Androulakis Ioannis I, Kandaraki Eleni, Christakou Charikleia, Karachalios Athansios, Marinakis Evangelos, Paterakis Thomas, Diamanti-Kandarakis Evanthia
Endocrine Unit, Third Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.
Clin Endocrinol (Oxf). 2014 Sep;81(3):426-31. doi: 10.1111/cen.12447. Epub 2014 Apr 15.
The clinical phenotype of polycystic ovary syndrome (PCOS) includes reproductive and hormonal aberrations. Visceral adiposity index (VAI) is an indicator which could connect hyperandrogenism and anovulation. The objective was to evaluate the relationship between VAI, menstrual disorders and hormonal, biochemical and ultrasound parameters in women with PCOS.
One hundred and ninety-three women with PCOS diagnosed with Rotterdam criteria.
We correlated VAI with metabolic and clinical features of the syndrome and with indices of inflammation and insulin sensitivity. In addition, we classified the patients into four groups according to the severity of menstrual disorders: Group A (n = 42), with severe menstrual disorders, Group B (n = 83), with mild menstrual disorders, Group C (n = 58), without menstrual disorders and Group D (n = 10) with women with sychnominorroia.
In women with PCOS studied, VAI significantly positively correlated with body weight, fasting glucose, insulin, homeostasis model assessment (HOMA) score, white blood cells, platelets, uric acid, free testosterone, oestradiol, total cholesterol, γ-GT, SGPT. Furthermore, a significant inverse correlation between VAI and SHBG, Matsuda index and menstrual cycles per year was documented. From the comparison of the four groups, PCOS women with menstrual disorders had significantly higher VAI and HOMA indices when compared to PCOS without menstrual disorders.
Visceral adiposity index is increased in patients with PCOS in concordance with the severity of anovulation, insulin resistance and inflammation. This index could be a very easy and helpful clinical tool in daily practice to predict insulin resistance in women with PCOS.
多囊卵巢综合征(PCOS)的临床表型包括生殖和激素异常。内脏脂肪指数(VAI)是一个可以将高雄激素血症和无排卵联系起来的指标。目的是评估PCOS女性中VAI、月经紊乱与激素、生化及超声参数之间的关系。
193例根据鹿特丹标准诊断为PCOS的女性。
我们将VAI与该综合征的代谢和临床特征以及炎症和胰岛素敏感性指标进行关联。此外,我们根据月经紊乱的严重程度将患者分为四组:A组(n = 42),有严重月经紊乱;B组(n = 83),有轻度月经紊乱;C组(n = 58),无月经紊乱;D组(n = 10),有月经频发。
在研究的PCOS女性中,VAI与体重、空腹血糖、胰岛素、稳态模型评估(HOMA)评分、白细胞、血小板、尿酸、游离睾酮、雌二醇、总胆固醇、γ-谷氨酰转移酶(γ-GT)、谷丙转氨酶(SGPT)显著正相关。此外,记录到VAI与性激素结合球蛋白(SHBG)、松田指数和每年月经周期数之间存在显著负相关。从四组比较来看,与无月经紊乱的PCOS女性相比,有月经紊乱的PCOS女性的VAI和HOMA指数显著更高。
PCOS患者的内脏脂肪指数随着无排卵、胰岛素抵抗和炎症的严重程度而增加。该指数可能是日常实践中预测PCOS女性胰岛素抵抗的一种非常简便且有用的临床工具。