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多囊卵巢综合征妇女的胰岛β细胞功能和胰岛素敏感性:2 型糖尿病家族史的影响。

Beta cell function and insulin sensitivity in women with polycystic ovary syndrome: influence of the family history of type 2 diabetes mellitus.

机构信息

Institute of Endocrinology, Narodni 8 Prague 1, Czech Republic.

出版信息

Gynecol Endocrinol. 2009 Sep;25(9):597-602. doi: 10.1080/09513590902972133.

Abstract

AIM

To study the impact of family history (FH) of type 2 diabetes mellitus on beta-cell compensatory mechanism in women with polycystic ovary syndrome (PCOS).

SUBJECTS AND METHODS

A total of 70 women with PCOS, 14 with first-degree relative with type 2 diabetes mellitus (T2DM) (FH+), 56 with negative FH of T2DM (FH-) and 72 age and BMI matched control healthy women (CNT) underwent oral glucose tolerance test (OGTT). Insulin resistance was evaluated as oral glucose index (OGIS); insulin and C-peptide secretion as the insulinogenic index in 30th min of OGTT.

RESULTS

Fasting blood glucose levels were significantly higher in FH+ than in FH- (p < 0.05). Fasting insulin was higher in FH+ than in CNT (p < 0.05). Fasting C-peptide was significantly higher in both FH- and FH+ than in CNT (p < 0.05 and p < 0.01, respectively). OGIS was lower in FH+ than in FH- or in CNT (p < 0.05). Insulinogenic index calculated from C-peptide values (II-Cp) was lower in FH+ than in CNT (p < 0.05). Adaptation index calculated from the values of OGIS and insulinogenic index was significantly lower in FH+ than in CNT or in FH- (p < 0.0001 and p < 0.01, respectively).

CONCLUSIONS

Insulin resistance and defective early-phase insulin secretion is present only in those PCOS-affected subjects who had positive FH of T2DM.

摘要

目的

研究 2 型糖尿病家族史(FH)对多囊卵巢综合征(PCOS)女性β细胞代偿机制的影响。

受试者和方法

共纳入 70 例 PCOS 患者,14 例一级亲属患有 2 型糖尿病(T2DM)(FH+),56 例 T2DM FH 阴性(FH-)和 72 例年龄和 BMI 匹配的健康对照组(CNT)患者行口服葡萄糖耐量试验(OGTT)。采用口服葡萄糖指数(OGIS)评估胰岛素抵抗;采用 OGTT 第 30 分钟的胰岛素原指数评估胰岛素和 C 肽分泌情况。

结果

FH+患者的空腹血糖水平明显高于 FH-患者(p<0.05)。FH+患者的空腹胰岛素水平高于 CNT 患者(p<0.05)。FH-和 FH+患者的空腹 C 肽水平均明显高于 CNT 患者(p<0.05 和 p<0.01)。FH+患者的 OGIS 低于 FH-和 CNT 患者(p<0.05)。基于 C 肽值计算的胰岛素原指数(II-Cp)在 FH+患者中低于 CNT 患者(p<0.05)。OGIS 和胰岛素原指数值计算的适应性指数在 FH+患者中明显低于 CNT 或 FH-患者(p<0.0001 和 p<0.01)。

结论

仅在那些患有 T2DM 阳性 FH 的 PCOS 患者中存在胰岛素抵抗和早期胰岛素分泌缺陷。

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