Kaushal R, Parchure N, Bano G, Kaski J-C, Nussey S S
Division of Oncology, Gastroenterology and Endocrinology, St George's Hospital Medical School, London, UK.
Clin Endocrinol (Oxf). 2004 Mar;60(3):322-8. doi: 10.1111/j.1365-2265.2004.01981.x.
Ultrasonographic appearances of polycystic ovaries (PCO) are found in 50% of South London Indian subcontinent Asians, a population at high risk of coronary disease and type 2 diabetes (DM). PCO is a familial condition but the genetics remain to be clarified. At present, the only characteristic documented in male family members is premature male pattern balding before the age of 30 years. Our aim was to quantify insulin resistance and endothelial cell function in the brothers of Indian subcontinent Asian women with PCO and/or a family history of type 2 DM.
Indian subcontinent Asian women (n = 40, age 16-40 years) with a brother available for study were recruited from the local population. They were stratified into four groups according to the ultrasound appearances of PCO and/or a family history of type 2 DM. Control subjects had no PCO and no family history of DM. Insulin sensitivity (KITT) was measured using a short insulin tolerance test and endothelial function using brachial artery ultrasound to measure flow-mediated dilatation (FMD).
Groups were well matched for age, body mass index (BMI) and waist-hip circumference ratios. Asian women with PCO demonstrated insulin resistance independent of BMI or family history of diabetes. Women with PCO and a family history of DM have reduced FMD, though PCO alone was not a marker. The brothers of women with PCO also have insulin resistance, comparable to that associated with a family history of type 2 DM. This was associated with elevations of blood pressure, abnormalities in serum lipid concentrations and impaired endothelial cell function. Endothelial cell function was particularly impaired in those subjects with both a sister with PCO and a family history of DM.
In an ethnic minority population at higher risk of coronary heart disease, brothers of women with PCO have evidence of insulin resistance and endothelial cell dysfunction in early adult life. Further study is required to establish whether these findings are associated with an increased incidence of cardiovascular events in this population.
在伦敦南部印度次大陆亚洲人群中，50%的人有多囊卵巢（PCO）的超声表现，该人群是冠心病和2型糖尿病（DM）的高危人群。PCO是一种家族性疾病，但其遗传学仍有待阐明。目前，在男性家庭成员中记录到的唯一特征是30岁前出现早发性男性型秃发。我们的目的是量化患有PCO和/或有2型糖尿病家族史的印度次大陆亚洲女性的兄弟的胰岛素抵抗和内皮细胞功能。
从当地人群中招募有兄弟可供研究的印度次大陆亚洲女性（n = 40，年龄16 - 40岁）。根据PCO的超声表现和/或2型糖尿病家族史将她们分为四组。对照组无PCO且无糖尿病家族史。使用短胰岛素耐量试验测量胰岛素敏感性（KITT），使用肱动脉超声测量血流介导的血管舒张（FMD）来评估内皮功能。
各组在年龄、体重指数（BMI）和腰臀围比方面匹配良好。患有PCO的亚洲女性表现出独立于BMI或糖尿病家族史的胰岛素抵抗。患有PCO且有糖尿病家族史的女性FMD降低，不过单独的PCO并非一个标志物。患有PCO的女性的兄弟也存在胰岛素抵抗，与有2型糖尿病家族史者相当。这与血压升高、血脂浓度异常和内皮细胞功能受损有关。在那些既有患PCO的姐妹又有糖尿病家族史的受试者中，内皮细胞功能尤其受损。
在冠心病风险较高的少数民族人群中，患有PCO的女性的兄弟在成年早期有胰岛素抵抗和内皮细胞功能障碍的证据。需要进一步研究以确定这些发现是否与该人群心血管事件发生率增加有关。
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