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脂质蓄积产物(LAP)和内脏脂肪指数(VAI)作为阿根廷多囊卵巢综合征年轻女性胰岛素抵抗和代谢相关紊乱标志物的研究

Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) as Markers of Insulin Resistance and Metabolic Associated Disturbances in Young Argentine Women with Polycystic Ovary Syndrome.

作者信息

Abruzzese Giselle A, Cerrrone Gloria E, Gamez Juan M, Graffigna Mabel N, Belli Susana, Lioy Gustavo, Mormandi Eduardo, Otero Patricia, Levalle Oscar A, Motta Alicia B

机构信息

Laboratorio de Fisio-patología Ovárica, Centro de Estudios Farmacológicos y Botánicos (CEFYBO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina.

Cátedra de Genética, Departamento de Microbiología, Inmunología y Biotecnología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires e Instituto de Inmunología, Genética y Metabolismo (CONICET-UBA). Buenos Aires, Argentina.

出版信息

Horm Metab Res. 2017 Jan;49(1):23-29. doi: 10.1055/s-0042-113463. Epub 2016 Aug 29.

Abstract

Polycystic ovary syndrome (PCOS) is an endocrine disorder. PCOS women are at high risk of developing insulin resistance (IR) and cardiovascular disorders since young age. We aimed to study the reliability of lipid accumulation product (LAP) and visceral adiposity index (VAI) as markers of metabolic disturbances (MD) associated with IR in young reproductive aged PCOS patients. We also evaluated the association between LAP and VAI and the presence of hyperandrogenism. In a cross-sectional study, 110 PCOS patients and 88 control women (18-35 years old) were recruited. PCOS patients were divided into 2 groups, as hyperandrogenic and non-hyperandrogenic considering the signs of hyperandrogenism (clinical or biochemical). Anthropometric measurements were taken and blood samples collected. Metabolic and anthropometric characteristics and their association with IR and associated MD were evaluated and LAP and VAI were calculated. LAP and VAI were compared with TC/HDL-c and TG/HDL-c to define the best markers of MD in this population. Independently of the phenotype, young PCOS patients showed high IR and dyslipidemia. Both LAP and VAI showed to be more effective markers to assess MD and IR in these young women than TG/HDL-c or TC/HDL-c [cut-off values: LAP: 18.24 (sensitivity: 81.43% specificity: 73.49%), positive predictive value (PPV): 75.0%, negative predictive value (NPV): 77.27%, VAI: 2.19 (sensitivity: 81.16% specificity: 72.15% PPV: 74.65% NPV: 72.22%)]. LAP and VAI are representative markers to assess MD associated with IR in young PCOS patients. All PCOS patients, independently of their androgenic condition, showed high metabolic risk.

摘要

多囊卵巢综合征(PCOS)是一种内分泌紊乱疾病。患有PCOS的女性从年轻时起就有发生胰岛素抵抗(IR)和心血管疾病的高风险。我们旨在研究脂质蓄积产物(LAP)和内脏脂肪指数(VAI)作为年轻生育年龄PCOS患者中与IR相关的代谢紊乱(MD)标志物的可靠性。我们还评估了LAP和VAI与高雄激素血症之间的关联。在一项横断面研究中,招募了110例PCOS患者和88名对照女性(年龄在18 - 35岁之间)。根据高雄激素血症的体征(临床或生化),将PCOS患者分为2组,即高雄激素组和非高雄激素组。进行了人体测量并采集了血样。评估了代谢和人体测量特征及其与IR和相关MD的关联,并计算了LAP和VAI。将LAP和VAI与总胆固醇/高密度脂蛋白胆固醇(TC/HDL-c)和甘油三酯/高密度脂蛋白胆固醇(TG/HDL-c)进行比较,以确定该人群中MD的最佳标志物。无论表型如何,年轻的PCOS患者都表现出高IR和血脂异常。与TG/HDL-c或TC/HDL-c相比,LAP和VAI在评估这些年轻女性的MD和IR方面都是更有效的标志物[临界值:LAP:18.24(敏感性:81.43%,特异性:73.49%),阳性预测值(PPV):75.0%,阴性预测值(NPV):77.27%,VAI:2.19(敏感性:81.16%,特异性:72.15%,PPV:74.65%,NPV:72.22%)]。LAP和VAI是评估年轻PCOS患者中与IR相关的MD的代表性标志物。所有PCOS患者,无论其雄激素状态如何,都表现出高代谢风险。

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