论文部分内容阅读
目的了解高胰岛素血症(HI)与多囊卵巢综合征(PCOS)发病的关系。方法检测记录2007年8月至2007年12月华中科技大学同济医学院附属协和医院97例PCOS患者年龄、身高、体重、腰围、臀围、Ferrimarr-Gallwey(F-G)评分、痤疮评分及体重指数(BMI),放射免疫法测定血清促黄体生成素(LH)、促卵泡生成素(FSH)、泌乳素(PRL)、睾酮(T)、脱氢表雄酮(DHEA)、雄烯二酮(A)、空腹血糖(FPG)和胰岛素(FINS)、口服糖耐量试验(OGTT)和胰岛素释放试验(IRT),计算腰臀比(WHR)、LH/FSH比值、葡萄糖及胰岛素曲线下面积(AUC)、胰岛素敏感指数(ISI)、稳态模型指数(HOMA),ISI和HOMA-IR评估胰岛素抵抗(IR)的程度,HOMA-IS评价胰岛B细胞功能。结果 97例患者中有60例伴有HI,HI者中肥胖及糖耐量异常(IGT)者均多于非高胰岛素血症(NHI)者(P均<0.05),腰围、臀围及BMI也均高于NHI者(P均<0.05),HI患者30、60和120min血糖、IRT各时点胰岛素值、IAUC、HOMA-IR均明显高于NHI患者(P均<0.05),而HI者ISI则明显低于NHI者(P<0.01)。相关分析结果显示,HOMA-IR与腰围、臀围、BMI、FPG、FIN、GAUC、IAUC、HOMA-IS均成正相关(P均<0.01)。结论 HI与PCOS患者肥胖尤其腹型肥胖的发生及PCOS糖代谢紊乱密切相关。早期干预HI对预防PCOS远期并发症具有积极意义。
Objective To investigate the relationship between hyperinsulinemia (HI) and polycystic ovary syndrome (PCOS). Methods The age, height, weight, waist circumference, hip circumference, Ferrimarr-Gallwey (FG) score, acne score and body mass index (PCA) were recorded in 97 PCOS patients at Tongji Medical College Affiliated Union Hospital of Huazhong University of Science and Technology from August 2007 to December 2007 (BMI), and the serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), testosterone (T), dehydroepiandrosterone (DHEA) FPG and FINS, oral glucose tolerance test (OGTT) and insulin release test (IRT) were used to calculate the ratio of WHR, LH / FSH, area under the curve of glucose and insulin (AUC) , Insulin sensitivity index (ISI), homeostasis model index (HOMA), ISI and HOMA-IR to assess the degree of insulin resistance (IR). HOMA-IS was used to evaluate islet B cell function. Results Sixty of 97 patients with HI and HI had more obesity and impaired glucose tolerance (IGT) than non-hyperinsulinemia (NHI) (all P <0.05). The waist circumference, hip circumference and BMI (P <0.05). The blood glucose levels at 30,60 and 120min, the insulin levels at each time point of IRT, IAUC and HOMA-IR in HI patients were significantly higher than those in NHI patients (all P <0.05) Was significantly lower than NHI (P <0.01). Correlation analysis showed that HOMA-IR was positively correlated with waist circumference, hip circumference, BMI, FPG, FIN, GAUC, IAUC and HOMA-IS (all P <0.01). Conclusion HI and PCOS patients with obesity, especially abdominal obesity and PCOS glucose metabolism disorders are closely related. The early intervention of HI has a positive effect on the prevention of long-term complications of PCOS.