Patel Arti A, Bloomgarden Zachary T, Futterweit Walter
Division of Endocrinology, Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.
Endocr Pract. 2008 Mar;14(2):193-200. doi: 10.4158/EP.14.2.193.
To determine the relationship between urinary albumin excretion and features of the metabolic syndrome in women with polycystic ovary syndrome (PCOS).
We retrospectively analyzed the medical records of 189 premenopausal women (mean age +/- SD, 28.9 +/- 7.7 years) with PCOS and 81 control patients (mean age +/- SD, 37.9 +/- 8.6 years) from a single endocrinology practice. Exclusion criteria were diabetes, heart disease, kidney disease, use of lipid-lowering agents, and use of antihypertensive agents (except spironolactone). The urine albumin-to-creatinine ratio (ACR) was measured in a random single-voided urine sample. Premicroalbuminuria was defined as an ACR >7 mg/g.
The prevalence of ACR >7 mg/g was 31.2% in the PCOS group (N = 189) and 35.8% in the control group (N = 81). The metabolic syndrome was noted in 16.3% (27 of 166) of patients with PCOS and in 2.9% (2 of 69) of control subjects. Nine percent of patients with PCOS who had an ACR <or=7 mg/g but 30.9% of those with an ACR >7 mg/g had the metabolic syndrome. Patients with PCOS who had an ACR >7 mg/g had significantly higher blood pressure and alanine aminotransferase levels than did those with an ACR <or=7 mg/g. In the patients with PCOS who had an ACR <or=7 mg/g versus those who had an ACR >7 mg/g, no significant difference was found in frequency of use of metformin, spironolactone, or oral contraceptives.
In women with PCOS, an ACR >7 mg/g was strongly associated with the metabolic syndrome, high blood pressure, and elevated alanine aminotransferase levels. It may be useful to consider ACR >7 mg/g as an associated sign of the presence of metabolic syndrome in women with PCOS.
确定多囊卵巢综合征（PCOS）女性尿白蛋白排泄与代谢综合征特征之间的关系。
我们回顾性分析了来自单一内分泌科的189例绝经前PCOS女性（平均年龄±标准差，28.9±7.7岁）和81例对照患者（平均年龄±标准差，37.9±8.6岁）的病历。排除标准为糖尿病、心脏病、肾病、使用降脂药物和使用抗高血压药物（螺内酯除外）。在随机单次排尿的尿液样本中测量尿白蛋白与肌酐比值（ACR）。微量白蛋白尿前期定义为ACR>7mg/g。
PCOS组（N = 189）中ACR>7mg/g的患病率为31.2%，对照组（N = 81）中为35.8%。PCOS患者中有16.3%（166例中的27例）患有代谢综合征，对照受试者中有2.9%（69例中的2例）患有代谢综合征。ACR≤7mg/g的PCOS患者中有9%患有代谢综合征，但ACR>7mg/g的患者中有30.9%患有代谢综合征。ACR>7mg/g的PCOS患者的血压和丙氨酸转氨酶水平显著高于ACR≤7mg/g的患者。在ACR≤7mg/g与ACR>7mg/g的PCOS患者中，二甲双胍、螺内酯或口服避孕药的使用频率没有显著差异。
在PCOS女性中，ACR>7mg/g与代谢综合征、高血压和丙氨酸转氨酶水平升高密切相关。将ACR>7mg/g视为PCOS女性存在代谢综合征的相关标志可能是有用的。
