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多囊卵巢综合征不同表型的内分泌和代谢特征

Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome.

作者信息

Pikee Saxena, Shivani Singh, Jayshree Bhattacharjee

机构信息

Department of Obstetrics and Gynaecology, Lady Hardinge Medical College & SSK Hospital, New Delhi, 110001 India.

Delhi Institute of Pharmaceutical Sciences, New Delhi, India.

出版信息

J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):560-6. doi: 10.1007/s13224-016-0898-7. Epub 2016 May 4.

Abstract

BACKGROUND

Polycystic ovarian syndrome (PCOS) is a common endocrinopathy associated with wide heterogeneity and serious clinical implications. Prevalence and characteristics of different phenotypes are not well defined. Therefore, this study was planned to determine the prevalence of four phenotypes of PCOS and to evaluate their endocrine and metabolic parameters including insulin resistance and metabolic syndrome with respect to controls.

METHODS

This observational, case-control study was conducted in the gynecology outpatient department of a tertiary care center where 161 PCOS and 50 non-PCOS women were recruited and investigated.

RESULTS

All phenotypes of PCOS had higher BMI with respect to controls (P < 0.000). Overweight women were maximum in phenotype H + O followed by phenotype H + P. Significantly higher levels of luteinizing hormone (P < 0.01), testosterone (P < 0.0001), were observed in all phenotypes of PCOS as compared to controls. Serum cholesterol (P < 0.026) and triglycerides (P < 0.05) were significantly higher in all PCOS phenotypes compared to controls. Levels of fasting (P < 0.000) and post-prandial (P < 0.009) insulin were significantly higher in all phenotypes of PCOS with respect to controls. Mean insulin resistance (IR) was 24.09 % in PCOS and 2 % in controls, prevalence being highest in H + O phenotype followed by H + O + P. Prevalence of metabolic syndrome in women with PCOS was 36.02 %, being highest in H + O + P followed by H + O and that of control was 10 %.

CONCLUSION

All phenotypes of PCOS had deranged endocrine and metabolic profile compared to controls, but prevalence of IR and metabolic syndrome was maximum in hyperandrogenic phenotypes which require a strict surveillance for prospective metabolic disorders as compared to O + P phenotype.

摘要

背景

多囊卵巢综合征(PCOS)是一种常见的内分泌病,具有广泛的异质性和严重的临床意义。不同表型的患病率和特征尚未明确界定。因此,本研究旨在确定PCOS四种表型的患病率,并评估其内分泌和代谢参数,包括与对照组相比的胰岛素抵抗和代谢综合征。

方法

本观察性病例对照研究在一家三级护理中心的妇科门诊进行,招募并调查了161名PCOS女性和50名非PCOS女性。

结果

与对照组相比,PCOS的所有表型BMI均较高(P < 0.000)。超重女性在H + O表型中最多,其次是H + P表型。与对照组相比,PCOS所有表型的促黄体生成素(P < 0.01)、睾酮(P < 0.0001)水平显著升高。与对照组相比,所有PCOS表型的血清胆固醇(P < 0.026)和甘油三酯(P < 0.05)显著更高。与对照组相比,PCOS所有表型的空腹(P < 0.000)和餐后(P < 0.009)胰岛素水平显著更高。PCOS患者的平均胰岛素抵抗(IR)为24.09%,对照组为2%,患病率在H + O表型中最高,其次是H + O + P。PCOS女性代谢综合征的患病率为36.02%,在H + O + P中最高,其次是H + O,对照组为10%。

结论

与对照组相比,PCOS的所有表型均有内分泌和代谢谱紊乱,但雄激素过多表型的IR和代谢综合征患病率最高,与O + P表型相比,需要对未来的代谢紊乱进行严格监测。

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