Feichtinger Michael, Linder Tina, Rosicky Ingo, Eppel Daniel, Schatten Christian, Eppel Wolfgang, Husslein Peter, Tura Andrea, Göbl Christian S
Wunschbaby Institut Feichtinger, 1130 Vienna, Austria.
Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2020 Dec 24;10(1):35. doi: 10.3390/jcm10010035.
To investigate insulin sensitivity and glucose metabolism in pregnant lean and overweight polycystic ovary syndrome (PCOS) patients vs. lean and overweight controls without PCOS.
Prospective cohort study on 67 pregnant women (31 with PCOS and 36 controls, subdivided into overweight or obese and normal weight). All women underwent a 2h-OGTT including glucose, insulin, and C-peptide in early- and mid-gestation and were followed-up until delivery.
Insulin sensitivity and glucometabolic parameters were comparable between PCOS patients and controls, whereas marked differences were observed between overweight/obese and lean mothers. Impaired whole-body insulin sensitivity at early pregnancy is mainly a consequence of higher BMI (body mass index; 0.001) compared to PCOS ( 0.216), whereby no interaction between overweight/obesity and PCOS was observed ( 0.194). Moreover, overweight was significantly associated with gestational diabetes ( 0.0003), whereas there were no differences between women with and without PCOS ( 0.51). Birth weight was inversely related to whole-body insulin sensitivity (rho = -0.33, 0.014) and positively associated with higher pregestational BMI (rho = 0.33, 0.012), whereas there was no association with PCOS.
Impaired insulin action was mainly a consequence of overweight rather than PCOS. Our data suggest that overweight is more relevant than PCOS for the effects on insulin sensitivity and impaired glucose metabolism.
研究怀孕的瘦型和超重多囊卵巢综合征（PCOS）患者与无PCOS的瘦型和超重对照者的胰岛素敏感性和葡萄糖代谢情况。
对67名孕妇进行前瞻性队列研究（31名PCOS患者和36名对照者，再细分为超重或肥胖以及正常体重）。所有女性在妊娠早期和中期均接受了2小时口服葡萄糖耐量试验（OGTT），检测血糖、胰岛素和C肽，并随访至分娩。
PCOS患者和对照者之间的胰岛素敏感性和糖代谢参数相当，而超重/肥胖母亲与瘦型母亲之间存在显著差异。与PCOS（P = 0.216）相比，妊娠早期全身胰岛素敏感性受损主要是由于较高的体重指数（BMI；P = 0.001），超重/肥胖与PCOS之间未观察到相互作用（P = 0.194）。此外，超重与妊娠期糖尿病显著相关（P = 0.0003），而有无PCOS的女性之间无差异（P = 0.51）。出生体重与全身胰岛素敏感性呈负相关（rho = -0.33，P = 0.014），与孕前较高的BMI呈正相关（rho = 0.33，P = 0.012），而与PCOS无关。
胰岛素作用受损主要是超重而非PCOS的结果。我们的数据表明，超重对胰岛素敏感性和糖代谢受损的影响比PCOS更相关。
