Apridonidze Teimuraz, Essah Paulina A, Iuorno Maria J, Nestler John E
Department of Internal Medicine, Medical College of Virginia, P.O. Box 980111, Richmond, Virginia 23298-0111, USA.
J Clin Endocrinol Metab. 2005 Apr;90(4):1929-35. doi: 10.1210/jc.2004-1045. Epub 2004 Dec 28.
The polycystic ovary syndrome (PCOS) is characterized by insulin resistance with compensatory hyperinsulinemia. Insulin resistance also plays a role in the metabolic syndrome (MBS). We hypothesized that the MBS is prevalent in PCOS and that women with both conditions would present with more hyperandrogenism and menstrual cycle irregularity than women with PCOS only. We conducted a retrospective chart review of all women with PCOS seen over a 3-yr period at an endocrinology clinic. Of the 161 PCOS cases reviewed, 106 met the inclusion criteria. The women were divided into two groups: 1) women with PCOS and the MBS (n = 46); and 2) women with PCOS lacking the MBS (n = 60). Prevalence of the MBS was 43%, nearly 2-fold higher than that reported for age-matched women in the general population. Women with PCOS had persistently higher prevalence rates of the MBS than women in the general population, regardless of matched age and body mass index ranges. Acanthosis nigricans was more frequent in women with PCOS and the MBS. Women with PCOS and the MBS had significantly higher levels of serum free testosterone (P = 0.002) and lower levels of serum SHBG (P = 0.001) than women with PCOS without the MBS. No differences in total testosterone were observed between the groups. We conclude that the MBS and its components are common in women with PCOS, placing them at increased risk for cardiovascular disease. Women with PCOS and the MBS differ from their counterparts lacking the MBS in terms of increased hyperandrogenemia, lower serum SHBG, and higher prevalence of acanthosis nigricans, all features that may reflect more severe insulin resistance.
多囊卵巢综合征（PCOS）的特征是胰岛素抵抗并伴有代偿性高胰岛素血症。胰岛素抵抗在代谢综合征（MBS）中也起作用。我们假设MBS在PCOS中普遍存在，并且同时患有这两种病症的女性比仅患有PCOS的女性会出现更多的高雄激素血症和月经周期不规律。我们对一家内分泌诊所3年内诊治的所有PCOS女性患者进行了回顾性病历审查。在审查的161例PCOS病例中，106例符合纳入标准。这些女性被分为两组：1）患有PCOS和MBS的女性（n = 46）；2）患有PCOS但不伴有MBS的女性（n = 60）。MBS的患病率为43%，几乎是普通人群中年龄匹配女性报告患病率的2倍。无论年龄和体重指数范围是否匹配，PCOS女性的MBS患病率始终高于普通人群中的女性。黑棘皮病在患有PCOS和MBS的女性中更为常见。与不伴有MBS的PCOS女性相比，患有PCOS和MBS的女性血清游离睾酮水平显著更高（P = 0.002），血清性激素结合球蛋白（SHBG）水平更低（P = 0.001）。两组之间总睾酮水平未观察到差异。我们得出结论，MBS及其组成成分在PCOS女性中很常见，这使她们患心血管疾病的风险增加。患有PCOS和MBS的女性与不伴有MBS的女性相比，在高雄激素血症增加、血清SHBG降低以及黑棘皮病患病率更高方面存在差异，所有这些特征可能反映了更严重的胰岛素抵抗。
