperandrogenism in patients with polycystic ovary syndrome (PCOS), in order to provide evidence for the diagnosis and treatment of PCOS. Methods Ninety patients with polycystic ovary syndrome (PCOS) treated in Department of Gynecology, Hanzhong Central Hospital from August 2017 to December 2018 were selected as the study subjects. According to their body mass index (BMI), 48 patients with BMI (>25 kg/m2) were included into the obesity group, and the remaining 42 patients were included into the non-obesity group. BMI, serum testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG) and fasting insulin (FIN) levels were compared between the two groups, and the insulin resistance index as determined by homeostasis model assessment (HOMA-IR) was also compared. The correlation of BMI with FIN and T was analyzed. Results BMI of the obesity group was (27.6±1.5) kg/m2, which was significantly higher than (22.7±1.7) kg/m2 of the non-obesity group, (P<0.05). FIN, HOMA-IR and T of the obesity group were (2.90±0.72) mU/L, (2.86±0.98), (3.72±1.19) nmol/L, respectively, which were significantly higher than corresponding (2.15±0.67) mU/L, (1.79±0.76), (3.01±1.03) nmol/L of the non-obesity group; SHBG was (28.29± 6.22) nmol/L, which was significantly lower than (35.18±5.17) nmol/L of the non-obesity group (all P<0.05). For obese PCOS patients, BMI was positively correlated with FIN and T (r=0.410, 0.397, P<0.05). Conclusion Hyperinsulinemia and insulin resistance are more obvious in obese patients with PCOS. Obesity and hyperinsulinemia are important factors leading to the increase of androgen levels. In clinic, positive measures should be taken to improve insulin resistance, control patients' weight and reduce hyperandrogenism in PCOS patients.
【摘要】 目的 探讨多囊卵巢综合征(PCOS)患者肥胖与高胰岛素、高雄激素血症的关系，以期为 PCOS 患者 的诊治提供依据。方法 选取汉中市中心医院妇科于 2017 年 8 月至 2018 年 12 月期间收治的 90 例 PCOS 患者为研究 对象，根据患者的体质量指数(BMI)，将BMI≥25 kg/m2的48例患者纳入肥胖组，余42例纳入非肥胖组。比较两组患者 的 BMI 及血清睾酮(T)、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、空腹胰岛素(FIN)水平，并比较胰岛素抵 抗指数(HOMA-IR)。分析 BMI 与 FIN、T 的相关性。结果 肥胖组患者的 BMI 为(27.6±1.5) kg/m2，明显高于非肥胖组 的(22.7±1.7) kg/m2，差异有统计学意义(P<0.05)；肥胖组患者的 FIN、HOMA-IR、T 分别为(2.90±0.72) mU/L、(2.86± 0.98)、(3.72±1.19) nmol/L，均明显高于非肥胖组的(2.15±0.67) mU/L、(1.79±0.76)、(3.01±1.03) nmol/L，SHBG 为 (28.29±6.22) nmol/L，明显低于非肥胖组的(35.18±5.17) nmol/L，差异均有统计学意义(P<0.05)；肥胖型 PCOS 患者的 BMI 与 FIN、T 均呈正相关性(r=0.410、0.397，P<0.05)。结论 肥胖型 PCOS 患者的高胰岛素血症及胰岛素抵抗更加 明显，肥胖和高胰岛素血症是导致患者雄激素水平升高的重要因素，临床上对于 PCOS 患者应该采取积极的措施以 改善胰岛素抵抗、控制患者的体重，降低高雄激素血症。
【关键词】 多囊卵巢综合征；肥胖；胰岛素抵抗；高胰岛素血症；高雄激素血症 【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1701—03
Relationship between obesity and hyperinsulinemia, hyperandrogenism in patients with polycystic ovary syndrome. ZHANG Ting, MA Dan. Department of Gynecology, Hanzhong Central Hospital, Hanzhong 723000, Shaanxi, CHINA
Hainan Med J, Jul. 2019, Vol. 30, No. 13
doi:10.3969/j.issn.1003-6350.2019.13.018
海南医学 201Baidu Nhomakorabea 年 7 月第 30 卷第 13 期
·论著·
多囊卵巢综合征患者肥胖与高胰岛素、高雄激素血症的关系
张婷，马丹 汉中市中心医院妇科，陕西 汉中 723000