Ran Yu, Yi Qiang, Li Cong
Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Dec 1;13:4711-4715. doi: 10.2147/DMSO.S285114. eCollection 2020.
To analyze the status of insulin resistance and hyperlipidemia in the regulation of menstrual cycle in patients undergoing sleeve gastrectomy (LSG).
Retrospective analysis of a typical metabolic syndrome population: 65 cases of sexually mature women underwent weight reduction surgery from January 2015 to June 2018, and for 35 of these cases we collected all clinical data including age, menstrual status, body mass index (BMI), waist-to-hip ratio (WHR), blood lipid level, homeostasis model assessment in insulin resistance (HOMA-IR) and free androgen index (FAI). Sixteen of these patients had menstrual disorder that was characterized by oligomenorrhea and their menstrual cycle was >2 months or <24 days before operation, while their menstrual cycle recovered approximately 1 month to one year after sleeve gastrectomy.
The age of our 35 patients with metabolic syndrome was 15-40 years; 19 cases were in the menstrual regularity group and 16 cases in the menstrual disorder group. On analysis of metabolic factors in the two groups, only BMI and FAI distribution in the two groups were statistically different, while lipid levels and insulin resistance levels for abnormal menstrual cycle were not statistically significant. The analysis of blood lipid components showed that high triglyceride levels and high cholesterol levels increased the occurrence of menstrual disorders.
BMI can be used as one of the important metabolic indicators of menstrual disorders in patients with metabolic syndrome. Excess androgen can increase the occurrence of menstrual disorders, leading to polycystic ovarian syndrome (PCOS). Although insulin resistance is universal in patients with metabolic syndrome, it is not a specific factor that affects menstrual cycle. Hyperlipidemia, especially triglyceride composition, may be one of the driving factors of menstrual disorder.
分析接受袖状胃切除术(LSG)患者胰岛素抵抗和高脂血症在月经周期调节中的状况。
对典型代谢综合征人群进行回顾性分析:2015年1月至2018年6月,65例性成熟女性接受减重手术,其中35例收集了所有临床资料,包括年龄、月经状况、体重指数(BMI)、腰臀比(WHR)、血脂水平、胰岛素抵抗稳态模型评估(HOMA-IR)和游离雄激素指数(FAI)。其中16例患者存在月经紊乱,表现为月经过少,术前月经周期>2个月或<24天,而袖状胃切除术后月经周期约1个月至1年恢复。
35例代谢综合征患者年龄为15 - 40岁;月经规律组19例,月经紊乱组16例。对两组代谢因素进行分析,两组间仅BMI和FAI分布存在统计学差异,而月经周期异常者的血脂水平和胰岛素抵抗水平无统计学意义。血脂成分分析显示,高甘油三酯水平和高胆固醇水平增加了月经紊乱的发生率。
BMI可作为代谢综合征患者月经紊乱的重要代谢指标之一。雄激素过多会增加月经紊乱的发生率,导致多囊卵巢综合征(PCOS)。虽然胰岛素抵抗在代谢综合征患者中普遍存在,但它不是影响月经周期的特异性因素。高脂血症,尤其是甘油三酯成分,可能是月经紊乱的驱动因素之一。