Acién P, Quereda F, Matallín P, Villarroya E, López-Fernández J A, Acién M, Mauri M, Alfayate R
Department of Obstetrics and Gynecology, School of Medicine, Miguel Hernández University, Alicante, Spain.
Fertil Steril. 1999 Jul;72(1):32-40. doi: 10.1016/s0015-0282(99)00184-3.
To analyze the correlations among insulin, androgens, body mass index (BMI), and other related metabolic anomalies in women with and without polycystic ovary syndrome (PCOS).
Retrospective study of normal and obese women with and without PCOS.
Gynecologic endocrinology units of Elche, San Juan, and Alicante Hospitals and Hormone Laboratory at Alicante University Hospital ("Miguel Hernández" University).
PATIENT(S): A total of 212 women were studied: 137 with PCOS and 75 without PCOS.
INTERVENTION(S): BMI, gonadotropins, insulin, androgens (T, androstenedione, DHEAS), 17alpha-hydroxyprogesterone, sex hormone-binding globulin, and triglycerides were studied. Glycemia and insulin response to the tolerance test (GTT) with a 100-g oral glucose load were also assessed in 103 women.
RESULT(S): A good correlation between insulin and BMI was found in normal and obese women without hormonal dysfunction and in patients with or without PCOS. Good correlations, although lower, between insulin and T, and BMI, insulin, and T with triglycerides were also found in patients with PCOS. These patients fell into clearly distinct categories: with or without insulin resistance and with or without obesity, but slim women with PCOS had insulin and metabolic variables similar to those without PCOS, and most obese women with PCOS were insulin-resistant and more hyperandrogenic and hypertriglyceridemic.
CONCLUSION(S): Insulin, androgens, and BMI are related in women both with PCOS and without PCOS, especially in obese ones. Insulin and metabolic indices are similar in lean women with PCOS and those without PCOS, but obese women with PCOS are more insulin-resistant, hyperandrogenic, and hypertriglyceridemic. Three types of disorders can be distinguished: simple nonhyperandrogenic obesity, typical nonhyperinsulinemic PCOS, and insulin-resistant PCOS.
分析患有和未患有多囊卵巢综合征（PCOS）的女性体内胰岛素、雄激素、体重指数（BMI）及其他相关代谢异常之间的相关性。
对患有和未患有PCOS的正常及肥胖女性进行回顾性研究。
埃尔切、圣胡安和阿利坎特医院的妇科内分泌科室以及阿利坎特大学医院（“米格尔·埃尔南德斯”大学）的激素实验室。
共研究了212名女性：137名患有PCOS，75名未患有PCOS。
研究了BMI、促性腺激素、胰岛素、雄激素（睾酮、雄烯二酮、硫酸脱氢表雄酮）、17α-羟孕酮、性激素结合球蛋白和甘油三酯。还对103名女性进行了口服100克葡萄糖耐量试验（GTT）后的血糖和胰岛素反应评估。
在无激素功能障碍的正常及肥胖女性以及患有或未患有PCOS的患者中，发现胰岛素与BMI之间存在良好相关性。在患有PCOS的患者中，胰岛素与睾酮、BMI、胰岛素与睾酮以及甘油三酯之间也存在良好相关性，尽管相关性较低。这些患者可明显分为不同类别：有或无胰岛素抵抗、有或无肥胖，但体型苗条的PCOS女性的胰岛素及代谢变量与未患PCOS的女性相似，而大多数肥胖的PCOS女性存在胰岛素抵抗，雄激素水平更高且甘油三酯水平更高。
患有和未患有PCOS的女性体内胰岛素、雄激素和BMI之间存在关联，尤其是肥胖女性。体型苗条的PCOS女性和未患PCOS的女性的胰岛素及代谢指标相似，但肥胖的PCOS女性胰岛素抵抗更强，雄激素水平更高且甘油三酯水平更高。可区分出三种类型的疾病：单纯非高雄激素性肥胖、典型非高胰岛素性PCOS和胰岛素抵抗性PCOS。
