Department of Obstetrics and Gynecology, University of Cagliari, Via Ospedale Cagliari, Cagliari, Italy.
J Adolesc Health. 2010 May;46(5):474-81. doi: 10.1016/j.jadohealth.2009.10.008. Epub 2010 Jan 4.
The objective of this study was evaluate influence of body mass index (BMI), hyperinsulinemia and/or insulin resistance (IR), and androgens on the lipid profile of adolescent polycystic ovary syndrome (PCOS).
A total of 71 PCOS and 94 healthy adolescent girls from a Southern Italian region were included in the study. At day 5-8 of menstrual cycle, patients underwent a 75-g oral glucose tolerance test to evaluate insulin levels; lipid and homocysteine levels were also assessed, baseline hormonal assays and ultrasound examination performed, and anthropometric characteristics measured.
No differences were observed in the incidence of overweight or obesity and total cholesterol, high-density lipoprotein (HDL) cholesterol level, low-density lipoprotein cholesterol level; triglycerides and homocysteine levels did not differ between PCOS and control groups. All fasting metabolic indexes were similar, whereas insulin secretion after glucose load (I-AUC) was significantly higher in PCOS subjects. Total cholesterol levels were significantly related to waist-hip ratio (WHR). Low-density lipoprotein level was positively correlated with BMI, waist, WHR, and homeostasis model assessment (HOMA) but not I-AUC. Findings obtained for HDL correlated negatively to the same parameters, being also negatively correlated to both fasting insulin and HOMA, but not I-AUC. Moreover, HDL was positively correlated to circulating androstenedione (A) and negatively to circulating testosterone (T) levels. Triglycerides seemed to correlate positively with body BMI, waist, and WHR, and negatively with A levels. Homocysteine levels correlated positively with plasma triglyceride content.
In the adolescent population studied, no differences were revealed in lipid profile between PCOS and controls. The PCOS is not a discriminant factor. The anthropometric characteristics resulted in the primary factor influencing the lipid derangement, confirming the importance of treating obesity at an early age to reduce morbidity rates. Hyperinsulinemia and IR, peculiarities of PCOS capable of influencing long-term evolution into cardiovascular diseases and diabetes mellitus, are not associated with worse lipid profile. Young patients should be encouraged and motivated to change their lifestyle, with the aim of losing weight and thus reducing risk of onset of overt dyslipidemia.
本研究旨在评估体重指数（BMI）、高胰岛素血症和/或胰岛素抵抗（IR）以及雄激素对青少年多囊卵巢综合征（PCOS）患者血脂谱的影响。
研究纳入了来自意大利南部地区的 71 名 PCOS 患者和 94 名健康的青少年女性。在月经周期的第 5-8 天，患者接受 75g 口服葡萄糖耐量试验以评估胰岛素水平；同时检测血脂和同型半胱氨酸水平，进行基础激素检测和超声检查，并测量人体测量学特征。
PCOS 组和对照组的超重或肥胖发生率、总胆固醇、高密度脂蛋白（HDL）胆固醇水平、低密度脂蛋白胆固醇水平无差异；PCOS 组和对照组的甘油三酯和同型半胱氨酸水平无差异。所有空腹代谢指标均相似，而葡萄糖负荷后胰岛素分泌（I-AUC）在 PCOS 患者中显著升高。总胆固醇水平与腰臀比（WHR）显著相关。低密度脂蛋白水平与 BMI、腰围、WHR 和稳态模型评估（HOMA）呈正相关，但与 I-AUC 无关。HDL 水平与上述参数呈负相关，与空腹胰岛素和 HOMA 也呈负相关，但与 I-AUC 无关。此外，HDL 与循环雄烯二酮（A）呈正相关，与循环睾酮（T）水平呈负相关。甘油三酯似乎与 BMI、腰围和 WHR 呈正相关，与 A 水平呈负相关。同型半胱氨酸水平与血浆甘油三酯含量呈正相关。
在本研究的青少年人群中，PCOS 组和对照组的血脂谱无差异。PCOS 不是一个有区别的因素。人体测量学特征是影响血脂紊乱的主要因素，证实了在年轻时治疗肥胖以降低发病率的重要性。高胰岛素血症和 IR 是 PCOS 的特有特征，可影响向心血管疾病和糖尿病的长期演变，但与更差的血脂谱无关。应鼓励和激励年轻患者改变生活方式，以达到减肥的目的，从而降低发生明显血脂异常的风险。
