非肥胖多囊卵巢综合征患者的代谢评估.docVIP

非肥胖多囊卵巢综合征患者的代谢评估 　　[摘要] 目的 研究非肥胖多囊卵巢综合征（PCOS）患者的临床特征及糖脂代谢的特点。 方法 选择2014年11月～2016年3月在首都医科大学附属北京妇产医院妇科内分泌门诊就诊的74例非肥胖PCOS患者作为研究组，同期45例年龄和体重指数相匹配的健康女性作为对照组。测量所有受试者的临床特征；测定血清性激素水平及代谢参数；采用稳态模型评估的胰岛素抵抗指数；比较两组上述各项指标的差异。 结果 PCOS组患者腰臀比、血清总睾酮、促黄体生成素水平、促黄体生成素/卵泡刺激素比值及血清低密度脂蛋白胆固醇均高于对照组（P 0.01或P 0.05）；载脂蛋白A浓度低于对照组，差异有高度统计学意义（P 0.01）。 结论 非肥胖PCOS患者同样存在代谢异常，临床上应引起重视。 　　[关键词] 多囊卵巢综合征；非肥胖；腰臀比；胰岛素抵抗；脂代谢 　　[中图分类号] R711.7 [文献标识码] A [文章编号] 1673-7210（2016）10（c）-0103-04 　　[Abstract] Objective To investigate the clinical features and metabolism characteristics of patients with non-obese polycystic ovary syndrome. Methods From November 2014 to March 2016， 74 patients with non-obese PCOS who visited the Department of Endocrinology of Beijing Obstetrics and Gynecology Hospital， Capital Medical University were enrolled as the study group， and 45 age-matched healthy women in the same period were included as the control group. Clinical characteristics， serum sex hormone levels and metabolic parameters were measured in all subjects and analyzed statistically. The insulin resistance index was evaluated by steady-state model and comparisons of all the hormone indicators mentioned above were conducted between the two groups. Results In PCOS group waist-hip ratio， serum total testosterone， luteinizing hormone， LH/FSH ratio and serum low density lipid protein were higher （P 0.01 or P 0.05）， and apolipoprotein A concentration was lower than those of control group， the differences were statistically significant （P 0.01）. Conclusion Non-obese PCOS patients may also have metabolism disorder， so more attention should be paid in clinic work. 　　[Key words] Polycystic ovary syndrome； Non-obese； Waist-hip ratio； Insulin resistance； Lipid metabolism 　　多囊卵巢综合征（polycystic ovary syndrome，PCOS）是育龄女性常见的妇科内分泌疾病，以月经失调、高雄激素血症/表现及卵巢多囊泡为特点，临床表现呈高度异质性。常伴随胰岛素抵抗及脂代谢异常等，因此PCOS患者发生肥胖、胰岛素抵抗、2型糖尿病、冠心病的风险较高。病因尚不明确，发病机制复杂，是一种涉及内分泌、代谢和遗传等许多因素的内分泌与代谢紊乱的疾病[1]。许多研究证明，肥胖型PCOS患者多伴随糖脂代谢异常[2-4]，而PCOS患者中有一部分属非肥胖型，关于非肥胖PCOS患