Stassek J, Erdmann J, Ohnolz F, Berg F D, Kiechle M, Seifert-Klauss V
Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Hochschule Weihenstephan-Triesdorf, Weidenbach, Germany.
Geburtshilfe Frauenheilkd. 2017 Jan;77(1):59-65. doi: 10.1055/s-0042-119199.
Known characteristics of patients with PCOS include infertility, menstrual disorders, hirsutism and also often insulin resistance. These symptoms increase with increasing body weight. In the LIPCOS study (ifestyle ntervention for Patients with Polycystic Ovary Syndrome []) long-term changes of the PCOS in dependence on pregnancy and parenthood were systematically assessed. In the framework of the LIPCOS study, PCOS patients were given a standardised carbohydrate-rich test meal in order to examine glucose homeostasis and insulin secretion. The results were compared with those of a eumenorrhoeic control group who all had corresponding BMI values and corresponding ages. 41 PCOS patients (without diabetes) and 68 controls received a standardised carbohydrate-rich test meal (260 kcal, 62 % carbohydrates, 32 % fat, 6 % proteins) in order to generate a submaximal insulin and glucose stimulation. The values were determined at baseline and postprandial after 60, 120 and 180 minutes. In addition, the corresponding C-peptide levels were recorded. In the PCOS patients (n = 41), the insulin secretion test after a standardised test meal showed almost identical baseline and postprandial insulin levels when compared with those of the age- and BMI-matched eumenorrhoeic controls (n = 68). In the PCOS patients, the baseline and postprandial glucose levels were significantly elevated (92.88 ± 10.28 [PCOS] vs. 85.07 ± 9.42 mg/dL [controls]; p < 0.001) so was C-peptide (p < 0.025). In the present study we have shown for the first time that, after consumption of a standardised test meal, PCOS patients formally exhibit a higher fasting insulin resistance than controls. In spite of the higher stimulated C-peptide levels, the insulin levels did not increase more strongly with increasing glucose levels than in controls which may be indicative of a higher insulin clearance in PCOS patients.
多囊卵巢综合征（PCOS）患者的已知特征包括不孕、月经紊乱、多毛症，且常常伴有胰岛素抵抗。这些症状会随着体重增加而加重。在LIPCOS研究（多囊卵巢综合征患者的生活方式干预）中，系统评估了PCOS患者因妊娠和生育而产生的长期变化。在LIPCOS研究框架内，为PCOS患者提供了标准化的富含碳水化合物的试验餐，以检测葡萄糖稳态和胰岛素分泌。将结果与月经正常的对照组进行比较，对照组的体重指数（BMI）值和年龄均与PCOS患者相对应。41名PCOS患者（无糖尿病）和68名对照组接受了标准化的富含碳水化合物的试验餐（260千卡，62%碳水化合物，32%脂肪，6%蛋白质）以产生次最大胰岛素和葡萄糖刺激。在基线以及餐后60、120和180分钟测定相关数值。此外，记录相应的C肽水平。在PCOS患者（n = 41）中，标准化试验餐后的胰岛素分泌测试显示，与年龄和BMI匹配的月经正常对照组（n = 68）相比，其基线和餐后胰岛素水平几乎相同。在PCOS患者中，基线和餐后血糖水平显著升高（PCOS组为92.88±10.28[mg/dL]，对照组为85.07±9.42[mg/dL]；p < 0.001），C肽水平也是如此（p < 0.025）。在本研究中，我们首次表明，食用标准化试验餐后，PCOS患者的空腹胰岛素抵抗正式高于对照组。尽管刺激后的C肽水平较高，但与对照组相比，PCOS患者的胰岛素水平并未随着血糖水平的升高而更强烈地升高，这可能表明PCOS患者的胰岛素清除率较高。
