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超重/肥胖及体重正常的多囊卵巢综合征年轻女性的胰岛素抵抗和不良代谢状况

Insulin resistance and adverse metabolic profile in overweight/obese and normal weight of young women with polycystic ovary syndrome.

作者信息

Gholinezhad Maryam, Gholsorkhtabaramiri Masoumeh, Esmaeilzadeh Sedigheh, Ghanbarpour Azita

机构信息

1. Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Clinical Research Development unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

出版信息

Caspian J Intern Med. 2018 Summer;9(3):260-267. doi: 10.22088/cjim.9.3.260.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOs) is an endocrine-metabolic disorder. This study intends to determine the comparison of insulin resistance (IR) and metabolic disturbance in overweight/obese and normal-weight of young women with polycystic ovary syndrome.

METHODS

Using a comparative cross-sectional study design in 2015, 27 normal weight (18<BMI<25) and 85 overweight/obese (BMI≥25) aged 18 and 35 underwent clinical measures of HOMA (IR) as insulin resistance and QUICKI as insulin sensitivity tools in Fatemezahra Infertility Research Center of Babol. Lipid profile and hormonal parameters were evaluated between two groups.

RESULTS

112 women with PCOS participated in this study. The mean age was 22.4±3.48 years in the normal PCOS group (n=27) and 24.4±5.06 years in the overweight/obese PCOS patients (n=85). BMI had a significant straight correlation with insulin resistance (p<0.001) and a negative correlation with insulin sensitivity (p<0.001). BMI showed a straight stronger correlation with triglyceride (TG) (p<0.001) and LDL cholesterol (<0.05) and a stronger reverse relationship with SHBG (p<0.001). In overweight/obese group, 91.7% (48) of the women showed insulin resistance (HOMA>3.15) vs. 8.3% (5) in the normal group (P<0.001). 82.4% (62) of the overweight/obese group revealed low insulin sensitivity (QUICKI<0.34) while this value was 17.6 % (13) within their lean counterparts (p<0.001). In the study group, 89.7 % (54) showed elevated fasting insulin concentration (>13µU/ml) vs. 10.3% (7) in the control group (p<0.001).

CONCLUSIONS

Overweight/obese PCOs patients revealed higher insulin resistance and lower insulin sensitivity, and also greater TG and LDL cholesterol. Priority of management of insulin resistance and lipid profile should be considered on identifying these potentially major complications.

摘要

背景

多囊卵巢综合征(PCOS)是一种内分泌代谢紊乱疾病。本研究旨在确定超重/肥胖和正常体重的年轻多囊卵巢综合征女性的胰岛素抵抗(IR)及代谢紊乱情况的比较。

方法

采用比较性横断面研究设计,2015年在巴博尔的法特梅扎赫拉不孕研究中心,对27名体重正常(18<BMI<25)以及85名超重/肥胖(BMI≥25)、年龄在18至35岁之间女性进行了作为胰岛素抵抗指标的HOMA(IR)及作为胰岛素敏感性指标的QUICKI的临床测量。对两组之间的血脂谱和激素参数进行了评估。

结果

112名患有PCOS的女性参与了本研究。正常PCOS组(n = 27)的平均年龄为22.4±3.48岁,超重/肥胖PCOS患者组(n = 85)的平均年龄为24.4±5.06岁。BMI与胰岛素抵抗呈显著正相关(p<0.001),与胰岛素敏感性呈负相关(p<0.001)。BMI与甘油三酯(TG)(p<0.001)和低密度脂蛋白胆固醇(<0.05)呈更强的正相关,与性激素结合球蛋白(SHBG)呈更强的负相关(p<0.001)。在超重/肥胖组中,91.7%(48)的女性表现出胰岛素抵抗(HOMA>3.15),而正常组为8.3%(5)(P<0.001)。超重/肥胖组中82.4%(62)的女性胰岛素敏感性较低(QUICKI<0.34),而在瘦体型的女性中这一比例为17.6%(13)(p<0.001)。在研究组中,89.7%(54)的女性空腹胰岛素浓度升高(>13µU/ml),而对照组为10.3%(7)(p<0.001)。

结论

超重/肥胖的PCOS患者表现出更高的胰岛素抵抗和更低的胰岛素敏感性,同时甘油三酯和低密度脂蛋白胆固醇水平更高。在识别这些潜在的主要并发症时应考虑优先处理胰岛素抵抗和血脂谱问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/884b/6121333/354e07230a15/cjim-9-260-g001.jpg

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