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目的研究不孕妇女中胰岛素抵抗(IR)的分布情况,探讨其与患者临床特征之间的关系。方法回顾分析907名不孕妇女的糖代谢及基础性激素数据,以空腹胰岛素(FINS)及稳态评估模型(HOMA-IR)评估患者IR状态,分析可能与IR有关的临床特征。结果取研究人群的FINS、HOMA-IR 75%位点值为生理高限值,FINS≥9.61 mIU/L或HOMA-IR≥2.20者被认为处于IR状态。IR组月经稀发发生率及超重者比例显著高于非IR组(P<0.01),但多囊卵巢综合征(PCOS)发生率相似(P>0.05)。IR组基础睾酮(T)值较非IR组显著升高(P<0.05)。多元回归分析示IR与BMI、是否超重以及T值有显著联系(P<0.01)。结论月经稀发的不孕女性患者中更易存在IR状态,与是否合并PCOS无关,同时,BMI的增加使IR的发生率更高。
Objective To study the distribution of insulin resistance (IR) in infertile women and to explore its relationship with the clinical features of patients. Methods The glucose metabolism and basic hormone data of 907 infertile women were retrospectively analyzed. The IR status of the patients was assessed by fasting insulin (FINS) and homeostasis model (HOMA-IR), and the clinical characteristics related to IR were analyzed. Results The FINS and HOMA-IR 75% sites in the study population were physiological high limit values, and those with FINS ≥9.61 mIU / L or HOMA-IR≥2.20 were considered as IR. IR group, the incidence of menstrual hair loss and overweight were significantly higher than non-IR group (P <0.01), but the incidence of polycystic ovary syndrome (PCOS) was similar (P> 0.05). The basal testosterone (T) in IR group was significantly higher than that in non-IR group (P <0.05). Multiple regression analysis showed that IR was significantly associated with BMI, overweight and T (P <0.01). Conclusions IR is more likely to exist in infertile women with oligomenorrhea, regardless of whether PCOS is combined or not. Meanwhile, the increase of BMI makes the incidence of IR higher.