伊朗女性多囊卵巢综合征四种表型中代谢综合征的患病率及其与雄激素成分的关系：一项横断面研究。
Prevalence of metabolic syndrome in four phenotypes of PCOS and its relationship with androgenic components among Iranian women: A cross-sectional study.
作者信息
Zaeemzadeh Narges, Sadatmahalleh Shahideh Jahanian, Ziaei Saeideh, Kazemnejad Anoshirvan, Mottaghi Azadeh, Mohamadzadeh Neda, Movahedinejad Maryam
机构信息
Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
出版信息
Int J Reprod Biomed. 2020 Apr 30;18(4):253-264. doi: 10.18502/ijrm.v13i4.6888. eCollection 2020 Apr.
BACKGROUND
Polycystic ovary syndrome (PCOS) increases the risk of metabolic syndrome (MetS). Insulin resistance (IR) plays a major role in the pathophysiology of both PCOS and MetS.
OBJECTIVE
This study was designed to compare the prevalence of MetS among different phenotypes of PCOS and its relationship with androgenic components.
MATERIALS AND METHODS
182 participants eligible for this five-group comparative study were selected by convenience sampling method. They were classified according to the Rotterdam criteria: clinical and/or biochemical hyperandrogenism (H) + PCOS on ultrasound (P) + ovulation disorders (O) (n = 41), clinical and/or biochemical H + PCOS on P (n = 33), PCOS on P + O (n = 40), clinical and/or biochemical H + O (n = 37), and control (without PCOS) (n = 31). MetS was measured based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Androgenic components included free-androgen-index (FAI), total-testosterone (TT) level and sex-hormone-binding-globulin (SHBG).
RESULTS
A significant difference was observed between the study groups in terms of MetS prevalence (p = 0.01). In phenotype H+P+O, there was a statistically significant positive association between TG and TT, and a significant negative association between SBP and DBP with SHBG. In phenotype O+P, WC was inversely associated with SHBG. In phenotype H+O, FBS and TG were positively associated with FAI but HDL was inversely associated with FAI. Moreover, WC and DBP were positively associated with TT in phenotype H+O. No associations were detected between MetS parameters and androgenic components in other PCOS subjects (phenotype H+P) and in the control group. TT was significantly higher in the PCOS group suffering from MetS (p = 0.04).
CONCLUSION
According to the research results, hyperandrogenic components are potent predictors of metabolic disorders. Thus, we suggest that MetS screening is required for the prevention of MetS and its related complications in PCOS women.
背景
多囊卵巢综合征（PCOS）会增加代谢综合征（MetS）的风险。胰岛素抵抗（IR）在PCOS和MetS的病理生理过程中起主要作用。
目的
本研究旨在比较不同表型PCOS患者中MetS的患病率及其与雄激素成分的关系。
材料与方法
采用便利抽样法选取182名符合该五组比较研究的参与者。根据鹿特丹标准对他们进行分类：临床和/或生化高雄激素血症（H）+超声检查显示PCOS（P）+排卵障碍（O）（n = 41），临床和/或生化H + P（n = 33），P + O型PCOS（n = 40），临床和/或生化H + O（n = 37），以及对照组（无PCOS）（n = 31）。根据美国国家胆固醇教育计划成人治疗小组第三次报告标准测量MetS。雄激素成分包括游离雄激素指数（FAI）、总睾酮（TT）水平和性激素结合球蛋白（SHBG）。
结果
各研究组在MetS患病率方面存在显著差异（p = 0.01）。在H+P+O表型中，甘油三酯（TG）与TT之间存在统计学上显著的正相关，收缩压（SBP）和舒张压（DBP）与SHBG之间存在显著的负相关。在O+P表型中，腰围（WC）与SHBG呈负相关。在H+O表型中，空腹血糖（FBS）和TG与FAI呈正相关，但高密度脂蛋白（HDL）与FAI呈负相关。此外，在H+O表型中，WC和DBP与TT呈正相关。在其他PCOS受试者（H+P表型）和对照组中，未检测到MetS参数与雄激素成分之间存在关联。患有MetS的PCOS组中TT显著更高（p = 0.04）。
结论
根据研究结果，高雄激素成分是代谢紊乱的有力预测指标。因此，我们建议对PCOS女性进行MetS筛查，以预防MetS及其相关并发症。
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