Department of Endocrinological Gynecology, Medical University of Silesia, Katowice, Poland.
Eur Rev Med Pharmacol Sci. 2017 Nov;21(21):4755-4761.
Polycystic ovarian syndrome and obesity contribute to the metabolic complications for women of reproductive age. The aim of present study was to analyze the effect of abdominal obesity expressed using waist/hip ratio (WHR) in patients with polycystic ovary syndrome on metabolic parameters.
The study included 659 women with PCOS with WHR <0.8 and ≥0.8 aged between 17 and 44 years. Patients were tested for follicular stimulating hormone, luteinizing hormone, 17-beta-estradiol, dehydroepiandrosterone sulfate, androstenedione, sex hormone binding globulin, and total lipid profile during the follicular phase (within 3 and 5 days of their menstrual cycle). Also, fasting glucose and insulin concentrations, and after, oral-glucose glucose administration, were determinate. De Ritis and Castelli index I and II were calculated.
Women with WHR ≥0.8 had higher concentration of glucose and insulin (both fasting and after 120 min of oral administration of 75 g glucose), as well as HOMA-IR value, than women with WHR value < 0.8. Also, abdominal obesity disorders hormonal parameters. Higher free androgen index and lower concentration of sex hormone binding globulin and dehydroepiandrosterone sulfate were found in female with WHR ≥ 0.8. Follicular stimulating hormone, luteinizing hormone, androstenedione, and 17-beta-estradiol, were on similar level in both groups. Elevation in triglycerides, total cholesterol, and low-density lipoprotein levels, as well as decrease in high density lipoprotein level in serum of women with WHR value ≥ 0.8, were found when compared to women with WHR < 0.8. A statistically significant correlation was found between WHR value and glucose, insulin, sex hormone binding globulin, free androgen index and lipid profile parameters.
Abdominal obesity causes additional disorders in metabolic and hormonal parameters in PCOS women, which confirmed changes in analyzed parameters between PCOS women with WHR < 0.8 and WHR ≥ 0.8 and statistically significant correlations between WHR value and analyzed parameters.
多囊卵巢综合征和肥胖会导致育龄妇女出现代谢并发症。本研究旨在分析多囊卵巢综合征患者用腰臀比（WHR）表示的腹型肥胖对代谢参数的影响。
本研究纳入了 659 名年龄在 17 至 44 岁之间、WHR<0.8 和≥0.8 的多囊卵巢综合征患者。在卵泡期（月经周期的第 3 至 5 天内），对患者进行卵泡刺激素、黄体生成素、17-β-雌二醇、硫酸脱氢表雄酮、雄烯二酮、性激素结合球蛋白和总脂质谱的检测。此外，还测定了空腹血糖和胰岛素浓度，以及口服葡萄糖后。计算了德赖蒂斯和卡斯蒂利指数 I 和 II。
WHR≥0.8 的女性空腹和口服 75g 葡萄糖后 120 分钟的血糖和胰岛素浓度均高于 WHR 值<0.8 的女性，HOMA-IR 值也较高。此外，腹型肥胖会影响激素参数。WHR≥0.8 的女性游离雄激素指数较高，而性激素结合球蛋白和硫酸脱氢表雄酮浓度较低。两组的卵泡刺激素、黄体生成素、雄烯二酮和 17-β-雌二醇水平相似。与 WHR<0.8 的女性相比，WHR 值≥0.8 的女性血清中甘油三酯、总胆固醇和低密度脂蛋白水平升高，高密度脂蛋白水平降低。WHR 值与血糖、胰岛素、性激素结合球蛋白、游离雄激素指数和血脂参数之间存在显著相关性。
腹型肥胖会导致多囊卵巢综合征女性的代谢和激素参数出现额外的异常，这证实了 WHR<0.8 和 WHR≥0.8 的多囊卵巢综合征女性之间分析参数的变化，以及 WHR 值与分析参数之间存在显著相关性。
