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在非代谢综合征的正常胰岛素血症多囊卵巢患者中,高敏血清 C 反应蛋白及其与其他心血管危险因素的关系。

High sensitive serum C-reactive protein and its relationship with other cardiovascular risk factors in normoinsulinemic polycystic ovary patients without metabolic syndrome.

机构信息

Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Yenisehir, 63050, Sanliurfa, Turkey.

出版信息

Arch Gynecol Obstet. 2010 Jun;281(6):1009-14. doi: 10.1007/s00404-009-1226-6. Epub 2009 Sep 22.

Abstract

PURPOSE

The aims of the study were to investigate high sensitive serum C-reactive protein (HS-CRP) levels in normoinsulinemic polycystic ovary syndrome (PCOS) patients without metabolic syndrome and whether there was any relationship between HS-CRP and other cardiovascular risk factors such as obesity and serum lipids.

METHODS

A total of 52 normoinsulinemic PCOS women without metabolic syndrome and 48 normoandrogenic ovulatory women were enrolled in the study. Standard clinical examinations, and ultrasonographic and endocrine screening including FSH, LH, total testosterone, free testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglyceride (TG) were measured. Normal insulin sensitivity was defined on the basis of fasting serum glucose and insulin levels, serum insulin response to an oral glucose tolerance test and homeostatic model of insulin resistance. HS-CRP was assessed spectrophotometrically.

RESULTS

PCOS patients had increased HS-CRP compared to the control group (P < 0.0001). HS-CRP was positively correlated with body mass index (BMI) (r = 0.44, P < 0.0001), waist-to-hip ratio (WHR) (r = 0.66, P < 0.0001), LDL (r = 0.62, P < 0.0001), TC (r = 0.56, P < 0.0001) and TG (r = 0.38, P < 0.0001), and negatively correlated with HDL (r = -0.45, P < 0.0001). There was also a strong association between HS-CRP and PCOS status (r = 0.69, P < 0.0001) in the study. Multivariate regression analysis demonstrated that BMI, WHR, LDL, HDL and PCOS status were also the independent variables that influenced HS-CRP in the overall group.

CONCLUSION

Elevated HS-CRP was associated with cardiovascular risk factors in normoinsulinemic PCOS without metabolic syndrome. These patients need more intensive screening or treatment for this disease.

摘要

目的

本研究旨在探讨无代谢综合征的正常胰岛素血症多囊卵巢综合征(PCOS)患者的高敏血清 C 反应蛋白(hs-CRP)水平,以及 hs-CRP 是否与肥胖和血清脂质等其他心血管危险因素有关。

方法

本研究共纳入 52 例无代谢综合征的正常胰岛素血症 PCOS 女性和 48 例正常雄激素排卵女性。进行标准临床检查,以及超声和内分泌筛查,包括 FSH、LH、总睾酮、游离睾酮、性激素结合球蛋白、硫酸脱氢表雄酮、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、总胆固醇(TC)和甘油三酯(TG)。正常胰岛素敏感性定义为空腹血糖和胰岛素水平、口服葡萄糖耐量试验和胰岛素抵抗稳态模型的血清胰岛素反应。采用分光光度法测定 hs-CRP。

结果

与对照组相比,PCOS 患者的 hs-CRP 升高(P<0.0001)。hs-CRP 与体重指数(BMI)(r=0.44,P<0.0001)、腰臀比(WHR)(r=0.66,P<0.0001)、LDL(r=0.62,P<0.0001)、TC(r=0.56,P<0.0001)和 TG(r=0.38,P<0.0001)呈正相关,与 HDL 呈负相关(r=-0.45,P<0.0001)。在研究中,hs-CRP 与 PCOS 状态之间也存在强烈关联(r=0.69,P<0.0001)。多元回归分析表明,BMI、WHR、LDL、HDL 和 PCOS 状态也是整个组中影响 hs-CRP 的独立变量。

结论

无代谢综合征的正常胰岛素血症 PCOS 患者 hs-CRP 升高与心血管危险因素相关。这些患者需要更加强化对这种疾病的筛查或治疗。

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