多囊卵巢综合征女性非酒精性脂肪性胰腺与临床及生化参数的关系：一项多中心研究
Relation Between Non-Alcoholic Fatty Pancreas and Clinical and Biochemical Parameters in Women with Polycystic Ovary Syndrome: A Multi-Centric Study.
作者信息
Osman Mustafa A A, Alkhouly Mohamed, Elmohaseb Ghada F, Nassef Eman Mostafa, Mohamed Ibrahim Ghonim Ramadan, El Mancy Ismail Mohamed, Sabry Seham, Abdulrehim Marwa M, Eliwa Ahmed, Eisa Yasmine H, Abdel-Ghany Ahmed, Abdelghani Yasser
机构信息
Gynecology and Obstetrics Department, Al-Azhar University, Cairo, Egypt.
Internal Medicine Department, Al-Azhar University, Cairo, Egypt.
出版信息
Int J Gen Med. 2022 Nov 19;15:8225-8233. doi: 10.2147/IJGM.S384073. eCollection 2022.
BACKGROUND
Polycystic ovary syndrome (PCOS) is the most common endocrinological disease affecting women in the reproductive age. Non-alcoholic fatty pancreas disease (NAFPD) can promote many aspects of pancreatic dysfunction. The present study aimed to determine the prevalence of NAFPD and to identify its association with clinical and biochemical parameters in PCOS patients.
METHODS
The present study included 150 patients with PCOS and 150 age-matched healthy controls. All patients were submitted to careful history taking and thorough clinical examination. Performed laboratory investigations included fasting and postprandial blood glucose, lipid profile, liver function tests, serum prolactin and total testosterone. Fatty pancreas was diagnosed using abdominal ultrasound.
RESULTS
Among PCOS women, NAFPD was diagnosed in 57 women (38.0%) in contrast to 18 women (12.0%) in the control group (p < 0.001). Patients with NAFPD were significantly older [median (IQR): 38.0 (35.0-43.0) versus 29.0 (25.5-33.0) years, p = 0.001] with higher BMI [median (IQR): 31.5 (29.1-34.7) versus 30.4 (28.6-32.4) kg/m, 0.042]. Moreover, they had significantly higher frequency of metabolic syndrome (84.2% versus 54.8%, p = 0.001), insulin resistance (68.4% versus 26.9%, p < 0.001) and severe NAFLD (22.8% versus 2.2%, p < 0.001). NAFPD patients had significantly lower sex hormone binding globulin (SHBG) [median (IQR): 36.0 (30.8-40.7) versus 38.1 (35.15-42.7), p = 0.002] and significantly higher free androgen index (FAI) [median (IQR): 4.08 (3.3-4.92) versus 3.47 (3.12-4.05), p < 0.001].
CONCLUSION
NAFPD is prevalent PCOS. It is related to metabolic syndrome, insulin resistance, dyslipidemia and hyperandrogenism.
背景
多囊卵巢综合征（PCOS）是影响育龄女性的最常见内分泌疾病。非酒精性脂肪性胰腺疾病（NAFPD）可促使胰腺功能障碍的多个方面。本研究旨在确定NAFPD的患病率，并确定其与PCOS患者临床和生化参数的关联。
方法
本研究纳入了150例PCOS患者和150例年龄匹配的健康对照。所有患者均接受了详细的病史采集和全面的临床检查。进行的实验室检查包括空腹和餐后血糖、血脂谱、肝功能检查、血清催乳素和总睾酮。使用腹部超声诊断脂肪性胰腺。
结果
在PCOS女性中，57例（38.0%）被诊断为NAFPD，而对照组为18例（12.0%）（p<0.001）。NAFPD患者年龄显著更大[中位数（四分位间距）：38.0（35.0 - 43.0）岁对29.0（25.5 - 33.0）岁，p = 0.001]，BMI更高[中位数（四分位间距）：31.5（29.1 - 34.7）对30.4（28.6 - 32.4）kg/m²，p = 0.042]。此外，他们代谢综合征的发生率显著更高（84.2%对54.8%，p = 0.001）、胰岛素抵抗（68.4%对26.9%，p<0.001）和重度非酒精性脂肪性肝病（NAFLD）（22.8%对2.2%，p<0.001）。NAFPD患者的性激素结合球蛋白（SHBG）显著更低[中位数（四分位间距）：36.0（30.8 - 40.7）对38.1（35.15 - 42.7），p = 0.002]，游离雄激素指数（FAI）显著更高[中位数（四分位间距）：4.08（3.3 - 4.92）对3.47（3.12 - 4.05），p<0.001]。
结论
NAFPD在PCOS中很常见。它与代谢综合征、胰岛素抵抗、血脂异常和高雄激素血症有关。
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