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对糖耐量正常的中国多囊卵巢综合征患者胰岛素抵抗的评估。

Assessment of insulin resistance in Chinese PCOS patients with normal glucose tolerance.

作者信息

Gao Jing, Zhou Li, Hong Jie, Chen Chen

机构信息

a Department of Gynecology and Obstetrics, Rui-Jin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , PR China.

b Department of Gynecology and Obstetrics , The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , PR China.

出版信息

Gynecol Endocrinol. 2017 Nov;33(11):888-891. doi: 10.1080/09513590.2017.1342238. Epub 2017 Jul 4.

Abstract

The study aimed to investigate insulin resistance (IR) status in polycystic ovary syndrome (PCOS) women with normal glucose tolerance (NGT), and further to evaluate feasible diagnostic method for those patients. Three hundred and twenty-five PCOS women with NGT and ninety-five healthy age-matched controls were recruited with Rotterdam criterion and 75 g oral glucose tolerance test (OGTT). IR status was estimated following a glycemic and insulinemic OGTT (0, 30, 60, 120, and 180 min). A modified HOMA-IR formula was applied to each time-course value of glycemia and insulinemia. The predictive performance of each IR index was analyzed with the use of ROC curves. Compared with healthy controls, both non-obese and obese PCOS patients with NGT had a higher BMI, serum glucose, insulin value (p < .05). The best predictive index of IR in non-obese PCOS-NGT was a HOMA-M30 value of 20.36 or more (AUC: 0.753). In obese PCOS-NGT population, the best predictive performance was obtained by a HOMA-M60 value of 32.17 or more (AUC: 0.868). IR was common in Chinese PCOS women with NGT, and the early assessment of IR should be heeded. We recommended HOMA-M30 (Cutoff: 20.36) and HOMA-M60 (Cutoff: 32.17) as the best predictive parameters for non-obese and obese PCOS-NGT patients, respectively.

摘要

该研究旨在调查糖耐量正常(NGT)的多囊卵巢综合征(PCOS)女性的胰岛素抵抗(IR)状况,并进一步评估这些患者可行的诊断方法。采用鹿特丹标准和75克口服葡萄糖耐量试验(OGTT)招募了325例糖耐量正常的PCOS女性和95例年龄匹配的健康对照者。在进行血糖和胰岛素水平的OGTT(0、30、60、120和180分钟)后评估IR状况。将改良的HOMA-IR公式应用于血糖和胰岛素水平的每个时间点值。使用ROC曲线分析每个IR指标的预测性能。与健康对照相比,非肥胖和肥胖的糖耐量正常的PCOS患者的BMI、血糖、胰岛素值均更高(p < 0.05)。非肥胖PCOS-NGT患者中IR的最佳预测指标是HOMA-M30值≥20.36(AUC:0.753)。在肥胖PCOS-NGT人群中,HOMA-M60值≥32.17时预测性能最佳(AUC:0.868)。IR在糖耐量正常的中国PCOS女性中很常见,应重视IR的早期评估。我们建议分别将HOMA-M3(临界值:20.36)和HOMA-M60(临界值:32.17)作为非肥胖和肥胖PCOS-NGT患者的最佳预测参数。

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