Anastasiou Olympia E, Canbay Ali, Fuhrer Dagmar, Reger-Tan Susanne
Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Department of Gastroenterology and Hepatology, University Hospital, University of Magdeburg, Essen, Germany.
Arch Gynecol Obstet. 2017 Aug;296(2):363-371. doi: 10.1007/s00404-017-4422-9. Epub 2017 Jun 12.
Polycystic ovary syndrome (PCOS) is a disorder associated with insulin resistance and obesity. Aim of our study is to clarify the prevalence of underweight in PCOS patients and whether metabolic and androgen profiles of PCOS differ depending on normal or low body weight.
Out of 1269 consecutive patients with PCOS recruited from the Department of Endocrinology and Metabolism at the University of Duisburg-Essen, 19 patients (1.5%) were underweight and were compared to 375 lean PCOS subjects (29.6%). Clinical and endocrine parameters were evaluated. Insulin resistance was assessed by 3-h oral glucose tolerance test (OGTT).
Prevalence of type 2 diabetes and free androgen index did not differ between the two groups. Total cholesterol and low density lipoprotein levels were significantly lower in the group of underweight patients. While no significant difference was found for the Homeostasis model assessment (HOMA) index at fasting state, the HOMA-M120, calculated 2 h after glucose intake in OGTT, was significantly higher in underweight patients. Underweight patients also showed significantly higher postprandial insulin secretion after glucose intake in OGTT. Six underweight PCOS patients received metformin treatment for oligomenorrhea. An improvement of the menstrual cycle was observed in three cases, while two patients were lost to follow up and one discontinued therapy due to side effects.
The prevalence of underweight in patients with PCOS is very low. Underweight in PCOS is associated with higher postprandial insulin levels. Several of our underweight patients were able to achieve regular menstrual cycle under metformin therapy.
多囊卵巢综合征（PCOS）是一种与胰岛素抵抗和肥胖相关的疾病。我们研究的目的是明确PCOS患者中体重过轻的患病率，以及PCOS患者的代谢和雄激素谱是否因体重正常或偏低而有所不同。
从杜伊斯堡-埃森大学内分泌与代谢科连续招募的1269例PCOS患者中，19例（1.5%）体重过轻，并与375例体重正常的PCOS患者（29.6%）进行比较。评估临床和内分泌参数。通过3小时口服葡萄糖耐量试验（OGTT）评估胰岛素抵抗。
两组之间2型糖尿病患病率和游离雄激素指数无差异。体重过轻患者组的总胆固醇和低密度脂蛋白水平显著较低。虽然空腹状态下稳态模型评估（HOMA）指数无显著差异，但OGTT葡萄糖摄入后2小时计算的HOMA-M120在体重过轻患者中显著更高。体重过轻患者在OGTT葡萄糖摄入后餐后胰岛素分泌也显著更高。6例体重过轻的PCOS患者因月经过少接受二甲双胍治疗。3例患者月经周期得到改善，2例患者失访，1例因副作用停药。
PCOS患者中体重过轻的患病率非常低。PCOS患者体重过轻与餐后胰岛素水平较高有关。我们的几名体重过轻患者在二甲双胍治疗下能够实现规律月经周期。
