Kim Min-Ju, Lim Nam-Kyoo, Choi Young-Min, Kim Jin-Ju, Hwang Kyu-Ri, Chae Soo-Jin, Park Chan-Woo, Choi Doo-Seok, Kang Byung-Moon, Lee Byung-Seok, Kim Tak, Park Hyun-Young
Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, Korea National Institute of Health, Chungbuk, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea; Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
PLoS One. 2014 Jun 5;9(6):e99252. doi: 10.1371/journal.pone.0099252. eCollection 2014.
Hyperandrogenism (HA) has been linked with several components of metabolic syndrome (MetS). Few studies in Asian women have evaluated the important risk factors for and prevalence of MetS according to PCOS subtype. In this study, we investigated differences in metabolic parameters and the prevalence of MetS in two major phenotypic subgroups of PCOS in Korea. Furthermore, we investigated the relationship between HA-associated parameters and MetS.
This cross-sectional observational study was conducted from May 2010 to December 2011 in Korea. A total of 837 females with PCOS, aged 15-40, were recruited from Departments of Obstetrics and Gynecology at 13 hospitals. Of those, 700 subjects with either polycystic ovaries (PCO)+HA+oligomenorrhea/amenorrhea (O) or PCO+O were eligible for this study. MetS was diagnosed according to the modified National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines and the International Diabetes Federation (IDF) criteria.
MetS was more prevalent in the PCO+HA+O group (19.7%) than in the PCO+O (11.9%) group. There were statistically significant trends for an increased risk of MetS in the PCO+HA+O group compared to the PCO+O group. After adjustment for age, the odds ratio of MetS was 2.192 in non-obese subjects with PCO+HA+O compared to those with PCO+O, whereas the risk of MetS was not different in obese patients. Multivariate logistic regression analysis showed that high free androgen index and low sex hormone-binding globulin were significantly associated with MetS in non-obese women with PCOS, with odds ratios of 4.234 (95% CI, 1.893-9.474) and 4.612 (95% CI, 1.978-10.750), respectively. However, no associations were detected between MetS and SHBG and FAI in obese PCOS subjects.
Our results indicate that HA and its associated parameters (FAI and SHBG) are significantly associated with MetS in non-obese PCOS subjects, whereas this association was not observed in obese subjects.
高雄激素血症（HA）与代谢综合征（MetS）的多个组成部分相关。在亚洲女性中，很少有研究根据多囊卵巢综合征（PCOS）的亚型评估MetS的重要危险因素和患病率。在本研究中，我们调查了韩国PCOS两个主要表型亚组的代谢参数差异和MetS患病率。此外，我们还研究了HA相关参数与MetS之间的关系。
本横断面观察性研究于2010年5月至2011年12月在韩国进行。从13家医院的妇产科招募了837名年龄在15 - 40岁的PCOS女性。其中，700名患有多囊卵巢（PCO）+HA+稀发月经/闭经（O）或PCO+O的受试者符合本研究条件。根据修改后的美国国家胆固醇教育计划（NCEP）成人治疗小组（ATP）III指南和国际糖尿病联盟（IDF）标准诊断MetS。
MetS在PCO+HA+O组（19.7%）中的患病率高于PCO+O组（11.9%）。与PCO+O组相比，PCO+HA+O组患MetS的风险有统计学意义的增加趋势。在调整年龄后，非肥胖的PCO+HA+O受试者患MetS的比值比为2.192，而肥胖患者患MetS的风险无差异。多因素逻辑回归分析显示，在非肥胖PCOS女性中，高游离雄激素指数和低性激素结合球蛋白与MetS显著相关，比值比分别为4.234（95%可信区间，1.893 - 9.474）和4.612（95%可信区间，1.978 - 10.750）。然而，在肥胖PCOS受试者中未检测到MetS与SHBG和FAI之间的关联。
我们的结果表明，HA及其相关参数（FAI和SHBG）在非肥胖PCOS受试者中与MetS显著相关，而在肥胖受试者中未观察到这种关联。
