Cree-Green Melanie, Bergman Bryan C, Coe Gregory V, Newnes Lindsey, Baumgartner Amy D, Bacon Samantha, Sherzinger Ann, Pyle Laura, Nadeau Kristen J
Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Pediatric Endocrinology, Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Obesity (Silver Spring). 2016 Nov;24(11):2399-2406. doi: 10.1002/oby.21651.
Increased liver fat and type 2 diabetes are prevalent in women with polycystic ovarian syndrome (PCOS) and cause excess mortality, yet little is known about their development during adolescence. The objective of this study was to measure hepatic steatosis and related metabolic contributors in girls with obesity, with and without PCOS.
Nondiabetic adolescents with obesity, 41 with PCOS (PCOS; age 15.0 [13.0-16.0] years, BMI 35.2 ± 0.61 kg/m ) and 30 without PCOS (OB; age 14.5 [13.0-17.0], BMI 33.2 ± 1.8), were studied. Visceral and liver fat were assessed with MRI. Serum measures included androgens and 16:1 and 18:1 N7 fatty acids specific to de novo lipogenesis. Adipose, hepatic, and peripheral insulin sensitivity (IS) were assessed with a four-phase hyperinsulinemic-euglycemic clamp with isotope tracers.
Forty-nine percent of the PCOS group had hepatic steatosis versus fourteen percent of the OB group (P = 0.02), and the PCOS group had higher N7 (43 ± 4 vs. 29 ± 5 nmol/g; P = 0.02). Peripheral IS was lower in PCOS (9.4 [7.2-12.3] vs. 14.5 [13.1-18.05 mg/lean kg/min]; P < 0.001) as was hepatic (P = 0.006) and adipose IS (P = 0.005). Percent liver fat correlated with N7 (R = 0.46, P = 0.02) and visceral fat (R = 0.42, P < 0.001), not androgens or peripheral IS.
Nearly 50% of nondiabetic girls with PCOS and obesity have hepatic steatosis, which relates to visceral fat and lipogenesis, but not to IS or androgens.
多囊卵巢综合征（PCOS）女性中肝脏脂肪增加和2型糖尿病很常见，且会导致额外的死亡率，但对于它们在青春期的发展情况知之甚少。本研究的目的是测量肥胖女孩（有或无PCOS）的肝脏脂肪变性及相关代谢影响因素。
对非糖尿病肥胖青少年进行研究，其中41例患有PCOS（PCOS组；年龄15.0[13.0 - 16.0]岁，BMI 35.2±0.61kg/m²），30例无PCOS（OB组；年龄14.5[13.0 - 17.0]岁，BMI 33.2±1.8）。用MRI评估内脏和肝脏脂肪。血清检测指标包括雄激素以及与从头脂肪生成特异相关的16:1和18:1 N7脂肪酸。通过使用同位素示踪剂的四阶段高胰岛素正常血糖钳夹技术评估脂肪组织、肝脏和外周胰岛素敏感性（IS）。
PCOS组49%有肝脏脂肪变性，而OB组为14%（P = 0.02），且PCOS组N7水平更高（43±4对29±5nmol/g；P = 0.02）。PCOS组外周IS较低（9.4[7.2 - 12.3]对14.5[13.1 - 18.05mg/瘦体重kg/min]；P < 0.001），肝脏IS（P = 0.006）和脂肪组织IS（P = 0.005）也较低。肝脏脂肪百分比与N7（R = 0.46，P = 0.02）和内脏脂肪（R = 0.42，P < 0.001）相关，与雄激素或外周IS无关。
近50%患有PCOS和肥胖的非糖尿病女孩有肝脏脂肪变性，这与内脏脂肪和脂肪生成有关，但与IS或雄激素无关。
