Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, People's Republic of China.
Department of Urology, Qilu Hospital of Shandong University, Jinan, People's Republic of China.
Fertil Steril. 2019 Jan;111(1):168-177. doi: 10.1016/j.fertnstert.2018.09.013.
To explore metabolic disturbances in nonobese women with polycystic ovary syndrome (PCOS) compared with nonobese healthy controls.
Systematic review and meta-analysis.
Not applicable.
PATIENT(S): Nonobese women with PCOS and nonobese healthy controls.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Prevalence of metabolic disturbances including hyperinsulinemia, insulin resistance (IR), impaired fasting glucose (IFG), impaired glucose intolerance (IGT), prediabetes, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and low high-density lipoprotein (low-HDL), as well as other metabolic outcomes such as type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome (Mets), myocardial infarction, stroke, cerebrovascular accident, arterial occlusive disease, and coronary heart disease.
RESULT(S): Compared to nonobese controls, nonobese women with PCOS showed a higher prevalence of hyperinsulinemia (odds ratio [OR], 36.27; 95% confidence interval [CI] 1.76-747.12), IR (OR, 5.70; 95% CI 1.46-22.32), IGT (OR, 3.42; 95% CI 1.56-7.52), T2DM (OR, 1.47; 95% CI 1.11-1.93), hypertriglyceridemia (OR, 10.46; 95% CI 1.39-78.56), low-HDL (OR, 4.03; 95% CI 1.26-12.95), and Mets (OR, 2.57; 95% CI 1.30-5.07). No significant difference was observed for IFG, pre-DM, dyslipidemia, hypercholesterolemia, and hypertension. In subgroup analysis, Whites exhibited increased risks of IR, IGT, IFG, T2DM, hypertension, and Mets, whereas no significant metabolic change was found in Asians. No study reported specifically an incidence of myocardial infarction, stroke, cerebrovascular accident, arterial occlusive disease, and coronary heart disease in nonobese women with PCOS.
CONCLUSION(S): Nonobese women with PCOS also suffer from metabolic disturbances and the risk of long-term metabolic complications. Further efforts should be made to elucidate underlying mechanisms and possible interventions in the early phase.
探讨非肥胖型多囊卵巢综合征（PCOS）妇女与非肥胖型健康对照者之间的代谢紊乱情况。
系统评价和荟萃分析。
不适用。
非肥胖型 PCOS 妇女和非肥胖型健康对照者。
无。
包括高胰岛素血症、胰岛素抵抗（IR）、空腹血糖受损（IFG）、糖耐量受损（IGT）、糖尿病前期、血脂异常、高胆固醇血症、高三酰甘油血症和低高密度脂蛋白（low-HDL），以及其他代谢结局，如 2 型糖尿病（T2DM）、高血压、代谢综合征（Mets）、心肌梗死、卒中等的患病率。
与非肥胖对照组相比，非肥胖型 PCOS 妇女高胰岛素血症（比值比 [OR]，36.27；95%置信区间 [CI]，1.76-747.12）、IR（OR，5.70；95% CI，1.46-22.32）、IGT（OR，3.42；95% CI，1.56-7.52）、T2DM（OR，1.47；95% CI，1.11-1.93）、高三酰甘油血症（OR，10.46；95% CI，1.39-78.56）、low-HDL（OR，4.03；95% CI，1.26-12.95）和 Mets（OR，2.57；95% CI，1.30-5.07）的患病率更高。IFG、前糖尿病、血脂异常、高胆固醇血症和高血压则无显著差异。亚组分析显示，白人妇女的 IR、IGT、IFG、T2DM、高血压和 Mets 风险增加，而亚洲人则无明显代谢变化。没有研究专门报告非肥胖型 PCOS 妇女心肌梗死、卒中等的发生率。
非肥胖型 PCOS 妇女也存在代谢紊乱，且存在长期代谢并发症的风险。应进一步努力阐明潜在机制，并在早期阶段进行可能的干预。
