本文選題：多囊卵巢綜合征 + 表型��； 參考：《中國(guó)糖尿病雜志》2017年01期

【摘要】：目的分析多囊卵巢綜合征(PCOS)患者不同表型間代謝異常的特點(diǎn)。方法選取因不孕癥在我院門(mén)診就診并擬診為PCOS的患者251例,行OGTT、血脂譜、卵泡期的性腺軸激素水平測(cè)定等,并行經(jīng)陰道卵巢和子宮超聲波檢查。選取34名月經(jīng)規(guī)律的正常育齡期女性作為健康對(duì)照組(NC)。結(jié)果 (1)根據(jù)鹿特丹診斷標(biāo)準(zhǔn),234例確診為PCOS,其中,同時(shí)符合全部3條診斷標(biāo)準(zhǔn)的患者129例(55.1%),為符合3條標(biāo)準(zhǔn)組;符合2條診斷標(biāo)準(zhǔn)者105例(44.9%),為符合2條標(biāo)準(zhǔn)組;單純的卵巢多囊化(PCO)患者17例,為單純PCO組。與NC組比較,PCOS患者雄激素水平、IR和代謝異常比例升高(P0.05);與單純PCO組比較,符合2條標(biāo)準(zhǔn)組的血清雄激素、TC水平及肥胖比例升高(P0.05);符合3條標(biāo)準(zhǔn)組的BMI、肥胖比例、TC、LDL-C、雄激素水平、LH/FSH比值升高,且HOMA-IR升高,而Matsuda指數(shù)降低(P0.05)。與符合2條標(biāo)準(zhǔn)組比較,符合3條標(biāo)準(zhǔn)組的BMI、肥胖比例、TC、LDL-C、雄激素水平、LH/FSH比值升高,且FPG和HOMA-IR升高,而Matsuda指數(shù)則降低(P0.05)。(2)在234例PCOS患者中,有高雄激素血癥(HA)者占69.2%。與非HA組比較,HA組的FPG、FIns及胰島素抵抗指數(shù)(HOMA-IR)升高,而Matsuda指數(shù)降低(P0.05)。(3)在234例PCOS患者中,超重或肥胖者占53.8%。與體重正常組比較,超重或肥胖組的雄激素水平、糖代謝異常和血脂異常的比例升高(P0.05)。結(jié)論在PCOS患者中,同時(shí)符合3條診斷標(biāo)準(zhǔn)的患者有更嚴(yán)重的IR和代謝異常;HA可能加重PCOS患者的IR;超重或肥胖可加重PCOS女性生殖內(nèi)分泌和代謝異常。
[Abstract]:Objective to analyze the characteristics of metabolic abnormalities among different phenotypes in patients with polycystic ovary syndrome (PCOS). Methods 251 patients who were diagnosed as PCOS in our outpatient clinic because of infertility were selected and examined by transvaginal ovarian and uterine ultrasound, including OGTT, blood lipid profile, gonadal hormone level in follicular phase and so on. 34 women with regular menstruation were selected as healthy control group. Results according to the Rotterdam diagnostic criteria, 234 patients were diagnosed as PCOS. among them, 129 patients who met all 3 diagnostic criteria were found to be in accordance with 3 criteria, 105 patients with 2 diagnostic criteria were in accordance with 2 criteria. There were 17 patients with simple ovarian polycystic PCO group. Compared with NC group, the levels of androgen and the proportion of abnormal metabolism in PCOS patients were higher than those in NC group, and those in PCO group were higher than those in simple PCO group. The serum androgen TC level and obesity ratio in the two standard groups were higher than those in the control group (P 0.05), and the obesity ratio in the three standard groups was higher than that in the control group (P < 0.05), and the ratio of androgen and the ratio of HOMA-IR and HOMA-IR were increased, while the Matsuda index was lower than that of the control group (P 0.05). Compared with the two standard groups, the obesity ratio and the ratio of androgen, FPG and HOMA-IR in the three standard groups were increased, while the Matsuda index was decreased (P 0.05). In 234 PCOS patients, hyperandrogenemia was found in 69.2% of the 234 PCOS patients. Compared with the non-HA group, the FINs and the insulin resistance index (HOMA-IRR) of the HA group were increased, while the Matsuda index decreased (P 0.05). Among the 234 patients with PCOS, the overweight or obese group accounted for 53.8% of the total. Compared with normal body weight group, the levels of androgen, abnormal glucose metabolism and abnormal blood lipids increased in overweight or obese group (P 0.05). Conclusion in patients with PCOS, more severe IR and abnormal metabolism may be found in those who meet the three diagnostic criteria, and overweight or obesity may aggravate the abnormality of reproductive endocrine and metabolism in women with PCOS.
【作者單位】： 北京大學(xué)第三醫(yī)院內(nèi)分泌科;北京大學(xué)第三醫(yī)院生殖醫(yī)學(xué)中心;
【基金】：國(guó)家973計(jì)劃資助項(xiàng)目(2012CB517502) 國(guó)家自然科學(xué)基金資助項(xiàng)目(81500626)
【分類(lèi)號(hào)】：R711.75

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