S C Das Memorial Medical & Research Center, Kolkata, India.
Gynecol Endocrinol. 2010 May;26(5):344-7. doi: 10.3109/09513590903367002.
To estimate (1) the prevalence of insulin resistance (IR) by fasting glucose: insulin ratio (G:I) (G:I <or= 4.5) in overweight-obese polycystic ovary syndrome (PCOS) women, (2) to compare the clinical and biochemical parameters between insulin-resistant and insulin-sensitive groups.
Eighty-one overweight-obese PCOS women (body mass index (BMI) >or= 23 kg/m(2)) were studied. PCOS was diagnosed as per the Rotterdam 2003 criteria. BMI, abdominal circumference (AC), hirsutism (Ferriman Gallway score >or=6), presence of acne and acanthosis nigricans (AN) were noted in each case. Serum testosterone, sex hormone binding globulin (SHBG), fasting plasma glucose and insulin levels were measured.
23.5% women were found to have IR. There were no differences in age, frequency of hirsutism, acne, serum testosterone and fasting glucose levels between insulin-resistant and insulin-sensitive women. However, there were significant differences in BMI, AC, frequency of AN, SHBG levels, fasting insulin levels and FAI between the two groups.
PCOS women with IR are more obese; they have more upper body adiposity and AN. They are more hyperandrogenic. Simple clinical parameters will help to suspect IR in PCOS women.
(1)通过空腹血糖与胰岛素比值(G:I)(G:I≤4.5)评估超重肥胖型多囊卵巢综合征(PCOS)妇女胰岛素抵抗(IR)的患病率,(2)比较胰岛素抵抗组与胰岛素敏感组的临床和生化参数。
共研究了 81 例超重肥胖型 PCOS 妇女(体重指数(BMI)≥23kg/m²)。根据 2003 年鹿特丹标准诊断 PCOS。记录每位患者的 BMI、腹围(AC)、多毛症(Ferriman-Gallway 评分≥6)、痤疮和黑棘皮病(AN)的存在情况。检测血清睾酮、性激素结合球蛋白(SHBG)、空腹血糖和胰岛素水平。
23.5%的妇女存在 IR。IR 妇女与胰岛素敏感妇女的年龄、多毛症、痤疮、血清睾酮和空腹血糖水平无差异。然而,两组间 BMI、AC、AN 发生率、SHBG 水平、空腹胰岛素水平和游离雄激素指数(FAI)存在显著差异。
存在 IR 的 PCOS 妇女更肥胖;她们上半身脂肪更多,且更易发生 AN。她们雄激素水平更高。简单的临床参数有助于怀疑 PCOS 妇女存在 IR。