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多囊卵巢综合征患者的代谢健康与生活质量:一项横断面研究。

Metabolic health and quality of life in patients with Polycystic Ovary Syndrome: a cross-sectional study.

作者信息

Hofmann Konstantin, Singer Susanne, Theis Susanne, Hasenburg Annette, Schwab Roxana, Skala Christine

机构信息

Department of Obstetrics and Gynecology, University Medical Center of Johannes Gutenberg University Mainz, Germany -

Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center of Johannes Gutenberg University Mainz, Germany.

出版信息

Minerva Endocrinol (Torino). 2025 Jun 18. doi: 10.23736/S2724-6507.25.04245-9.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is an endocrine disorder that can result in reduced health-related quality of life (HRQOL). Metabolic changes, particularly insulin resistance and obesity, play a significant role in PCOS pathogenesis. This study examined associations between metabolic factors and HRQOL in PCOS patients.

METHODS

A cross-sectional study of 77 patients was conducted at University Medical Center Mainz. At the time of inclusion in the study, patients had to be over 18 and not undergoing active PCOS therapy. A desire to conceive or fertility therapy led to exclusion. Participants were over 18, not undergoing PCOS therapy, and not seeking pregnancy. HRQOL and psychological distress were measured using the Modified-PCOS-Questionnaire (MPCOSQ) and Hospital Anxiety and Depression Scale (HADS). Linear regression analyses assessed associations between metabolic markers and HRQOL, with significant variables included in a multivariate model.

RESULTS

Worsening metabolic markers were linked to lower HRQOL, especially in body hair and menstrual symptom domains. Markers such as HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) levels (P=0.040), elevated VAI (Visceral Adiposity Index) (P=0.035), and increased FLI (Fatty Liver Index) (P=0.023) were associated with diminished HRQOL. In the multivariate regression analysis, only a BMI ≥25kg/m (P=0.001) emerged as a statistically significant value.

CONCLUSIONS

This study showed a significant correlation between metabolic markers, including BMI, FLI, VAI, HOMA-IR, and HRQOL in PCOS patients. BMI was the most meaningful predictor for HRQOL. BMI, despite being controversial and prone to errors, may be more indicative of HRQOL than specific metabolic markers.

摘要

背景

多囊卵巢综合征(PCOS)是一种内分泌紊乱疾病,可导致健康相关生活质量(HRQOL)下降。代谢变化,尤其是胰岛素抵抗和肥胖,在PCOS发病机制中起重要作用。本研究探讨了PCOS患者代谢因素与HRQOL之间的关联。

方法

在美因茨大学医学中心对77例患者进行了横断面研究。纳入研究时,患者年龄须超过18岁且未接受PCOS的积极治疗。有怀孕意愿或接受生育治疗者被排除。参与者年龄超过18岁,未接受PCOS治疗,且未寻求怀孕。使用改良PCOS问卷(MPCOSQ)和医院焦虑抑郁量表(HADS)测量HRQOL和心理困扰。线性回归分析评估代谢指标与HRQOL之间的关联,显著变量纳入多变量模型。

结果

代谢指标恶化与较低的HRQOL相关,尤其是在体毛和月经症状方面。诸如胰岛素抵抗稳态模型评估(HOMA-IR)水平(P=0.040)、内脏脂肪指数(VAI)升高(P=0.035)和脂肪肝指数(FLI)增加(P=0.023)等指标与HRQOL降低有关。在多变量回归分析中,只有BMI≥25kg/m(P=0.001)具有统计学意义。

结论

本研究表明,PCOS患者的代谢指标,包括BMI、FLI、VAI、HOMA-IR与HRQOL之间存在显著相关性。BMI是HRQOL最有意义的预测指标。BMI尽管存在争议且容易出错,但可能比特定的代谢指标更能反映HRQOL。

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