Montefiore Medical Center, Obstetrics and Gynecology and Women's Health of Division of Reproductive Endocrinology, Albert Einstein College of Medicine, Bronx, New York 10461-2375 , USA.
Endocr Pract. 2010 Sep-Oct;16(5):810-7. doi: 10.4158/EP09330.OR.
To determine the sensitivity of a high-glucose load in a meal as an alternative to the standard oral glucose tolerance test (OGTT) in detecting impaired glucose tolerance and insulin resistance in women with polycystic ovarian syndrome (PCOS) and the relationship of body composition to insulin resistance in the PCOS cohort.
In this prospective, single-center study, women with PCOS who were being followed up as out-patients were recruited. The study was performed between November 2007 and March 2008. All participants underwent OGTT before study enrollment. Participants were given a meal including carbohydrates, fat, and protein. Glucose and insulin levels were measured every 30 minutes for 2 hours after completing the meal. Body composition was measured by dual-energy x-ray absorptiometry.
Thirteen of the 15 participants completed the meal tolerance test and the body composition study. Four of 13 participants (31%) had abnormal glucose tolerance with the meal test compared with 2 of 8 participants (25%) who completed the OGTT. Those who had insulin resistance on OGTT were detected with the meal test. The 2-hour insulin levels following the meal were 38% higher than with the OGTT. Of 10 participants with insulin resistance, 9 had a total body fat mass greater than the 90th percentile, whereas 1 of 3 participants (33%) with normal body composition was insulin resistant.
Administration of oral glucose load via a meal is an effective alternative to the OGTT in diagnosing impaired glucose tolerance and insulin resistance and may be more sensitive, without the adverse effects of the oral glucose load in the OGTT. PCOS is an independent risk factor for impaired glucose tolerance and insulin resistance, regardless of body composition.
确定高糖负荷餐与标准口服葡萄糖耐量试验（OGTT）相比，在检测多囊卵巢综合征（PCOS）女性糖耐量受损和胰岛素抵抗方面的敏感性，以及在 PCOS 队列中，体成分与胰岛素抵抗的关系。
在这项前瞻性、单中心研究中，招募了正在接受门诊随访的 PCOS 女性。该研究于 2007 年 11 月至 2008 年 3 月进行。所有参与者在研究入组前均进行 OGTT。参与者接受包括碳水化合物、脂肪和蛋白质的膳食。完成膳食后，每 30 分钟测量一次血糖和胰岛素水平，共 2 小时。通过双能 X 线吸收法测量体成分。
在 15 名参与者中，有 13 名完成了餐耐受性试验和体成分研究。与完成 OGTT 的 8 名参与者中的 2 名（25%）相比，13 名参与者中有 4 名（31%）在餐试验中出现异常糖耐量。在 OGTT 中出现胰岛素抵抗的患者也在餐试验中被检测到。餐试验后 2 小时胰岛素水平比 OGTT 高 38%。在 10 名胰岛素抵抗患者中，9 名患者的全身脂肪量超过第 90 百分位数，而 3 名正常体成分患者中有 1 名（33%）出现胰岛素抵抗。
口服葡萄糖负荷餐是诊断糖耐量受损和胰岛素抵抗的有效 OGTT 替代方法，可能更敏感，且没有 OGTT 中口服葡萄糖负荷的不良反应。PCOS 是糖耐量受损和胰岛素抵抗的独立危险因素，与体成分无关。
