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[高雄激素血症对肥胖型多囊卵巢综合征女性代谢综合征发生发展的影响]

[Contribution of hyperandrogenism to the development of metabolic syndrome in obese women with polycystic ovary syndrome].

作者信息

Rehme Marta Francis Benevides, Pontes Ana Gabriela, Corrente José Eduardo, Franco José Gonçalves, Pontes Anaglória

出版信息

Rev Bras Ginecol Obstet. 2013 Dec;35(12):562-8. doi: 10.1590/s0100-72032013001200006.

Abstract

PURPOSE

To assess the contribution of hyperandrogenism to the development of metabolic syndrome (MetS) in obese women with polycystic ovary syndrome (PCOS).

METHODS

Retrospective cross-sectional study conducted on 60 obese women with classic PCOS phenotype - Rotterdam Consensus - and 70 non-PCOS obese women. MetS was diagnosed by the NCEP-ATP III criteria and obesity was defined by body mass index. The Ferriman-Gallwey score (mFG) was used to evaluate hirsutism. The following measurements were performed: total testosterone, dehydroepiandrosterone sulfate (DHEA-S), glucose and insulin, total cholesterol, HDL, and triglycerides. Insulin resistance was measured using the HOMA-IR and insulin sensitivity index of Matsuda and De Fronzo (ISI). Statistical analysis was performed using the Student's t-test, χ² test and multivariate logistic regression analysis (p<0.05).

RESULTS

Obese women with PCOS had significantly higher mFG (15.4 ± 6.1), waist circunference (105.6 ± 11.4 cm), DHEA-S (200.8 ± 109.2 µg/dL), testosterone (135.8 ± 71.4 ng/dL), and HOMA-IR (8.4 ± 8.5) values and lower ISI values (2.0 ± 1.8) than non-obese PCOS women (3.2 ± 2.1; 101.4 ± 9.2 cm; 155.0 ± 92.7 µg/dL; 50.0 ± 18.2 ng/dL; 5.1 ± 4.7 and 3.3 ± 2.7, respectively) (p<0.05). The frequency of MetS was higher in PCOS obese (75%) than non-PCOS obese (52.8%) women (p=0.015). Multivariate analysis did not reveal the contribution of the variables IFG, testosterone, and DHEAS to the development of MetS (p>0.05).

CONCLUSION

Obese women with PCOS have a higher frequency of metabolic syndrome than non-PCOS obese women, and hyperandrogenism does not contribute to the development of metabolic syndrome in this group of women.

摘要

目的

评估高雄激素血症对多囊卵巢综合征(PCOS)肥胖女性代谢综合征(MetS)发生发展的影响。

方法

对60例具有经典PCOS表型(鹿特丹共识)的肥胖女性和70例非PCOS肥胖女性进行回顾性横断面研究。根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATP III)标准诊断MetS,根据体重指数定义肥胖。采用费里曼-盖尔韦评分(mFG)评估多毛症。进行以下测量:总睾酮、硫酸脱氢表雄酮(DHEA-S)、血糖和胰岛素、总胆固醇、高密度脂蛋白(HDL)和甘油三酯。使用稳态模型评估胰岛素抵抗(HOMA-IR)以及松田和德·弗龙佐胰岛素敏感性指数(ISI)测量胰岛素抵抗。采用学生t检验、χ²检验和多因素逻辑回归分析进行统计分析(p<0.05)。

结果

与非PCOS肥胖女性相比,PCOS肥胖女性的mFG(15.4±6.1)、腰围(105.6±11.4 cm)、DHEA-S(200.8±109.2 μg/dL)、睾酮(135.8±71.4 ng/dL)和HOMA-IR(8.4±8.5)值显著更高,ISI值(2.0±1.8)更低(非PCOS肥胖女性分别为3.2±2.1;101.4±9.2 cm;155.0±92.7 μg/dL;50.0±18.2 ng/dL;5.1±4.7和3.3±2.7)(p<0.05)。PCOS肥胖女性中MetS的发生率(75%)高于非PCOS肥胖女性(52.8%)(p=0.015)。多因素分析未显示空腹血糖受损(IFG)、睾酮和DHEAS这些变量对MetS发生发展的影响(p>0.05)。

结论

PCOS肥胖女性代谢综合征的发生率高于非PCOS肥胖女性,且高雄激素血症对该组女性代谢综合征的发生发展无影响。

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