Vigil Pilar, Contreras Patricio, Alvarado Jorge L, Godoy Ana, Salgado Ana M, Cortés Manuel E
Unidad de Reproducción y Desarrollo, Departamento de Ciencias Fisiológicas, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Alameda B O'Higgins 340, Santiago, Chile.
Hum Reprod. 2007 Nov;22(11):2974-80. doi: 10.1093/humrep/dem302. Epub 2007 Sep 25.
Polycystic ovary syndrome (PCOS) is non-uniformly associated with insulin resistance (IR). We examined IR in women with PCOS.
Sixty-nine PCOS women were subjected to the insulin suppression test (IST) to determine their steady-state plasma glucose (SSPG) as a direct measure of insulin sensitivity.
SSPG exhibited a multimodal distribution suggesting the existence of subpopulations. The heterogeneous distribution of plasma glucose at 180 min (P = 0.011), with three modes, suggested differences in the plasma glucose level trajectories during the IST. Hence, the population was separated into three groups: (i) (n = 33), subjects with SSPG < or = 152.5 mg/dl, corresponding to the first to fifth deciles; (ii) (n = 29), subjects in the interval 152.5 mg/dl < SSPG < or = 300 mg/dl; (iii) (n = 7), subjects with SSPG > 300 mg/dl, corresponding to the tenth decile. Plasma glucose distributions at 180 min showed differences in their mean values and ranges among groups (P < 0.0001). The trajectories of the groups differed significantly during the IST (P < 0.0001).
insulin sensitivity in our patients exhibited a discontinuous distribution, implying that PCOS is a heterogeneous disorder possessing subpopulations regarding IR.
多囊卵巢综合征（PCOS）与胰岛素抵抗（IR）的关联并不一致。我们对PCOS女性的胰岛素抵抗情况进行了研究。
对69名PCOS女性进行胰岛素抑制试验（IST），以测定其稳态血糖（SSPG），作为胰岛素敏感性的直接指标。
SSPG呈现多峰分布，提示存在亚组人群。180分钟时血浆葡萄糖的异质性分布（P = 0.011），有三个峰，表明IST期间血浆葡萄糖水平轨迹存在差异。因此，将人群分为三组：（i）（n = 33），SSPG≤152.5mg/dl的受试者，对应第一至第五十分位数；（ii）（n = 29），SSPG在152.5mg/dl＜SSPG≤300mg/dl区间的受试者；（iii）（n = 7），SSPG＞300mg/dl的受试者，对应第十十分位数。180分钟时血浆葡萄糖分布在各组间的平均值和范围存在差异（P＜0.0001）。各组在IST期间的轨迹差异显著（P＜0.0001）。
我们患者的胰岛素敏感性呈现间断分布，这意味着PCOS是一种异质性疾病，在胰岛素抵抗方面存在亚组人群。
