Nutritional Biology Graduate Group, Department of Nutrition, The University of California at Davis, Davis, California, USA.
Metabolism. 2012 Sep;61(9):1256-60. doi: 10.1016/j.metabol.2012.02.004. Epub 2012 Mar 17.
Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Muscle is the major tissue utilizing glucose while excess adipose tissue relates to insulin resistance. Thus, body composition is likely to be an important regulator of insulin sensitivity. Thirty-nine PCOS patients (age: 29.9±1.0 years; BMI: 33.8±1.2 kg/m(2)) participated in a cross sectional study. Body composition was measured by dual energy x-ray absorptiometry (DEXA). Insulin resistance and secretion were assessed using oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FS-IVGTT). In contrast with the conventional expectations, lean mass correlated directly (P<.05) with the insulin resistance measure HOMA (r=0.440); and inversely with the insulin sensitivity index QUICKI (r=-0.522) independent of fat mass. In 11 pairs of subjects matched for fat mass (35.6±2.2 and 35.6±2.4 kg) but with discordant lean mass (52.8±1.8 vs 44.4±1.6 kg), those with higher lean mass had a higher glucose response during OGTT (AUC(Glucose); P=.034). In contrast, 17 pairs matched for lean mass (48.7±1.7 and 48.9±1.6 kg) but discordant for fat mass (43.3±2.6 vs 30.3±8.9 kg) showed no differences in insulin resistance parameters. These novel findings indicate that lean mass relates directly to insulin resistance in PCOS.
胰岛素抵抗在多囊卵巢综合征（PCOS）女性中很常见。肌肉是利用葡萄糖的主要组织，而过多的脂肪组织与胰岛素抵抗有关。因此，身体成分可能是胰岛素敏感性的重要调节因素。39 名 PCOS 患者（年龄：29.9±1.0 岁；BMI：33.8±1.2 kg/m²）参与了一项横断面研究。身体成分通过双能 X 射线吸收法（DEXA）进行测量。使用口服葡萄糖耐量试验（OGTT）和频繁采样静脉葡萄糖耐量试验（FS-IVGTT）评估胰岛素抵抗和分泌。与传统预期相反，瘦体重与胰岛素抵抗测量 HOMA 直接相关（P<.05；r=0.440）；与胰岛素敏感指数 QUICKI 呈负相关（r=-0.522），与脂肪量无关。在 11 对按脂肪量匹配（35.6±2.2 和 35.6±2.4 kg）但瘦体重不匹配（52.8±1.8 与 44.4±1.6 kg）的患者中，瘦体重较高的患者在 OGTT 期间的葡萄糖反应更高（AUC（葡萄糖）；P=.034）。相比之下，在 17 对按瘦体重匹配（48.7±1.7 和 48.9±1.6 kg）但脂肪量不匹配（43.3±2.6 与 30.3±8.9 kg）的患者中，胰岛素抵抗参数没有差异。这些新发现表明，在 PCOS 中，瘦体重与胰岛素抵抗直接相关。
