Chen Li, Lan Zhen, Zhang Dan
Department of Reproductive Endocrinology, West China Second Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Nov;44(6):945-9.
To investigate the value of three different obese criteria: body mass index (BMI), waist circumference (WC) and visceral fat area (VAA, CT measurement) in the evaluation of polycystic overy syndrome (PCOS) with insulin resistance.
There were 300 cases of PCOS included in this study. According to the three criteria, there were 210 cases of abdominal obesity (WC > or = 80 cm), and 90 cases of nonabdominal obesity (WC < 80 cm); 97 cases of overall obesity (BMI > or = 25 kg/m2), and 203 cases of non-overall obese (BMI < 25 kg/m2); 198 cases of visceral obesity (VAA > or = 80 cm2), and 102 cases non-visceral obesity (VAA < 80 cm2). Fasting plasma glucose (FPG) and fasting insulin (FINS) were detected, and HOMA-IR index was calculated; analyze the detection rate of the three criteria in the diagnosis of obese PCOS patients and insulin resistance. The serum levels of sex hormones, thyroid hormones, and plasma total cortisol (PTC) were measured as well.
(1) The levels of blood hormone (including LH/FSH), thyroid hormone, PTC, fasting blood glucose were no significant differences between groups (P > 0.05), while the weight and fasting insulin were significantly difference between groups (P < 0.05) in three different obese. (2) The detection rates of obese PCOS patients in three criteria: overall obesity was 32.33% (97/300), abdominal obesity was 70.00% (210/300), visceral obesity was 66.00% (198/300). Compared to WC and VAA, BMI had the lowest detection rate of obesity, the differences were statistically significant (P < 0.05), while the detection rates of obesity in VAA and WC were no significant difference (P > 0.05). (3) The detection rates of insulin resistance in BMI,WC,VAA were respectively 38.60% (83/215), 85.11% (183/215), 69.77% (150/215), the differences were significant (P < 0.05). (4) The misdiagnosis rates of insulin resistance in BMI, WC,VAA were 61.40% (132/215), 14.88% (32/215), 30. 23% (65/215) respectively, and the differences were statistically significant (P < 0.05).
There was obviously insufficient of BMI in screening obesity, WCmay has more advantages than BMI and VAA in the assessment of insulin resistance in obese PCOS patients.
探讨三种不同肥胖标准，即体重指数（BMI）、腰围（WC）和内脏脂肪面积（VAA，CT测量）在评估伴有胰岛素抵抗的多囊卵巢综合征（PCOS）中的价值。
本研究纳入300例PCOS患者。根据这三种标准，有210例腹型肥胖（WC≥80 cm），90例非腹型肥胖（WC<80 cm）；97例全身肥胖（BMI≥25 kg/m²），203例非全身肥胖（BMI<25 kg/m²）；198例内脏肥胖（VAA≥80 cm²），102例非内脏肥胖（VAA<80 cm²）。检测空腹血糖（FPG）和空腹胰岛素（FINS），并计算HOMA-IR指数；分析这三种标准在诊断肥胖PCOS患者及胰岛素抵抗中的检出率。同时检测血清性激素、甲状腺激素及血浆总皮质醇（PTC）水平。
（1）三组间血激素（包括LH/FSH）、甲状腺激素、PTC、空腹血糖水平差异无统计学意义（P>0.05），而三种不同肥胖类型组间体重和空腹胰岛素差异有统计学意义（P<0.05）。（2）三种标准下肥胖PCOS患者的检出率：全身肥胖为32.33%（97/300），腹型肥胖为70.00%（210/300），内脏肥胖为66.00%（198/300）。与WC和VAA相比，BMI对肥胖的检出率最低，差异有统计学意义（P<0.05），而VAA和WC对肥胖的检出率差异无统计学意义（P>0.05）。（3）BMI、WC、VAA对胰岛素抵抗的检出率分别为38.60%（83/215）、85.11%（183/215）、69.77%（150/215），差异有统计学意义（P<0.05）。（4）BMI、WC、VAA对胰岛素抵抗的误诊率分别为61.40%（132/215）、14.88%（32/215）、30.23%（65/215），差异有统计学意义（P<0.05）。
BMI在筛查肥胖方面明显不足，WC在评估肥胖PCOS患者胰岛素抵抗方面可能比BMI和VAA更具优势。
