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:S243-6. doi: 10.1016/j.diabres.2007.01.065. Epub 2007 Jul 3.
Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance also plays an important role in the metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS in young Korean women with PCOS and whether it is associated insulin resistance. One hundred and seventeen young women with PCOS (age: 26+/-5, 16-39 years) were evaluated for the frequency of MS according to the modified Adult Treatment Panel III. Total testosterone (T), free T, androstenedione, dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were measured, and insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. The prevalence of MS in women with PCOS was 14.5%, nearly 3.5-fold higher than in age-matched women in Korean urban population (4.3%) [J.-Y. Oh, Y.-A. Sung, Y.S. Hong, E. Barrett-Conner, Prevalence and factor analysis of metabolic syndrome in an urban Korean population, Diabetes Care 27 (2004) 2027-2032]. The most frequently occurring component of MS was low HDL cholesterol (45%), and the least frequent was high fasting serum glucose level (0.9%). PCOS women with MS had significantly higher free T, and lower SHBG compared with those without MS. And women with MS showed significantly lower M-value and higher fasting/post-glucose load insulin levels. M-value was still significantly lower in women with MS even after the adjustment for BMI. MS is frequent in young Korean women with PCOS and it reflects more severe insulin resistance. These results suggest the importance of early and regular screening of metabolic disturbance in even young women with PCOS.
多囊卵巢综合征（PCOS）的特征是胰岛素抵抗及随之而来的高胰岛素血症。胰岛素抵抗在代谢综合征（MS）中也起重要作用。我们进行了一项横断面研究，以确定韩国年轻PCOS女性中MS的患病率，以及它是否与胰岛素抵抗相关。根据修改后的成人治疗小组III标准，对117名年轻PCOS女性（年龄：26±5岁，16 - 39岁）进行了MS频率评估。测量了总睾酮（T）、游离T、雄烯二酮、硫酸脱氢表雄酮（DHEAS）和性激素结合球蛋白（SHBG），并通过正常血糖高胰岛素钳夹技术评估胰岛素敏感性。PCOS女性中MS的患病率为14.5%，几乎是韩国城市同龄女性（4.3%）的3.5倍[J.-Y. Oh，Y.-A. Sung，Y.S. Hong，E. Barrett-Conner，韩国城市人群中代谢综合征的患病率及因素分析，《糖尿病护理》27（2004）2027 - 2032]。MS最常见的组成部分是低高密度脂蛋白胆固醇（45%），最不常见的是高空腹血清葡萄糖水平（0.9%）。患有MS的PCOS女性与未患MS的女性相比，游离T显著更高，SHBG更低。并且患有MS的女性M值显著更低，空腹/葡萄糖负荷后胰岛素水平更高。即使在调整BMI后，患有MS的女性M值仍然显著更低。MS在韩国年轻PCOS女性中很常见，并且它反映了更严重的胰岛素抵抗。这些结果表明，即使是年轻的PCOS女性，早期和定期筛查代谢紊乱也很重要。
