Battaglia C, Artini P G, Genazzani A D, Sgherzi M R, Salvatori M, Giulini S, Volpe A
Institute of Pathophysiology of Human Reproduction, University of Modena, Italy.
Ultrasound Obstet Gynecol. 1996 May;7(5):342-6. doi: 10.1046/j.1469-0705.1996.07050342.x.
The objective of this study was to determine whether obese patients with polycystic ovary syndrome (PCOS) show different ovarian and uterine blood flow patterns in comparison with lean patients. Sixteen obese (body mass index: BMI = 31.4 +/- 3.6 kg/m2) and 22 lean (BMI = 21.1 +/- 1.3 kg/m2) PCOS patients underwent, in the early follicular phase if oligomenorrheic or randomly if amenorrheic, ultrasonographic evaluation of ovarian volume, echodensity and follicle number; transvaginal color Doppler evaluation of uterine and intraovarian blood flow; and radioimmunological assay of luteinizing hormone, follicle stimulating hormone, growth hormone, estradiol, progesterone, testosterone, androstenedione, insulin, insulin-like growth factor I, and other hormonal parameters. Hematocrit, plasma glucose, total cholesterol, high density lipoprotein and triglycerides were also evaluated. Insulin levels were significantly higher in the obese group, whereas levels of growth hormone were significantly lower. Moreover, a more adverse lipid profile was observed in overweight patients. This was associated with higher hematocrit values. At Doppler analysis, a significantly higher mean uterine artery pulsatility index (PI) was observed in the obese group. Furthermore, the PI was inversely correlated with high density lipoprotein values (r = -0.4820; p < 0.05). In both groups, androstenedione was correlated with the uterine PI. The above findings may, in part, explain the increased risk in women with PCOS of developing cardiovascular diseases, and emphasize that obesity may further increase the risk.
本研究的目的是确定多囊卵巢综合征(PCOS)肥胖患者与瘦患者相比是否表现出不同的卵巢和子宫血流模式。16名肥胖(体重指数:BMI = 31.4 +/- 3.6 kg/m2)和22名瘦(BMI = 21.1 +/- 1.3 kg/m2)的PCOS患者,若为月经过少则在卵泡早期接受检查,若为闭经则随机接受检查,进行卵巢体积、回声密度和卵泡数量的超声评估;子宫和卵巢内血流的经阴道彩色多普勒评估;以及促黄体生成素、促卵泡生成素、生长激素、雌二醇、孕酮、睾酮、雄烯二酮、胰岛素、胰岛素样生长因子I和其他激素参数的放射免疫测定。还评估了血细胞比容、血糖、总胆固醇、高密度脂蛋白和甘油三酯。肥胖组的胰岛素水平显著更高,而生长激素水平显著更低。此外,超重患者的血脂谱更不利。这与更高的血细胞比容值相关。在多普勒分析中,肥胖组观察到子宫动脉搏动指数(PI)显著更高。此外,PI与高密度脂蛋白值呈负相关(r = -0.4820;p < 0.05)。在两组中,雄烯二酮都与子宫PI相关。上述发现可能部分解释了PCOS女性患心血管疾病风险增加的原因,并强调肥胖可能会进一步增加这种风险。