Department of Endocrinology, The First Affiliated Hospital of Shantou University Medcial College, Shantou, China.
Endocr J. 2012;59(9):765-70. doi: 10.1507/endocrj.ej12-0049. Epub 2012 May 12.
To clarify the necessity of improving glucose metabolism in polycystic ovary syndrome (PCOS) women as early as possible, 111 PCOS women with normal glucose tolerance and 92 healthy age-matched controls were recruited to investigate glucose levels distribution, insulin sensitivity and β cell function. 91 PCOS women and 33 controls underwent hyperinsulinemic-euglycemic clamp to assess their insulin sensitivity, which was expressed as M value. β cell function was estimated by homeostatic model assessment (HOMA)-β index after adjusting insulin sensitivity (HOMA-βad index). Compared with lean controls, lean PCOS women had similar fasting plasma glucose (FPG), higher postprandial plasma glucose (PPG) (6.03±1.05 vs. 5.44±0.97 mmol/L, P<0.05), lower M value but similar HOMA-βad index, while overweight/obese PCOS women had higher levels of both FPG (5.24±0.58 vs. 4.90±0.39, P<0.05) and PPG (6.15±0.84 vs. 5.44±0.97 mmol/L, P<0.05), and lower levels of both M value and HOMA-βad index. Linear regression and ROC analysis found BMI was independently associated with M value and HOMA-βad index in PCOS women separately, and the cutoff of BMI indicating impaired β cell function of PCOS women was 25.545kg/m². In conclusion, insulin resistance and dysregulation of glucose metabolism were common in Chinese PCOS women with normal glucose tolerance. BMI ≥ 25.545kg/m² indicated impaired β cell function in PCOS women with normal glucose tolerance.
为了阐明尽早改善多囊卵巢综合征（PCOS）女性葡萄糖代谢的必要性，招募了 111 名糖耐量正常的 PCOS 女性和 92 名健康年龄匹配的对照者，以研究葡萄糖水平分布、胰岛素敏感性和β细胞功能。91 名 PCOS 女性和 33 名对照者接受了高胰岛素正葡萄糖钳夹试验以评估其胰岛素敏感性，用 M 值表示。调整胰岛素敏感性（HOMA-βad 指数）后，用稳态模型评估（HOMA）-β指数估计β细胞功能。与瘦对照者相比，瘦 PCOS 女性的空腹血糖（FPG）相似，餐后血糖（PPG）更高（6.03±1.05 比 5.44±0.97mmol/L，P<0.05），M 值较低但 HOMA-βad 指数相似，而超重/肥胖 PCOS 女性的 FPG（5.24±0.58 比 4.90±0.39mmol/L，P<0.05）和 PPG（6.15±0.84 比 5.44±0.97mmol/L，P<0.05）更高，M 值和 HOMA-βad 指数更低。线性回归和 ROC 分析发现，BMI 分别与 PCOS 女性的 M 值和 HOMA-βad 指数独立相关，提示 PCOS 女性糖耐量正常者β细胞功能受损的 BMI 切点为 25.545kg/m²。总之，中国糖耐量正常的 PCOS 女性中普遍存在胰岛素抵抗和葡萄糖代谢失调。BMI≥25.545kg/m²提示糖耐量正常的 PCOS 女性存在β细胞功能受损。
