Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.
Clin Endocrinol (Oxf). 2018 Dec;89(6):779-788. doi: 10.1111/cen.13832. Epub 2018 Sep 9.
To investigate both independent and combined effects of insulin resistance and β-cell dysfunction on cardio-metabolic abnormalities in polycystic ovary syndrome (PCOS).
A national epidemiologic survey was performed in reproductive aged females in China from October 2007 to September 2011.
A total of 824 PCOS and 2715 non-PCOS were included. The Rotterdam Criteria were applied for PCOS diagnosis. We used the homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-β) to evaluate insulin resistance and β-cell dysfunction, respectively.
Compared with non-PCOS, PCOS showed a higher index of HOMA-IR and HOMA-β, and a higher prevalence of obesity, central obesity, and dyslipidaemia. High HOMA-IR was independently related to a high prevalence of obesity, central obesity, dyslipidaemia, and high blood glucose in PCOS. In contrast, a low index of HOMA-β index was independently correlated with a low prevalence of obesity, and central obesity, but negatively correlated with an elevated prevalence of high blood glucose in PCOS. In addition, proportion of insulin resistance was higher than that of β-cell dysfunction in PCOS with cardio-metabolic disorders. β-cell dysfunction was negatively correlated with the prevalence of central obesity and obesity.
Insulin resistance and β-cell dysfunction independently affected cardio-metabolic abnormalities in PCOS, while insulin resistance was correlated with a higher prevalence of cardio-metabolic abnormalities than that of β-cell dysfunction. Moreover, β-cell dysfunction and insulin resistance showed divergent correlations with obesity in PCOS.
探讨胰岛素抵抗和β细胞功能障碍对多囊卵巢综合征（PCOS）患者心脏代谢异常的独立和联合影响。
2007 年 10 月至 2011 年 9 月在中国进行了一项针对育龄期女性的全国性流行病学调查。
共纳入 824 例 PCOS 患者和 2715 例非 PCOS 患者。采用 Rotterdam 标准诊断 PCOS。使用稳态模型评估胰岛素抵抗（HOMA-IR）和β细胞功能的 HOMA 评估（HOMA-β）分别评估胰岛素抵抗和β细胞功能障碍。
与非 PCOS 患者相比，PCOS 患者的 HOMA-IR 和 HOMA-β指数更高，肥胖、中心性肥胖和血脂异常的患病率也更高。高 HOMA-IR 与 PCOS 患者肥胖、中心性肥胖、血脂异常和高血糖患病率升高独立相关。相反，低 HOMA-β指数与 PCOS 患者肥胖和中心性肥胖患病率降低独立相关，但与高血糖患病率升高呈负相关。此外，在伴有心脏代谢紊乱的 PCOS 患者中，胰岛素抵抗的比例高于β细胞功能障碍。β细胞功能障碍与中心性肥胖和肥胖的患病率呈负相关。
胰岛素抵抗和β细胞功能障碍独立影响 PCOS 患者的心脏代谢异常，而胰岛素抵抗与心脏代谢异常的患病率高于β细胞功能障碍相关。此外，β细胞功能障碍和胰岛素抵抗与 PCOS 患者的肥胖呈不同的相关性。
