Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Reprod Biomed Online. 2019 Nov;39(5):868-876. doi: 10.1016/j.rbmo.2019.06.014. Epub 2019 Jul 3.
The study aimed to evaluate the associations of endocrine and ultrasound characteristics with metabolic syndrome in women with polycystic ovary syndrome (PCOS), and whether these associations were modified by body mass index (BMI).
The study was a secondary analysis of baseline data from a randomized controlled trial of induction of ovulation in women with PCOS.
Among 947 Chinese women with PCOS, 153 (16.2%) were diagnosed with metabolic syndrome. The prevalence of metabolic syndrome in women with normal (<24 kg/m) and high (≥24 kg/m) BMI was 3.6% and 30.5%, respectively. In all women, a high free androgen index (FAI ≥5%) was positively associated with metabolic syndrome (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.11-3.82). High FAI was positively associated with metabolic syndrome among women with high BMI (adjusted OR 3.37, 95% CI 1.78-6.37), but the association was not significant in women with normal BMI (adjusted OR 1.27, 95% CI 0.34-4.70). The presence of polycystic ovary morphology was negatively associated with metabolic syndrome (adjusted OR 0.52, 95% CI 0.26-1.03) in all women (normal BMI adjusted OR 0.42, 95% CI 0.11-1.67; high BMI adjusted OR 0.54, 95% CI 0.23-1.28). LH, sex hormone-binding globulin (SHBG) and anti-Müllerian hormone (AMH) were negatively associated with metabolic syndrome. The associations of FAI, SHBG and AMH in relation to metabolic syndrome were significantly modified by BMI.
CONCLUSION(S): The associations of endocrine characteristic with metabolic syndrome were modified by BMI in women with PCOS. Women with PCOS and normal BMI did not have an increased risk of metabolic syndrome.
本研究旨在评估多囊卵巢综合征（PCOS）女性的内分泌和超声特征与代谢综合征之间的关联，以及这些关联是否受体重指数（BMI）的影响。
本研究是对多囊卵巢综合征患者诱导排卵随机对照试验的基线数据进行的二次分析。
在 947 名中国 PCOS 女性中，有 153 人（16.2%）被诊断为代谢综合征。正常（<24kg/m）和高（≥24kg/m）BMI 女性的代谢综合征患病率分别为 3.6%和 30.5%。在所有女性中，高游离雄激素指数（FAI≥5%）与代谢综合征呈正相关（调整后的优势比[OR]2.06，95%置信区间[CI]1.11-3.82）。高 FAI 与高 BMI 女性的代谢综合征呈正相关（调整后的 OR 3.37，95%CI 1.78-6.37），但在正常 BMI 女性中无显著相关性（调整后的 OR 1.27，95%CI 0.34-4.70）。多囊卵巢形态的存在与所有女性的代谢综合征呈负相关（调整后的 OR 0.52，95%CI 0.26-1.03）（正常 BMI 调整后的 OR 0.42，95%CI 0.11-1.67；高 BMI 调整后的 OR 0.54，95%CI 0.23-1.28）。LH、性激素结合球蛋白（SHBG）和抗苗勒氏管激素（AMH）与代谢综合征呈负相关。FAI、SHBG 和 AMH 与代谢综合征的关联受 BMI 的显著影响。
在多囊卵巢综合征女性中，内分泌特征与代谢综合征的关联受 BMI 的影响。BMI 正常的多囊卵巢综合征女性患代谢综合征的风险没有增加。
