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多囊卵巢综合征育龄妇女2型糖尿病和心血管疾病风险概况的综合评估:一项大型加拿大队列研究

Comprehensive Evaluation of Type 2 Diabetes and Cardiovascular Disease Risk Profiles in Reproductive-Age Women with Polycystic Ovary Syndrome: A Large Canadian Cohort.

作者信息

Kazemi Maryam, Pierson Roger A, Lujan Marla E, Chilibeck Philip D, McBreairty Laura E, Gordon Julianne J, Serrao Shani B, Zello Gordon A, Chizen Donna R

机构信息

Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK.

Department of Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatoon, SK.

出版信息

J Obstet Gynaecol Can. 2019 Oct;41(10):1453-1460. doi: 10.1016/j.jogc.2018.11.026. Epub 2019 Feb 1.

Abstract

OBJECTIVE

This study compared the prevalence of metabolic syndrome (MetS) and characterized type 2 diabetes (DM2) and cardiovascular disease (CVD) risk profiles between Canadian women with polycystic ovary syndrome (PCOS) and healthy women recruited from the general population. Furthermore, within the PCOS cohort, the study contrasted the CVD and DM2 risk profiles of women with or without MetS.

METHODS

Measures of MetS (International Diabetes Federation; National Heart, Lung, and Blood Institute; and the American Heart Association definition), DM2 (Diabetes Canada Clinical Guidelines), and CVD risk factors (Androgen Excess and Polycystic Ovary Syndrome Society statement) were evaluated for 237 women with PCOS (Androgen Excess and PCOS Society definitions) and 42 controls (aged 18-36) in a prospective observational study (Canadian Task Force Classification II-2).

RESULTS

The prevalence of MetS was 29.5% in the PCOS group, which was approximately six-fold higher than age-matched controls (P < 0.001). Women with PCOS exhibited higher glucose abnormality, acanthosis nigricans, total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C), and lower sex hormone-binding globulin concentrations when compared with controls after accounting for differences in the BMI (P < 0.01). Further, women with PCOS and MetS exhibited exacerbated insulin and glucose responses to a 75-g oral glucose tolerance test and greater acanthosis nigricans, hirsutism, TC/HDL-C, TC, and sex hormone-binding globulin concentrations compared with their BMI-adjusted counterparts without MetS (P < 0.05).

CONCLUSION

Canadian reproductive-age women with PCOS have a high prevalence of MetS and exhibit adverse cardiometabolic risk factors that warrant early screening and regular monitoring across their reproductive lifespan.

摘要

目的

本研究比较了加拿大患有多囊卵巢综合征(PCOS)的女性与从普通人群中招募的健康女性之间代谢综合征(MetS)的患病率、2型糖尿病(DM2)的特征以及心血管疾病(CVD)风险概况。此外,在PCOS队列中,该研究对比了患有或未患有MetS的女性的CVD和DM2风险概况。

方法

在一项前瞻性观察性研究(加拿大工作组分类II-2)中,对237名患有PCOS(雄激素过多和PCOS协会定义)的女性和42名对照(年龄18 - 36岁)评估了MetS(国际糖尿病联盟;美国国家心肺血液研究所;以及美国心脏协会定义)、DM2(加拿大糖尿病临床指南)和CVD风险因素(雄激素过多与多囊卵巢综合征协会声明)。

结果

PCOS组中MetS的患病率为29.5%,约为年龄匹配对照组的6倍(P < 0.001)。在考虑体重指数差异后,与对照组相比,患有PCOS的女性表现出更高的血糖异常、黑棘皮病、总胆固醇与高密度脂蛋白胆固醇比值(TC/HDL-C)以及更低的性激素结合球蛋白浓度(P < 0.01)。此外,与体重指数调整后未患MetS的对应女性相比,患有PCOS且患MetS的女性在75克口服葡萄糖耐量试验中表现出更严重的胰岛素和血糖反应,以及更严重的黑棘皮病、多毛症、TC/HDL-C、TC和性激素结合球蛋白浓度(P < 0.05)。

结论

患有PCOS的加拿大育龄女性MetS患病率高,且表现出不良的心脏代谢风险因素,这需要在其整个生殖寿命期进行早期筛查和定期监测。

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