Park Hwi Ra, Choi Youngju, Lee Hye-Jin, Oh Jee-Young, Hong Young Sun, Sung Yeon-Ah
Division of Endocrinology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
Diabetes Res Clin Pract. 2007 Sep;77 Suppl 1:S233-7. doi: 10.1016/j.diabres.2007.01.063. Epub 2007 Jul 2.
Over 50% of women with polycystic ovary syndrome (PCOS) have been reported to have varying degree of insulin resistance and it may contribute to hyperandrogenism. The aim of the study is to identify whether the insulin resistance is present in non-obese Korean women with PCOS and whether the phenotype is different according to insulin sensitivity. Seventy-three non-obese (BMI<23 kg/m(2)) women with PCOS and 34 age and BMI comparable control women with regular menstrual cycles were examined. Standard 75 g OGTT was performed to determine the status of glucose tolerance. Insulin sensitivity was measured by euglycemic hyperinsulinemic clamp technique. The fasting plasma glucose (p<0.01) and post-glucose load plasma insulin (p<0.01) of women with PCOS were higher than those of controls. Glucose disposal rate (M-value) was lower in women with PCOS compared to controls (p<0.05). Insulin resistant (IR) and insulin sensitive (IS) PCOS were divided by the M-value of 25-percentile (5.5mg/kg min) in controls. Between IR and IS groups, DHEAS (p<0.01), post-glucose load plasma insulin (p<0.05) showed differences after the adjustment for BMI. Our non-obese women with PCOS showed significant insulin resistance compared to their age and BMI comparable control subjects and their insulin resistance may contribute to hyperandrogenism especially via adrenal androgen overproduction.
据报道,超过50%的多囊卵巢综合征(PCOS)女性存在不同程度的胰岛素抵抗,这可能导致高雄激素血症。本研究的目的是确定非肥胖的韩国PCOS女性是否存在胰岛素抵抗,以及胰岛素敏感性不同时其表型是否存在差异。对73名非肥胖(BMI<23 kg/m²)的PCOS女性和34名年龄及BMI相匹配、月经周期正常的对照女性进行了检查。采用标准75g口服葡萄糖耐量试验(OGTT)来确定糖耐量状态。通过正常血糖高胰岛素钳夹技术测量胰岛素敏感性。PCOS女性的空腹血糖(p<0.01)和葡萄糖负荷后血浆胰岛素水平(p<0.01)高于对照组。与对照组相比,PCOS女性的葡萄糖处置率(M值)较低(p<0.05)。根据对照组25%百分位数的M值(5.5mg/kg·min)将PCOS患者分为胰岛素抵抗(IR)组和胰岛素敏感(IS)组。在IR组和IS组之间,经BMI校正后,硫酸脱氢表雄酮(DHEAS,p<0.01)、葡萄糖负荷后血浆胰岛素(p<0.05)存在差异。与年龄及BMI相匹配的对照受试者相比,我们研究中的非肥胖PCOS女性表现出显著的胰岛素抵抗,且其胰岛素抵抗可能尤其通过肾上腺雄激素过度分泌导致高雄激素血症。