Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Metabolism, Auenbruggerplatz 15, 8036 Graz, Austria.
J Clin Endocrinol Metab. 2011 Jun;96(6):E986-90. doi: 10.1210/jc.2011-0031. Epub 2011 Apr 6.
Women with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances. Lipid accumulation product (LAP) is an emerging cardiovascular risk factor. We aimed to investigate the association of LAP with impaired glucose tolerance (IGT) in PCOS and control women.
The LAP was calculated as [waist circumference (centimeters) - 58] × [triglycerides (millimoles per liter)] in 392 PCOS and 140 body mass index (BMI)-matched control women within the same age range. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.
PCOS women had significantly higher LAP levels than control women in age-adjusted analyses [22.2 (10.9-46.2) and 18.2 (10.7-36.3), respectively, P = 0.001). In PCOS and control women, age, BMI, blood pressure, fasting and stimulated glucose, fasting and stimulated insulin, and free testosterone progressively increased, whereas SHBG decreased across LAP quartiles. In PCOS and control women, receiver operating characteristic curve analysis revealed that the best cutoff value for LAP to define the presence of IGT was 44.1 and 41.8, respectively [sensitivity 79.5%, specificity 80.5%, and area under the curve (AUC) 0.86 and sensitivity 82.3%, specificity 90.5%, and AUC 0.86, respectively]. In PCOS and control women, receiver operating characteristic curve analyses for BMI (0.77 and 0.54, respectively) and waist circumference (0.80 and 0.72, respectively) to define IGT revealed lower AUC. Odds ratios for IGT for PCOS women in the highest LAP, BMI, and waist-to-hip ratio quartile were 41.81 (5.52-316.54), 10.24 (2.94-35.63), and 18.45 (4.19-81.30), respectively, when compared with PCOS women in the lowest LAP, BMI, and WHR quartile, respectively.
LAP is an easily obtainable and cheap marker associated with IGT in PCOS and control women.
患有多囊卵巢综合征(PCOS)的女性常伴有代谢紊乱。脂联素水平是心血管疾病的一个新兴风险因子。我们旨在研究脂联素水平与 PCOS 和对照组女性糖耐量受损(IGT)之间的关系。
在年龄匹配的 392 名 PCOS 患者和 140 名对照组女性中,我们计算了脂联素水平([腰围(厘米)-58]×[甘油三酯(毫摩尔/升)])。进行了代谢、内分泌和人体测量学测量以及口服葡萄糖耐量试验。
在年龄调整分析中,PCOS 女性的脂联素水平明显高于对照组女性[分别为 22.2(10.9-46.2)和 18.2(10.7-36.3),P=0.001]。在 PCOS 和对照组女性中,年龄、BMI、血压、空腹和刺激后的血糖、空腹和刺激后的胰岛素以及游离睾酮水平随着脂联素四分位数的增加而增加,而 SHBG 则逐渐下降。在 PCOS 和对照组女性中,ROC 曲线分析显示,脂联素最佳截断值为 44.1 和 41.8,以定义 IGT 的存在[分别为敏感性 79.5%、特异性 80.5%和曲线下面积(AUC)0.86、敏感性 82.3%、特异性 90.5%和 AUC 0.86]。在 PCOS 和对照组女性中,用于定义 IGT 的 BMI(分别为 0.77 和 0.54)和腰围(分别为 0.80 和 0.72)的 ROC 曲线分析显示 AUC 较低。在 PCOS 女性中,脂联素水平最高四分位数、BMI 最高四分位数和腰围-臀围比最高四分位数与 PCOS 女性中脂联素水平最低四分位数、BMI 最低四分位数和 WHR 最低四分位数相比,IGT 的优势比分别为 41.81(5.52-316.54)、10.24(2.94-35.63)和 18.45(4.19-81.30)。
脂联素是 PCOS 和对照组女性中与 IGT 相关的一种易于获得且廉价的标志物。