Marsden P J, Murdoch A P, Taylor R
Department of Obstetrics and Gynaecology, University Hospital of North Durham, Durham, UK.
Clin Endocrinol (Oxf). 2001 Aug;55(2):191-9. doi: 10.1046/j.1365-2265.2001.01303.x.
Polycystic ovarian syndrome (PCOS) and obesity both affect insulin sensitivity. This study was designed to investigate the biochemical indices of PCOS and tissue insulin sensitivity in groups of lean and obese women with clinically equivalent degrees of the syndrome, relative to control subjects.
A prospective study of in vivo parameters and in vitro study of adipocytes to assess insulin sensitivity.
Six lean and 14 overweight patients fulfilling formal diagnostic criteria for PCOS were studied. The degree of hirsutism and amenorrhoea was similar in each group. Eight control subjects were also studied.
Endocrine and metabolic parameters were measured in lean and overweight patients with PCOS and control subjects. In vitro studies of adipocyte insulin receptor binding and adipocyte insulin action were performed.
The mean plasma LH level was elevated in both groups of PCOS but was significantly higher in the lean group (LH levels were 25.1 +/- 3.1 and 14.5 +/- 1.6 iu/l in lean PCOS and obese PCOS, respectively (P = 0.01)). There was a strong inverse correlation between BMI and LH levels (R = - 0.70, P = 0.001). Fasting insulin levels were elevated in both lean and obese groups (11.5 +/- 2.8 and 26.8 +/- 8.1 mU/l, respectively; P = 0.068). Mean serum testosterone and serum androstenedione levels were also elevated in PCOS compared to control subjects but there was no difference between the two groups of PCOS subjects. Insulin receptor binding in amenorrhoeic subjects with PCOS was low in both lean and obese patients with PCOS but was not significantly different between the two groups (0.79 +/- 0.17% and 0.66 +/- 0.07% per 10 cm2 cell membrane, respectively). Maximally insulin-stimulated rates of 3-O-methylglucose transport were low in both groups compared to previously studied normal subjects (0.96 +/- 0.21 and 0.64 +/- 0.07 pmol per 10 cm2 membrane in lean and obese PCOS subjects, respectively; P = NS).
Lean subjects with a given phenotypic expression of PCOS have an equivalent degree of tissue insulin resistance compared to obese PCOS subjects. This implies that the insulin resistance may be a primary feature of PCOS. If this is so, a similar clinical degree of the syndrome may be brought about by genetically determined insulin resistance in lean subjects or by insulin resistance which is secondary to obesity.
多囊卵巢综合征（PCOS）和肥胖均会影响胰岛素敏感性。本研究旨在调查临床症状程度相当的瘦型和肥胖型PCOS女性群体相对于对照受试者的PCOS生化指标及组织胰岛素敏感性。
一项关于体内参数的前瞻性研究以及一项关于脂肪细胞以评估胰岛素敏感性的体外研究。
对6名符合PCOS正式诊断标准的瘦型患者和14名超重患者进行了研究。每组患者的多毛症和闭经程度相似。还对8名对照受试者进行了研究。
对瘦型和超重型PCOS患者以及对照受试者的内分泌和代谢参数进行了测量。进行了脂肪细胞胰岛素受体结合及脂肪细胞胰岛素作用的体外研究。
两组PCOS患者的平均血浆促黄体生成素（LH）水平均升高，但瘦型组显著更高（瘦型PCOS和肥胖型PCOS患者的LH水平分别为25.1±3.1和14.5±1.6国际单位/升，P = 0.01）。体重指数（BMI）与LH水平呈强负相关（R = - 0.70，P = 0.001）。瘦型和肥胖型组的空腹胰岛素水平均升高（分别为11.5±2.8和26.8±8.1毫国际单位/升；P = 0.068）。与对照受试者相比，PCOS患者的平均血清睾酮和血清雄烯二酮水平也升高，但两组PCOS受试者之间无差异。瘦型和肥胖型PCOS闭经患者的胰岛素受体结合率均较低，但两组之间无显著差异（每10平方厘米细胞膜分别为0.79±0.17%和
