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多囊卵巢综合征患儿及其有母系多囊卵巢综合征病史者的胰岛素抵抗及其与高分子量脂联素的关系。

Insulin resistance and its relationship with high molecular weight adiponectin in adolescents with polycystic ovary syndrome and a maternal history of polycystic ovary syndrome.

机构信息

Kovancılar State Hospital, Elazıg, Turkey.

Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.

出版信息

Fertil Steril. 2014 Sep;102(3):826-30. doi: 10.1016/j.fertnstert.2014.05.032. Epub 2014 Jun 25.

Abstract

OBJECTIVE

To assess the rate of insulin resistance (IR) and the relationship between IR and high molecular weight (HMW) adiponectin in normal weight adolescents with polycystic ovary syndrome (PCOS) and a maternal history of PCOS.

DESIGN

Case-controlled study.

SETTING

Adolescent clinic of a teaching and research hospital.

PATIENT(S): Forty normal weight adolescents with PCOS and a maternal history of PCOS and 40 normo-ovulatory age- and body mass index (BMI)-matched controls.

INTERVENTION(S): A 75-g oral glucose tolerance test (OGTT) was performed for each participant.

MAIN OUTCOME MEASURE(S): Homeostasis model assessment of IR and HMW adiponectin.

RESULT(S): There were no statistically significant differences between the PCOS and control groups in terms of fasting glucose, fasting insulin, and lipid parameters. Although total and free T were significantly higher, HMW adiponectin levels were significantly lower in the PCOS group compared with the control group. When the PCOS group was compared according to the IR, the HMW adiponectin level was significantly lower in the adolescents with PCOS and IR. The adolescents with PCOS and biochemical hyperandrogenemia had significantly lower HMW adiponectin levels and significantly higher homeostasis model assessment of IR score compared with the adolescents with PCOS and normoandrogenemia.

CONCLUSION(S): The adolescents with PCOS had a significantly increased rate of IR without clinical findings of metabolic disorders or obesity. The HMW adiponectin levels were negatively correlated with IR.

摘要

目的

评估正常体重多囊卵巢综合征(PCOS)青少年及有 PCOS 家族史者的胰岛素抵抗(IR)发生率,以及 IR 与高分子量(HMW)脂联素的关系。

设计

病例对照研究。

地点

教学研究医院的青少年诊所。

患者

40 例正常体重 PCOS 青少年及有 PCOS 家族史者和 40 例年龄、体重指数(BMI)匹配的正常排卵对照者。

干预

每位参与者均行 75g 口服葡萄糖耐量试验(OGTT)。

主要观察指标

IR 的稳态模型评估和 HMW 脂联素。

结果

PCOS 组与对照组间空腹血糖、空腹胰岛素和血脂参数均无统计学差异。与对照组相比,PCOS 组总 T 和游离 T 显著升高,但 HMW 脂联素水平显著降低。与无 IR 者相比,PCOS 且 IR 者的 HMW 脂联素水平显著降低。与 PCOS 且正常雄激素血症者相比,PCOS 且生化性高雄激素血症者的 HMW 脂联素水平显著降低,稳态模型评估的 IR 评分显著升高。

结论

PCOS 青少年存在显著的 IR 发生率,而无代谢紊乱或肥胖的临床发现。HMW 脂联素水平与 IR 呈负相关。

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