伊朗人群中与多囊卵巢综合征相关的胰岛素抵抗的危险因素。

Risk factors for insulin resistance related to polycystic ovarian syndrome in Iranian population.

机构信息

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Endocrinology and Metabolic Research Center, Institute of Basic and Clinic Physiology Science and Department of Internal Medicine, Kerman University of Medical Science, Kerman, Iran.

出版信息

Sci Rep. 2023 Jun 24;13(1):10269. doi: 10.1038/s41598-023-37513-2.

DOI:10.1038/s41598-023-37513-2

PMID:37355686

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10290663/

Abstract

Polycystic ovary syndrome (PCOS) has significant metabolic sequelae linked to insulin resistance. This study aimed to compare clinical, metabolic, and hormonal characteristics of PCOS women with and without insulin resistance. The second aim was to compare the clinico-biochemical profiles of the various PCOS phenotypes. In this cross-sectional secondary analysis, we combined the baseline data from two separate randomized controlled trials (RCTs) in women diagnosed with PCOS. PCOS patients were categorized into the four Rotterdam PCOS phenotypes according to the presence of at least two criteria of oligomenorrhea/anovulation (O), hyperandrogenism (H), and polycystic ovary morphology (P): O-H-P, H-P, O-H, and O-P. Participants were categorized into two groups according to the homeostasis model assessment index of insulin resistance (HOMA-IR) levels: < 3.46, and ≥ 3.46. The correlation between the HOMA-IR and biometric, clinical, and biochemical variables was assessed in normal weight (BMI < 25) and overweight/obese (BMI ≥ 25) PCOS women. Then, the association between PCOS phenotypes and insulin resistance was investigated using logistic regression analysis. A total of 125 PCOS patients aged 18-40 years were included in the present study. Based on our results, the HOMA-IR index was positively correlated with diastolic blood pressure, free androgen index, and triglycerides levels; and negatively correlated with sex hormone-binding globulin in overweight/obese PCOS women. In addition, the HOMA-IR index was found to be positively correlated with alanine transaminase and negatively correlated with diastolic blood pressure in normal weight PCOS women. Moreover, individuals with O-H-P phenotype (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.02-6.24) had about two-fold increased risk of insulin resistance. In conclusion, the full-blown PCOS (O-H-P) phenotype has an increased risk of insulin resistance. Accordingly, phenotype division may help physicians to predict adverse metabolic outcomes.

摘要

多囊卵巢综合征（PCOS）与胰岛素抵抗有关，存在显著的代谢后果。本研究旨在比较有和无胰岛素抵抗的 PCOS 女性的临床、代谢和激素特征。第二个目的是比较各种 PCOS 表型的临床生物化学特征。在这项横断面二次分析中，我们结合了两项单独的随机对照试验（RCT）中诊断为 PCOS 的女性的基线数据。根据少排卵/无排卵（O）、高雄激素血症（H）和多囊卵巢形态学（P）至少两个标准的存在情况，将 PCOS 患者分为四个 Rotterdam PCOS 表型：O-H-P、H-P、O-H 和 O-P。根据胰岛素抵抗的稳态模型评估指数（HOMA-IR）水平，将参与者分为两组：<3.46 和≥3.46。在正常体重（BMI<25）和超重/肥胖（BMI≥25）的 PCOS 女性中，评估了 HOMA-IR 与人体测量学、临床和生化变量之间的相关性。然后，使用逻辑回归分析研究了 PCOS 表型与胰岛素抵抗之间的关系。本研究共纳入了 125 名年龄在 18-40 岁的 PCOS 患者。根据我们的结果，在超重/肥胖的 PCOS 女性中，HOMA-IR 指数与舒张压、游离雄激素指数和甘油三酯水平呈正相关，与性激素结合球蛋白呈负相关。此外，在正常体重的 PCOS 女性中，HOMA-IR 指数与丙氨酸转氨酶呈正相关，与舒张压呈负相关。此外，O-H-P 表型的个体（比值比 [OR] 2.52，95%置信区间 [CI] 1.02-6.24）发生胰岛素抵抗的风险增加了两倍。总之，完全型 PCOS（O-H-P）表型发生胰岛素抵抗的风险增加。因此，表型分型可能有助于医生预测不良的代谢结果。