Rehme Marta Francis Benevides, Pontes Ana Gabriela, Corrente José Eduardo, Franco José Gonçalves, Pontes Anaglória
Rev Bras Ginecol Obstet. 2013 Dec;35(12):562-8. doi: 10.1590/s0100-72032013001200006.
To assess the contribution of hyperandrogenism to the development of metabolic syndrome (MetS) in obese women with polycystic ovary syndrome (PCOS).
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).
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).
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.
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。
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)。
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)。
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。