Department of Anesthesiology and Operation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Endocrinol (Lausanne). 2024 Jul 23;15:1370578. doi: 10.3389/fendo.2024.1370578. eCollection 2024.
Polycystic ovary syndrome (PCOS) is an endocrine metabolic disorder in reproductive-aged women. The study was designed to investigate the metabolic characteristics of different phenotypes in women with PCOS of reproductive age.
A total of 442 women with PCOS were recruited in this cross-sectional study. According to different phenotypes, all women were divided into three groups: the chronic ovulatory dysfunction and hyperandrogenism group (OD-HA group, = 138), the chronic ovulatory dysfunction and polycystic ovarian morphology group (OD-PCOM group, = 161), and the hyperandrogenism and polycystic ovarian morphology group (HA-PCOM group, = 143). The metabolic risk factors and prevalence rates of metabolic disorders among the three groups were compared.
The body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) of women from the OD-HA group and HA-PCOM group were significantly higher than those of women from the OD-PCOM group ( < 0.05). The serum insulin concentration and homeostasis model assessment of insulin resistance (HOMA IR) at 2 h and 3 h after oral glucose powder in women from the OD-HA group and HA-PCOM group were significantly higher than those from the OD-PCOM group ( < 0.05). The serum total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in women from the OD-HA group and HA-PCOM group were significantly higher than those in women from the OD-PCOM group ( < 0.05). The prevalence rates of impaired glucose tolerance (IGT), type 2 diabetes mellitus (T2DM), insulin resistance (IR), metabolic syndrome (MS), nonalcoholic fatty liver disease (NAFLD), and dyslipidemia of women with PCOS were 17.9%, 3.6%, 58.4%, 29.4%, 46.6%, and 43.4%, respectively. The prevalence rates of IGT, IR, MS, NAFLD, and dyslipidemia of women in the OD-HA group and HA-PCOM group were significantly higher than those of women in the OD-PCOM group ( < 0.05). T concentration (>1.67 nmol/L) and Ferriman-Gallwey (F-G) score (>3) significantly increased the risk of metabolic disorders in women with PCOS ( < 0.05).
The phenotypes of OD-HA and HA-PCOM in women with PCOS were vulnerable to metabolic disorders compared to OD-PCOM. Thus, the metabolic disorders in women with PCOS especially those with the HA phenotype should be paid more attention in order to reduce long-term complications.
多囊卵巢综合征（PCOS）是一种生殖期女性的内分泌代谢紊乱疾病。本研究旨在探讨生殖期 PCOS 不同表型女性的代谢特征。
本横断面研究共纳入 442 例 PCOS 女性。根据不同表型，所有女性分为三组：慢性排卵功能障碍伴高雄激素血症组（OD-HA 组，n=138）、慢性排卵功能障碍伴多囊卵巢形态组（OD-PCOM 组，n=161）和高雄激素血症伴多囊卵巢形态组（HA-PCOM 组，n=143）。比较三组间的代谢危险因素及代谢紊乱的患病率。
OD-HA 组和 HA-PCOM 组女性的体重指数（BMI）、腰围和腰臀比（WHR）明显高于 OD-PCOM 组（<0.05）。OD-HA 组和 HA-PCOM 组女性口服葡萄糖粉后 2 h 和 3 h 的血清胰岛素浓度和稳态模型评估的胰岛素抵抗（HOMA-IR）明显高于 OD-PCOM 组（<0.05）。OD-HA 组和 HA-PCOM 组女性的血清总胆固醇（TC）、三酰甘油（TG）和低密度脂蛋白胆固醇（LDL-C）明显高于 OD-PCOM 组（<0.05）。PCOS 女性中糖耐量受损（IGT）、2 型糖尿病（T2DM）、胰岛素抵抗（IR）、代谢综合征（MS）、非酒精性脂肪性肝病（NAFLD）和血脂异常的患病率分别为 17.9%、3.6%、58.4%、29.4%、46.6%和 43.4%。OD-HA 组和 HA-PCOM 组女性 IGT、IR、MS、NAFLD 和血脂异常的患病率明显高于 OD-PCOM 组（<0.05）。T 浓度（>1.67 nmol/L）和 Ferriman-Gallwey（F-G）评分（>3）显著增加了 PCOS 女性发生代谢紊乱的风险（<0.05）。
与 OD-PCOM 相比，PCOS 女性的 OD-HA 和 HA-PCOM 表型更易发生代谢紊乱。因此，对于 PCOS 女性，尤其是存在 HA 表型的女性，应更加关注其代谢紊乱情况，以降低长期并发症的发生风险。
