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不同多囊卵巢综合征表型的身体成分、雄激素血清浓度与胰岛素抵抗

Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes.

作者信息

Polak Aleksandra Maria, Adamska Agnieszka, Krentowska Anna, Łebkowska Agnieszka, Hryniewicka Justyna, Adamski Marcin, Kowalska Irina

机构信息

Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland.

Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland.

出版信息

J Clin Med. 2020 Mar 9;9(3):732. doi: 10.3390/jcm9030732.

Abstract

Insulin resistance and hyperandrogenemia observed in polycystic ovary syndrome (PCOS) are associated with metabolic disturbances and could be connected with body composition pattern. To date, several studies defining the parameters of body composition using dual energy X-ray absorptiometry (DXA) method in the group of PCOS patients have been published, however, without the analysis in different phenotypes. The aim of the present study was to investigate the relationships between serum androgens concentration, insulin resistance and distribution of fat mass using DXA method in various PCOS phenotypes according to the Rotterdam criteria. We examined 146 women: 34 (38%) had PCOS phenotype A, 20 (23%) phenotype B, 20 (23%) phenotype C and 15 (16%) phenotype D (with mean age of each phenotype 25 years), and 57 control subjects (mean age of 25.5 years). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) were assessed and free androgen index (FAI) was calculated. In phenotypes A, B and C, we observed higher FAI in comparison to the control group (all < 0.01). Serum concentrations of androstenedione and DHEA-S were higher in phenotypes A and C in comparison to the control group (all < 0.01). However, only in phenotype A we found higher visceral adipose tissue (VAT) mass and android/gynoid ratio (A/G ratio) in comparison to the control group (all < 0.01). In phenotype A, we observed connection of VAT with FAI ( = 0.58, < 0.01). Accordingly, A/G ratio was related with FAI in all phenotypes (all < 0.05). Additionally, in phenotype C, A/G ratio was related to serum concentrations of DHEA-S and androstenedione ( = 0.46, = 0.03; = 0.53, = 0.01, respectively). We also found connections of HOMA-IR with VAT and A/G ratio in all phenotypes (all < 0.05). Women with phenotype A had higher amount of VAT and A/G ratio in comparison to the control group. Serum concentration of androgens and insulin resistance are connected with VAT and A/G ratio in normoandrogenic and hyperandrogenic PCOS phenotypes.

摘要

多囊卵巢综合征(PCOS)中观察到的胰岛素抵抗和高雄激素血症与代谢紊乱相关,并且可能与身体组成模式有关。迄今为止,已经发表了几项使用双能X线吸收法(DXA)定义PCOS患者组身体组成参数的研究,然而,没有对不同表型进行分析。本研究的目的是根据鹿特丹标准,使用DXA方法研究各种PCOS表型中血清雄激素浓度、胰岛素抵抗与脂肪量分布之间的关系。我们检查了146名女性:34名(38%)具有PCOS A型表型,20名(23%)B型表型,20名(23%)C型表型,15名(16%)D型表型(每种表型的平均年龄为25岁),以及57名对照受试者(平均年龄为25.5岁)。计算胰岛素抵抗的稳态模型评估(HOMA-IR)。评估血清睾酮、雄烯二酮和硫酸脱氢表雄酮(DHEA-S)的浓度,并计算游离雄激素指数(FAI)。在A、B和C型表型中,我们观察到与对照组相比FAI更高(均<0.01)。与对照组相比,A和C型表型中雄烯二酮和DHEA-S的血清浓度更高(均<0.01)。然而,仅在A型表型中,我们发现与对照组相比内脏脂肪组织(VAT)量和男性化/女性化比例(A/G比例)更高(均<0.01)。在A型表型中,我们观察到VAT与FAI相关(=0.58,<0.01)。因此,在所有表型中A/G比例均与FAI相关(均<0.05)。此外,在C型表型中,A/G比例与DHEA-S和雄烯二酮的血清浓度相关(分别为=0.46,=0.03;=0.53,=0.01)。我们还发现在所有表型中HOMA-IR与VAT和A/G比例相关(均<0.05)。与对照组相比,A型表型的女性具有更高的VAT量和A/G比例。在正常雄激素性和高雄激素性PCOS表型中,血清雄激素浓度和胰岛素抵抗与VAT和A/G比例相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f16/7141288/ace863cbbe0f/jcm-09-00732-g001.jpg

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