Sir-Petermann T, Angel B, Maliqueo M, Carvajal F, Santos J L, Pérez-Bravo F
Laboratory of Endocrinology, Department of Medicine, School of Medicine, San Juan de Dios Hospital and Food Technology Institute, University of Chile, Santiago, Chile.
Diabetologia. 2002 Jul;45(7):959-64. doi: 10.1007/s00125-002-0836-3. Epub 2002 Apr 26.
AIMS/HYPOTHESIS: Insulin resistance with increased risk of Type II (non-insulin-dependent) diabetes is a common feature of polycystic ovary syndrome (PCOS). To investigate antecedents of metabolic disorders in family members of patients with PCOS, we evaluated glucose tolerance and insulin resistance in parents of patients with PCOS compared to parents of healthy women.
A total of 200 parents of women with clinical and hormonal evidence of PCOS (PCOSp) and 120 parents of healthy normally cycling women (HWp) were studied. A 75-g OGGT was performed and subjects were classified according to the World Health Organization (WHO) criteria (1999). Serum glucose and insulin were measured before the glucose load and 30, 60 and 120 min after. C-peptide and sex hormone-binding globulin were also determined before the glucose load. Insulin resistance was assessed by HOMA model and ISI composite.
The prevalence of Type II diabetes was 1.89-(1.06-3.38)-fold higher in PCOSp compared to HWp. Insulin resistance, evaluated by HOMA(IR)and ISI composite was also significantly higher in the PCOSp group compared to the HWp group. After both study groups were distributed by sex, and adjusted by age and BMI, the metabolic parameters were still significantly different between PCOSp and HWp.
CONCLUSIONS/INTERPRETATION: The data suggest that parents of PCOS women exhibit insulin resistance and Type II diabetes more frequently than those of healthy women, thus constituting a high-risk group but an ideal cohort to detect and prevent the development of Type II diabetes.
目的/假设:胰岛素抵抗伴2型(非胰岛素依赖型)糖尿病风险增加是多囊卵巢综合征(PCOS)的常见特征。为了研究PCOS患者家庭成员代谢紊乱的前驱因素,我们评估了PCOS患者的父母与健康女性的父母的糖耐量和胰岛素抵抗情况。
共研究了200名有PCOS临床和激素证据的女性的父母(PCOSp)以及120名健康正常月经周期女性的父母(HWp)。进行了75g口服葡萄糖耐量试验(OGGT),并根据世界卫生组织(WHO)标准(1999年)对受试者进行分类。在葡萄糖负荷前以及负荷后30、60和120分钟测量血清葡萄糖和胰岛素。在葡萄糖负荷前还测定了C肽和性激素结合球蛋白。通过稳态模型评估法(HOMA)模型和胰岛素敏感指数(ISI)综合评估胰岛素抵抗。
与HWp相比,PCOSp中2型糖尿病的患病率高1.89-(1.06-3.38)倍。通过HOMA(IR)和ISI综合评估,PCOSp组的胰岛素抵抗也显著高于HWp组。在按性别对两个研究组进行分组,并根据年龄和体重指数(BMI)进行调整后,PCOSp和HWp之间的代谢参数仍有显著差异。
结论/解读:数据表明,PCOS女性的父母比健康女性的父母更频繁地出现胰岛素抵抗和2型糖尿病,因此构成了一个高危群体,但也是检测和预防2型糖尿病发生的理想队列。